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Clavicle Plating
Clavicle Plating (ORIF) is an orthopaedic procedure that surgically realigns and fixes a displaced or comminuted clavicle fracture using a specially contoured plate and screws — restoring clavicle length and alignment, enabling early shoulder mobilisation, and providing superior functional outcomes compared to non-operative management for appropriate fractures.
Overview
Clavicle Plating — Open Reduction and Internal Fixation (ORIF) — is performed for displaced mid-shaft or lateral clavicle fractures where non-operative management carries an unacceptable risk of non-union, malunion with functional deficit, or where early return to function is required. Through a precisely planned incision over the clavicle, the fracture fragments are anatomically reduced and held in position with a pre-contoured anatomical plate and bicortical screws, restoring the normal length, alignment, and rotational position of the clavicle. The stable fixation achieved allows immediate shoulder mobilisation and a significantly faster return to full function compared to shoulder immobilisation alone.
Types of Clavicle Fracture Fixation
Clavicle fractures can be managed surgically through several approaches depending on the fracture location, pattern, and degree of displacement.
- Mid-Shaft Clavicle ORIF with Anterior-Inferior Plate (most common — for displaced mid-shaft fractures)
- Superior Plating for Mid-Shaft Clavicle Fracture (alternative plate position)
- Lateral Clavicle ORIF with Hook Plate (for Neer Type II lateral clavicle fractures)
- Intramedullary Nail Fixation (for simple mid-shaft transverse fractures)
- Coracoclavicular Ligament Reconstruction with Fixation (for AC joint dislocations)
Risk Factors for Clavicle Fractures Requiring Surgery
Clavicle fractures are one of the most common fractures in adults, and several factors increase the likelihood of requiring surgical fixation rather than conservative management.
- High-energy injury — road traffic accidents, sports collisions, or falls from height producing significantly displaced fractures
- Shortening of more than 2 cm or displacement of more than one shaft width on X-ray indicating high non-union risk
- Open fracture with skin compromise or neurovascular involvement
- Bilateral clavicle fractures where non-operative management of both sides is impractical
- Floating shoulder (concurrent ipsilateral scapula neck fracture) requiring clavicle fixation for stability
- Overhead athlete or manual worker requiring early return to full shoulder function
Clavicle Fracture Symptoms
Clavicle fractures present with characteristic features that guide the decision between operative and non-operative management.
- Immediate pain at the point of impact on the shoulder or clavicle
- Visible deformity or tenting of the skin over the fractured clavicle
- Shoulder drooping, shortening, or forward displacement compared to the other side
- Inability to raise the arm due to severe pain
- Crepitus (grating sensation) with any attempted shoulder movement
- Bruising and swelling over the clavicle within hours of injury
- Numbness or tingling in the arm from associated brachial plexus or vascular irritation
- Difficulty breathing in cases of associated rib fractures or pneumothorax
Key Benefits
Discover the advantages of choosing our clavicle plating services.
Immediate rigid fracture stabilisation eliminates the severe pain of clavicle fracture movement
Restores normal clavicle length and alignment preventing the deformity of malunion
Allows early shoulder physiotherapy from the day after surgery preventing stiffness
Significantly lower non-union rate compared to non-operative management for displaced fractures
Faster return to function, work, and sport compared to prolonged conservative management
Clinical Features
The technology, techniques and clinical approach behind our clavicle plating.
Pre-contoured anatomical clavicle plate designed for a precise fit to clavicle geometry
Bicortical screw fixation on both sides of the fracture provides stable three-dimensional fixation
Fracture length and rotation corrected precisely under direct surgical vision
Subcuticular skin closure technique minimises scar visibility over the clavicle
Post-operative neurovascular examination of the arm confirms no surgical complications
Preparation Instructions
- Complete plain X-rays (AP and 15-degree cephalad views) and CT scan for comminuted fractures
- Provide blood tests including CBC, coagulation, and blood group
- Stop anticoagulants 5 to 7 days before surgery under supervision
- Fast for 6 to 8 hours before surgery
- Ensure neurovascular examination of the arm is documented before surgery
- Arrange a sling for immediate post-operative comfort
- Arrange home support for the first 2 weeks while the dominant arm is restricted
- Inform the orthopaedic team of all medications, allergies, and any prior shoulder problems or surgeries
The Procedure
Step-by-step guide to what you can expect during your clavicle plating procedure.
Fracture Classification and Surgical Planning
Your orthopaedic surgeon reviews your clavicle X-rays and CT scan to classify the fracture by location, displacement, comminution, and shortening — confirming that surgical fixation is indicated due to significant displacement, shortening, or skin compromise, and selecting the optimal implant and plating configuration for your fracture pattern.
General Anaesthesia and Beach Chair Positioning
General anaesthesia is administered and you are positioned in the beach chair position — partially sitting up with the head turned away from the affected side — which provides excellent surgical access to the clavicle and allows comfortable arm positioning throughout the procedure.
Surgical Approach to the Clavicle
A precisely planned incision is made over the clavicle along the direction of Langer's lines to optimise the cosmetic scar outcome. The skin and subcutaneous tissue are divided carefully and the platysma muscle is elevated to expose the full length of the fractured clavicle without disturbing the underlying neurovascular structures.
Fracture Reduction
The fracture fragments are carefully identified and all periosteal attachments are preserved wherever possible. The fracture is reduced anatomically — restoring the normal clavicle length, alignment, and rotation — and temporarily held with reduction forceps while definitive plate fixation is applied.
Anatomical Plate Application and Fixation
A pre-contoured anatomical clavicle plate is positioned along the superior or anterior-inferior surface of the clavicle and secured with bicortical screws on both sides of the fracture. Each screw is placed carefully to achieve maximum purchase in the clavicle bone without endangering the subclavian vessels beneath the bone.
Wound Closure and Sling Application
The wound is closed in careful anatomical layers with fine absorbable deep sutures and subcuticular skin sutures for the most cosmetically acceptable scar. A sling is applied for comfort in the first 2 to 4 weeks. Before discharge, you receive clear instructions on pendulum exercises, wound care, and your follow-up X-ray timing.
What to Expect
Clavicle Plating is performed under general anaesthesia in 60 to 90 minutes. A carefully planned incision is made over the clavicle, the fracture fragments are precisely reduced to restore clavicle length and alignment, and the pre-contoured anatomical plate is secured with screws that grip both cortices of the clavicle. The wound is closed in layers and dressed neatly. Most patients are discharged the same day or after one overnight stay and can begin gentle pendulum shoulder exercises the day after surgery.
Recovery
After Clavicle Plating, wear the prescribed sling for comfort for the first 2 to 4 weeks but begin gentle pendulum exercises and elbow range of motion from day one as instructed by your physiotherapist. Attend wound review at 10 to 14 days for suture removal and X-ray review at 6 weeks to confirm fracture union and plate position. Avoid lifting above shoulder height, contact sports, and manual work for 8 to 12 weeks. Contact your orthopaedic team immediately for fever, wound changes, increasing pain, or any new numbness or tingling in the arm.
Frequently Asked Questions
Common questions about clavicle plating.
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