Collarbone Fractures (Clavicle Fractures): Open Reduction Internal Fixation With a Plate and Suture Implant Animation

Collarbone Fractures (Clavicle Fractures): Open Reduction Internal Fixation With a Plate and Suture Implant Animation

This animation demonstrates the use of a plate, screws, and suture button implant to repair a break in the end of the collarbone, also known as a distal clavicle fracture. A tear to the coracoclavicular ligament, or C C ligament, often occurs with this type of fracture. This ligament connects the clavicle to the shoulder blade.

Here is a right shoulder. An incision will be made overlying the distal clavicle to carefully expose the fracture. Here you see the fracture of the distal clavicle. The fracture will be brought to its normal alignment while placing a contoured plate on the bone. A clamp and temporary wire will be used to hold the plate and bone in place, while screws are inserted.

Next, a drill guide and drill bit will be used to create a hole for the screw. An instrument will be used to protect the underlying structures from the drill. The hole will be measured so the proper length screw is inserted. The screw is then inserted flush into the plate and bone. This process will be repeated for the other desired screws to ensure the fracture is held in place and heals properly. The clamp and wire will be removed during this step.

Next, attention will be turned to the outside of the shoulder in preparation for the suture button implant to hold the distal clavicle in place. Small skin incisions will be made and the blue and purple tubes, called cannulas, are used to bring a camera and instruments into the shoulder. Again, a drill and guide will be used to drill a hole through the clavicle and shoulder blade.

A suture will be passed through the drill bit, and an instrument will grab the suture. Utilizing the blue suture, a knotless loop of white suture will be shuttled through the previously drilled hole in both bones. A metal implant will be placed on the loop of the suture. The white, looped suture and metal implant will be pulled securely against the underside of the bone. The white suture will then be cinched from on top until this metal button sits flush in the plate. The extra white suture will be cut, and the surgery is complete.