Clavicle Fracture Fixation Info Consent
Reviewed by Dr Kieran Hirpara, Specialist Orthopaedic Surgeon Last reviewed
Why this operation has been suggested
This page reflects how Dr Kieran Hirpara, an upper-limb surgeon at Mater Private Hospital Rockhampton, approaches this in our clinic. We usually recommend clavicle fixation when non-operative care has not given enough improvement. This procedure uses a metal plate and screws to hold the broken collarbone in place while it heals.
We typically offer this to patients with significantly displaced midshaft fractures. These are breaks where the bone ends are shifted more than 2 cm apart or shortened by more than 2 cm. Surgery helps restore stability and reduces the risk of the bone failing to unite. For these cases, operative fixation is associated with a nonunion rate of only 2%, compared with 15% for non-operative treatment. The main benefit is improved early function and a lower chance of chronic pain or deformity.
Before the operation
You will need X-rays to check your bone alignment and blood tests to ensure you are fit for surgery. An anaesthetic review may also be required. Please arrange for someone to drive you home after the procedure. You must fast from midnight the night before. Bring a list of all current medications. We will advise you on which medicines to pause, but do not stop any without specific instructions. Wear loose, comfortable clothing that is easy to remove. This preparation helps us plan your open fixation safely and efficiently.
On the day
You will arrive at the hospital and check in with our nursing team. Your surgeon will meet you to confirm the plan. This operation is done under general anaesthetic. You will be fully asleep for the operation. Some patients may also have a regional nerve block for post-operative pain relief — the anaesthetist decides on the day based on your individual circumstances.
You will then be taken into the operating theatre. We use an open approach with a single conventional incision over the operative site. This allows us to place a plate and screws to hold the bone in place. Once the procedure is complete, you will wake up in the recovery area. Our team will monitor you closely as you regain full awareness and comfort.
What the operation involves
Your surgeon makes a single cut about 8 to 10 cm long over the front of your shoulder. This gives clear access to the broken bone. You lie on your back with a small pad behind your shoulder to keep it in the right position.
Your surgeon carefully moves the tissue aside to find the fracture. The bone pieces are realigned to their natural position. If there is a gap or poor contact between the fragments, your surgeon may place a small piece of healthy bone from another site into the gap. This helps the bone heal together.
A pre-shaped metal plate is placed against the front of the collarbone. Your surgeon uses screws to fix the plate firmly to the bone. This holds the fracture in place while it heals. The cut is then closed with stitches or staples, and a dressing is applied.
After the operation
You will wake up in the recovery ward with your arm supported in a sling. Most patients stay one night in hospital after this operation, though some are able to go home the same day. Your surgeon will manage your pain and check your wound dressing. You must have someone stay with you for the first 24 hours to help with daily tasks. We advise you not to drive for at least six weeks after any shoulder operation, regardless of which arm was operated on. Please see our guide on Driving after upper-limb surgery for more details. Keep the sling on as directed while you rest and begin gentle movement.
Recovery
You will likely feel soreness and swelling around your collarbone for the first few days. This is normal. We manage this discomfort with prescribed pain relief and ice packs. Keeping your arm supported in the sling helps reduce strain on the healing bone. Most patients find that pain levels drop significantly as the initial swelling settles.
Your physiotherapist will guide you through gentle movements to keep your shoulder mobile. You will start with simple pendulum exercises to prevent stiffness. As your pain allows, we introduce light range-of-motion activities. You must keep your sling on for daily activities until your surgeon advises otherwise. Avoid lifting heavy objects or reaching overhead during this early phase.
Sleeping may be challenging at first. We recommend resting in a semi-upright position, propped up by pillows, to reduce swelling and ease pressure on the surgical site. This position often feels more comfortable than lying flat.
Return to driving is not permitted for at least six weeks after surgery, regardless of which arm was operated on. You must not drive while wearing a sling. Your surgeon will clear you to drive typically at the six-week review, once you have regained sufficient strength and control. For more details, see Driving after upper-limb surgery.
Recovery varies between individuals. Your timeline may differ; your surgeon and physio will guide you through each stage of your rehabilitation.
What can go wrong
Most patients do well, but problems can occasionally happen. Your surgeon and the team monitor you closely to spot any issue early.
Infection You might notice increasing redness, warmth, or swelling around the incision. The area may feel tender or throb. You might see pus or have a fever. Contact the clinic immediately if you suspect an infection.
Hardware Irritation The metal plate and screws sit under your skin. Sometimes, they can rub against your skin or clothing, causing a visible bump or discomfort. You might feel a sharp pain when pressing on the area. If this bothers you, discuss it with your surgeon at your next review.
Non-union This means the bone does not heal as expected. You may continue to feel pain or notice movement at the fracture site long after your initial recovery period. Your surgeon will check for this during follow-up visits. If the bone does not unite, further treatment may be needed.
Malunion The bone heals in a slightly different position. You might see a bump under the skin or feel a change in the shape of your collarbone. In most cases, this is accepted unless it causes skin irritation or significant cosmetic concern.
Nerve or Vessel Injury Damage to nearby nerves or blood vessels is rare. You might experience unusual numbness, tingling, or weakness in your arm or hand. If you notice sudden changes in sensation or circulation, seek medical attention right away.
Scar Issues You may develop a raised, thickened, or discolored scar. While scars are a normal part of healing, some people find them unsightly. Your surgeon can advise on scar management if needed.
The complications table on this page lists typical rates if you want the specifics.
When to call us
Call us if you develop a fever, increasing wound redness, or discharge. Go to emergency if you experience sudden severe pain, calf swelling, or shortness of breath. Seek urgent care for loss of sensation or inability to move your limb. These signs need immediate assessment to ensure your recovery stays on track.
