Surgery: Clavicle Fracture Open Reduction and Internal Fixation

Open Reduction and Internal Fixation (ORIF) is a surgical procedure used to stabilize and heal a fractured collarbone (clavicle). Clavicle fractures commonly occur in the middle of the bone, but can also happen near its attachments to the ribcage or shoulder blade. ORIF is necessary when bones are out of alignment. During the procedure, surgeons realign the bones surgically and use screws, plates, wires, or nails to maintain alignment. It’s done under general anesthesia.

Why might I need a clavicle fracture Open Reduction and Internal Fixation?

Certain medical conditions, like osteoporosis, increase the risk of clavicle fractures, often caused by direct trauma to the shoulder. Fractures can also occur from falls or during birth. Not all fractured clavicles need ORIF, conservative treatments like pain medication, splints, and slings are often preferred. ORIF is considered if conservative treatments may not result in normal healing. You may require ORIF if:

• The pieces of your clavicle are significantly misaligned
• Your clavicle has broken through the skin
• Your clavicle has fractured into multiple pieces

In such cases, ORIF can realign your bones, significantly improving the chances of proper bone healing. However, in some instances, individuals may choose not to undergo ORIF even if their clavicle is substantially misaligned, as the bone often heals correctly without surgical intervention. Your doctor can discuss the risks and benefits of ORIF or explore alternative, conservative treatments based on your specific situation.

What are the risks for clavicle fracture Open Reduction and Internal Fixation?

Most individuals undergo ORIF for their clavicle fracture with favorable outcomes. Nonetheless, rare complications may arise.
Potential complications include:

• Broken screws or plates
• Infection
• Damage to an artery or vein
• Nerve damage
• Misalignment of the bone
• Lung injury
• Anesthesia-related complications
• Additionally, there is a risk of inadequate healing of the fracture, necessitating repeat surgery.

Individual risk of complications varies based on factors such as age, the specific anatomy of the clavicle fracture, and existing medical conditions. For instance, individuals with low bone density or diabetes may face a higher risk of complications. Smoking can also increase the risk. Consult your doctor to determine the risks most relevant to you.

How do I prepare for a clavicle fracture Open Reduction and Internal Fixation?

ORIF often occurs as an emergency or urgent procedure. Prior to your procedure, a healthcare professional will review your medical history and conduct a physical examination. You will also undergo an X-ray of your clavicle. Inform your doctor about all medications you are taking, including over-the-counter drugs like aspirin. Additionally, inform your doctor about the last time you ate.

In certain cases, ORIF may be scheduled as a planned procedure. If so, discuss preparation instructions with your doctor. Inquire about whether you need to discontinue any medications beforehand, such as blood thinners. You will be required to refrain from eating or drinking after midnight on the night before your procedure.

What happens during a clavicle fracture Open Reduction and Internal Fixation?

Your doctor will explain the specifics of your surgery, which typically lasts a few hours. You’ll receive general anesthesia to ensure you’re asleep throughout the procedure, or possibly local anesthesia with medication to relax you. Throughout the operation, your vital signs will be closely monitored, and a breathing tube may be inserted to assist breathing. After the area is cleaned, your surgeon will make an incision near your clavicle, realign the bone pieces, and secure them together using screws, plates, wires, or pins. Additional repairs may be performed if necessary. Once the bone is secured, the incisions will be closed surgically.

What happens after a clavicle fracture Open Reduction and Internal Fixation?