Clavicle (collarbone) fracture fixation is an operation to realign and stabilise a broken collarbone using a metal plate and screws. It is performed when the fracture is significantly displaced, shortened, or at high risk of non-union.
An incision is made along the top of the collarbone directly over the fracture. The bone fragments are realigned and held in position with a contoured metal plate and screws. In some cases, particularly for fractures near the outer end, sutures or hook plates may be used. The operation typically takes 45–90 minutes.
Surgery is recommended for significantly displaced or shortened clavicle fractures, fractures with skin tenting or threatened skin breakdown, fractures near the outer end (lateral third) with displacement, open fractures, and in patients who need to return to activity sooner. Evidence suggests surgical fixation reduces the risk of non-union and malunion in displaced midshaft fractures.
Many clavicle fractures heal well with a sling for four to six weeks. Non-operative treatment is appropriate for undisplaced fractures and many minimally displaced fractures. However, displaced fractures have a higher risk of non-union (up to 15%) and malunion with non-operative treatment compared to approximately 5% with surgery.
Standard pre-operative assessment and fasting. Surgery is usually performed within one to two weeks of the injury. Inform the team about all medications.
The aim is to restore the normal length and alignment of the collarbone, reduce the risk of non-union, relieve pain, and allow earlier return to activity. Most patients experience good outcomes with reliable fracture healing by three months.
The plate sits just beneath the skin and is often palpable. Some patients find it uncomfortable, particularly with rucksack straps or seat belts.
A patch of numbness below the incision is very common due to small sensory nerves being unavoidably divided.
The scar is visible on the upper chest and shoulder area.
Approximately 20–30% of patients choose to have the plate removed after healing, usually at 12–18 months.
The fracture may fail to heal despite fixation. Risk is approximately 5%.
Wound infection requiring antibiotics or rarely further surgery.
Major vessels and the brachial plexus lie beneath the clavicle. Injury is rare with careful technique.
After plate removal, the bone may fracture through screw holes.
Usually performed under general anaesthesia. A nerve block may be used for post-operative pain relief. You are positioned in a beach-chair or supine position.
A sling is worn for comfort for approximately two weeks. Gentle shoulder exercises begin immediately. Most patients return to desk work within one to two weeks. Driving resumes at two to four weeks once comfortable. Heavy lifting and contact sport are restricted for six to twelve weeks until the fracture has healed. The plate may be removed after twelve months if it causes irritation.
Wound check at two weeks. X-ray and review at six weeks and three months to confirm healing.
Not always, but approximately 20–30% of patients choose removal because of irritation from straps, clothing, or cosmetic preference. This is done after the fracture has fully healed.
Yes, the scar runs along the top of the collarbone and is usually 8–12 cm long. It tends to heal well but is visible in low-cut clothing.
Non-contact sport at six to eight weeks. Contact sport at twelve weeks once the fracture has healed on X-ray.