If you and your surgeon have decided that your clavicle fracture requires surgery, this is normally achieved using a clavicle-specific plate and screws. Occasionally the plate construct is augmented by a ligament repair in lateral clavicle fractures, where the bone for fixation is very small or fragmented.
Clavicle fixation is normally performed as a day-case operation under general anaesthesia and sometimes with additional regional nerve block.
An incision is made over your broken bone. The orientation of the incision is usually designed to give you the best scar, whilst also allowing your surgeon access to the broken bone. In the midshaft this is usually an oblique incision, but more laterally it is more over-the-top where a bra strap might lie in a lady.
There are small sensory nerves just beneath the skin over your collarbone then these are cut as part of the surgery. This means you will have a numb patch below, or lateral to your incision. This patch tends to shrink with time and is rarely a problem for patients.
Your bone is then reduced (put back into the correct shape) and fixed with the plate and screws. Sometimes extra screws that don't go through the plate are used as well. Your wound is closed with dissolving sutures and covered with a dressing.
X-ray of a fixed midshaft collarbone fracture - a clavicle-specific low-profile plate was used
Lateral clavicle plate with ligament repair augmentation (note the button beneath the coracoid process of the shoulder blade). This holds sutures which are helping to hold down the plate on the bone.
The complication rate is low, but there are specific risks of fixation that you need to be aware of.
Bleeding – there are major blood vessels that run just behind and beneath your collarbone. It is very rare for these to get injured, but if it does happen, major bleeding, or air embolism can occur. There are extremely rare case reports of fatalities from clavicle surgery.
Nerve injury – you will get a numb patch beneath and lateral to your scar where sensory nerves are cut in the incision. Major nerve injury affecting function in your arm is extremely rare, but slightly more likely in revision and non union surgery, where scar tissue can tether the nerves.
Lung injury – the top of your lung lies just behind your collarbone. It is very rare for the lung to get punctured. If it does happen you may need a chest tube to help re- inflate the lung.
Infection – as for all surgery, there is a small chance of infection (approx. 1-2%) which sometimes requires further surgery.
Failure of healing or fixation is rare (<5%) after fixation. If it does happen, revision surgery may be required.
You will wake up in a polysling and usually go home the same day. Please take your painkillers regularly for the first few days and begin them before your nerve block wears off. Normally you will feel your shoulder is much better pretty quickly. Please leave your dressing on until your clinic appointment at 2 weeks, when your wound will be inspected and any suture ends trimmed. You will also have an x-ray. You can begin gentle shoulder motion immediately, but do not do anything heavy for at least 8 weeks.
Patients vary in their recovery, but you can expect to return to:
Office Work – 2 weeks
Light manual work 6-8 weeks
Heavy manual work 12-18 weeks
Driving is allowed once you are confident and competent to control your vehicle for routine and emergency manoeuvres. This usually takes a few weeks
Mr Granville-Chapman was very polite and his examination and explanation of my symptoms and expected treatment was thorough
I found Mr Granville-Chapman to be very knowledgeable and professional. He put me very much at ease and explained all the options that I have thoroughly. He also told me to look for further information on the condition and procedures that I needed on his website, which gave lots of information and detail. It was also easy to understand for those without a medical background. I would highly recommend his services to anyone that has shoulder problems and requires a solution.
I attended for a repair of my right bicep tendon. After a thorough examination, Mr Granville-Chapman arranged an operation to be undertaken within 2 days which was extremely quick; he explained his reasoning which was both thorough and reassuring, explaining both the options of undergoing surgery and deciding to undertake conservative management.On the day of the surgery Mr Granville-Chapman was again very reassuring as although this is minor surgery I was still somewhat apprehensive. He came to fully explain the procedure and afterI woke up was quick to check on how I was doing.Overall I am very happy with the careMr Granville-Chapman
I have been very pleased with my treatment so far. Mr Granville-Chapman combines brisk efficiency with a pleasant, sympathetic manner. My operation, however, is still to come ...
From the initial consultation, through surgery on a fractured wrist, and now post-operative follow up, it has been a very positive and reassuring experience with Mr Granville-Chapman. I would have no hesitation in recommending him to someone else.
A first class clinician. A skilled surgeon with an excellent bedside manner.
A very pleasant Consultant who knows exactly how to make pain go away.
Mr Granville - Chapman has an excellent bedside manner. He engaged with my 12 year old son at an appropriate level and took the time to ensure that he understood the procedure and answer all his questions. He is thoroughly professional and I would not hesitate to recommend him.
I have been very pleased with the attention I have received. Mr. Granville-Chapman has reassured me that my symptoms are normal. It is very easy to make appointments that suit me.
Mr Granville chapman I found be caring informative and professional I would recommend him to all if you have a problem don't hesitate to contact him you won't be disappointed.
I recently broke my right clavicle in a mountain bike accident and it was repaired by Mr Granville-Chapman by adding a plate on top of the bone. Having just finished the last post-op consultation, I can confirm that I have been very happy with the process all along. In particular, Jeremy took time to explain in detail why a plate was needed, what the procedure would entail, and also was very patient answering my questions comprehensively beforehand and after during the recovery phase. Would certainly trust this competent surgeon to fix any future fractures I might sustain.
Mr Granville-Chapman has looked after my 15 year old son brilliantly, explaining the surgery, recovery and best way forward, and Kate has been very supportive helping with logistics etc, thank you so much.
So far my experience with Mr Jeremy Granville-Chapman has been personal and informative with regard to the operation I will be having. I feel confident that my operation will be a success and for this reason I am very happy to have Mr Jeremy Granville-Chapman as my consultant.
Very knowledgeable and helpful. Takes the time to make sure you're getting the treatment you need.
Mr Jeremy Granville -Chapman is not only a highly skilled consultant but is able to put you straight away at ease .My appointments were arranged very swiftly which was great, when you are experiencing severe pain. I am very happy with my treatment so far . many thanks to everyone who was involved in my treatment.
Polite, helpful, professional. Makes an effort to ensure full understanding of issues and procedures to be done. Highly satisfied
Very pleasant. Clear, careful explanations & options/possibilities. I feel well informed, and happy that my concerns are being well addressed, with a plan of review of the symptoms.
Excellent advise with everything explained clearly and a successful treatment which has benefited be greatly.
BMI The Princess Margaret Hospital
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