This 29 year old lady fell off her bicycle and landed on her right shoulder. She presented to the hospital immediately with pain and deformity around the right shoulder. Clinically she had a displaced clavicle fracture and this was confirmed on X-ray.
The X-ray demonstrates a complex 3-4 part displaced clavicle fracture; the central fragment is in a few pieces and there appears to be a Z type fracture configuration.
The options were discussed with her – early surgery was recommended given her young age, fracture displacement and fracture comminution/configuration. She elected to proceed with surgery and she underwent Open Reduction and Internal Fixation (ORIF) the following day.
At surgery, we were able to reduce all of the small fragments of bone with separate small screws outside of the plate (2.4mm screws) and then achieve stable fixation with a plate and screws. X-rays taken during surgery confirmed anatomical reduction and stable fixation. She was pain-free the day after surgery and commenced JPL therapy at 2 weeks postoperatively. She went on to heal her fracture at the 3-month X-ray and is back to riding her bicycle (albeit more carefully).
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