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Clavicle Fracture Fixation
Dr Kau Chung Yuan (许医生)
MBBS (S’PORE)
MRCS (Ireland)
MMed (Ortho)
FRCSEd (Ortho)
What is Clavicle Fracture Fixation?
Clavicle fracture fixation is a medical procedure aimed at repairing a broken clavicle, commonly known as the collarbone.
The clavicle is a long bone that connects the shoulder blade to the sternum, playing a crucial role in shoulder movement and upper limb mobility. Fractures in this bone can result from various causes, including sports injuries, falls, or direct impacts.
This procedure is a common orthopaedic intervention, given the frequency of clavicle fractures, particularly among young adults and those engaged in contact sports.
When is Clavicle Fracture Fixation Needed?
The necessity for clavicle fracture fixation depends on various factors, and not all clavicle fractures require surgical intervention. The decision is influenced by the fracture’s characteristics, the patient’s health, and lifestyle needs.
- Displaced Fractures
Surgery is often necessary when bone fragments have shifted out of place. - Open Fractures
Fractures where the bone breaks the skin require surgery to realign the bone and prevent infection. - Comminuted Fractures
Surgical intervention is typically needed when the bone is shattered into multiple pieces. - Non-union or Malunion
In cases where a fracture fails to heal or heals incorrectly, surgery might be indicated to rectify the issue.
Benefits and Risks of Clavicle Fracture Fixation
Benefits
- Improved Alignment and Healing: Surgical fixation realigns the bone fragments, promoting proper healing.
- Reduced Risk of Non-union and Malunion: Surgery decreases the likelihood of the fracture healing incorrectly or not healing at all.
- Restored Functionality: Proper alignment and stabilisation of the fracture can restore shoulder strength and mobility.
- Faster Recovery: In some cases, surgery can expedite the recovery process, allowing a quicker return to daily activities and sports.
Risks
- Surgical Complications: As with any surgery, there is a risk of complications such as infection, bleeding, or adverse reactions to anaesthesia.
- Hardware Issues: Problems related to the fixation hardware, like irritation or the need for future removal, can occur.
- Nerve or Blood Vessel Damage: There is a small risk of damaging nearby nerves or blood vessels during surgery.
- Persistent Pain or Stiffness: Some patients may experience ongoing pain or stiffness in the shoulder after surgery.
Preoperative Considerations for Clavicle Fracture Fixation
Before undergoing clavicle fracture fixation, several preoperative considerations are important to ensure the best possible outcome. These considerations involve a range of assessments and preparations to optimise the patient’s condition for surgery.
- Health Evaluation
A comprehensive health assessment is necessary to identify any underlying conditions that might affect surgical outcomes. - Medication Review
Patients should inform their surgeon about all medications they are taking, as some may need to be adjusted or stopped before surgery. - X-rays
Essential for assessing the fracture’s specifics, including location, severity, and displacement. - CT Scan
This may be required for more complex fractures to provide detailed images of the bone and surrounding structures. - Smoking Cessation
Smoking can impair bone healing; therefore, patients are advised to quit or reduce smoking before surgery. - Dietary Guidelines
Proper nutrition is crucial for healing. Patients may be advised to follow specific dietary recommendations from their orthopaedic surgeon to support bone health.
What Can You Expect During a Clavicle Fracture Fixation?
Clavicle fracture fixation typically follows a structured process, which includes preparation, the surgical procedure itself, and immediate postoperative care.
- Anaesthesia: The patient will receive either general anaesthesia, rendering them unconscious during the procedure, or regional anaesthesia, numbing only the upper body.
- Incision: A small incision is made over the clavicle to access the fracture.
- Fracture Reduction: The bone fragments are realigned into their normal position.
- Fixation: Metal plates, screws, or rods are used to hold the bone fragments in place.
- Closure: The incision is closed with sutures or staples.
Postoperative Care and Rehabilitation
Postoperative care and rehabilitation are aimed at promoting healing, restoring function, and preventing complications.
Immediate Postoperative Care
- Wound Care: Proper care of the surgical site is crucial to prevent infection.
- Pain Management: Pain relief measures, including medications, are provided to manage discomfort.
- Arm Support: The arm may need to be immobilised in a sling for a period to support healing.
Rehabilitation
- Physical Therapy: Begins with gentle exercises to improve range of motion and gradually progresses to strength-building exercises.
- Activity Modification: Patients are advised on how to modify activities to avoid strain on the healing clavicle.
Follow-Up Appointments
- Regular Check-ups: Scheduled to monitor the healing process and ensure the fracture is healing properly.
- X-rays: Periodic X-rays may be taken to assess the progress of bone healing.
Long-Term Care
- Monitoring for Complications: Ongoing vigilance for signs of complications such as infection, non-union, or hardware problems.
- Lifestyle Adjustments: Recommendations on lifestyle changes, if necessary, to support long-term bone health.
Patient Feedback
Dr. Kau Chung Yuan
MBBS (S’pore)
MRCS (Ireland)
MMed (Ortho)
FRCSEd (Ortho)
Dr Kau (许医生) is a Fellowship trained Orthopaedic Surgeon with a subspecialty interest in Hip and Knee surgery and has been in practice for more than 15 years.
He is experienced in trauma and fracture management, sports injuries, and joint replacement surgery.
- Fellow of the Royal College of Surgeons Edinburgh, Orthopaedics (FRCS, Edin) 2014
- Master of Medicine (Orthopaedics), Singapore (MMed) 2013
- Member of the Royal College of Surgeons Ireland (MRCS, Ire) 2009
- Bachelor of Medicine and Surgery (MBBS, Singapore) 2004
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Frequently Asked Questions (FAQs)
How Long Does It Take for a Clavicle Fracture to Heal After Fixation?
The time it takes for a clavicle fracture to heal after fixation varies, depending on factors such as the fracture’s severity, the patient’s age, and overall health, including the severity of the fracture, the patient’s age, and overall health. Typically, the bone takes about 6-12 weeks to heal sufficiently.
However, full recovery, which includes regaining strength and range of motion, might take several months. Patients should follow their orthopaedic surgeon’s guidance and not rush this process to ensure proper healing.
Will I Need to Wear a Sling After the Surgery, and for How Long?
Post-surgery, wearing a sling is usually necessary to immobilise and support the arm. The duration of wearing a sling can vary but is generally for a few weeks. This period allows the clavicle to heal in the correct alignment.
The exact duration will be determined by the orthopaedic surgeon based on the specifics of the surgery and the patient’s healing process.
Are There Any Restrictions on Movement or Activities After the Surgery?
After clavicle fracture fixation surgery, patients are generally advised to avoid activities that may strain the healing bone, such as heavy lifting or high-impact sports, until the clavicle is fully healed. The orthopaedic surgeon will provide specific guidelines on movement and activity restrictions, which are tailored to the patient’s particular situation and the nature of their fracture and surgery.
Is Physical Therapy Necessary After Clavicle Fracture Fixation?
Physical therapy is often a key component of the recovery process after clavicle fracture fixation. It helps in restoring the range of motion, strength, and functionality of the shoulder.
The specific physical therapy regimen will be tailored to the patient’s individual needs, depending on the nature of their fracture and their overall health and fitness levels.
Can the Metal Hardware Used for Fixation Cause Problems in the Future?
In some cases, the metal hardware used for clavicle fracture fixation might cause discomfort or irritation and may need to be removed after the bone has fully healed. However, this is not always necessary and largely depends on individual circumstances and patient preferences.