Clavicle Plate Fractures: Causes and Treatment Options

The clavicle brace is broken?

In January, I fractured my right clavicle due to a car accident.
After being taken to the hospital, the doctor recommended surgery to install a clavicle plate.
There were options for both National Health Insurance coverage and self-pay.
I chose the self-pay option for a titanium alloy distal clavicle hook locking plate (Taiwan FDA Medical Device Registration No.
003129).
My recovery went well, and I returned to work.

However, in September, while working, I suddenly felt a pulling sensation, which was soon followed by pain.
The pain did not improve, so I returned to the outpatient clinic for an examination on Monday.
An X-ray revealed that the plate had broken.
The doctor said I would need surgery to replace the plate and would also need to cut into the pelvic bone for support.
Alternatively, I could opt for a self-pay biodegradable bone substitute material HF1602-2.5cc (Taiwan FDA Medical Device Registration No.
023041), which would cost a total of NT$86,000.

I am puzzled as to how the clavicle plate could break without any external force.
My job involves machine maintenance, and since my injury, the company has not assigned me any heavy tasks.
I primarily use my left hand while working.
Why is it that the self-pay option is so fragile?

Xiao Guo, 30~39 year old female. Ask Date: 2022/09/27

Dr. Shi Guozheng reply Orthopedics

After a clavicle fracture, surgery typically involves the use of a titanium alloy plate for fixation.
It is usually necessary to wait until the bone has healed before applying greater force during work.
The plate may break because the bone has not fully healed, leading to excessive stress that causes it to fracture.
Surgical revision and bone grafting can achieve the goal of healing, but it is not mandatory to use absorbable materials; fixation with a plate is a viable option.

Reply Date: 2022/09/27

More Info

Clavicle fractures, particularly those requiring surgical intervention, can be a significant concern for patients, especially following traumatic events like car accidents. Understanding the causes, treatment options, and potential complications associated with clavicle plate fractures is crucial for effective recovery and management.

Causes of Clavicle Fractures
Clavicle fractures commonly occur due to direct trauma, such as falls or vehicle accidents. The clavicle, or collarbone, is particularly vulnerable because it acts as a strut between the shoulder blade and the sternum, making it susceptible to fractures from impacts. In your case, the fracture was a direct result of the car accident, which is a typical scenario for such injuries.

Treatment Options
The treatment for clavicle fractures can vary based on the type and severity of the fracture. Non-displaced fractures often heal well with conservative management, including the use of a sling or figure-of-eight bandage. However, displaced fractures or those with significant comminution may require surgical intervention to restore proper alignment and stability.

In your situation, you opted for surgical treatment using a titanium alloy plate, which is a common choice due to its strength and biocompatibility. The use of a locking plate can provide enhanced stability, especially in complex fractures. However, complications can arise, including hardware failure, which seems to be your current issue with the plate breaking without significant external force.

Complications and Hardware Failure
The unexpected failure of the titanium plate can be concerning. Several factors may contribute to this, including:
1. Material Fatigue: Although titanium is known for its strength, repeated stress or improper load distribution during recovery can lead to fatigue and eventual failure of the hardware.

2. Bone Quality: If the bone quality is compromised due to factors like osteoporosis or inadequate healing, the plate may not have adequate support, leading to failure.

3. Activity Level: Even if you were advised to avoid heavy lifting, certain movements or repetitive stress during your job could have contributed to the plate's failure.

4. Surgical Technique: The initial surgical technique and placement of the hardware can also impact the longevity and effectiveness of the implant.

Next Steps
Given that your X-ray revealed a broken plate, the recommended course of action is to undergo another surgical procedure to replace the broken hardware. The suggestion to use a bioabsorbable bone substitute is an interesting option, as it can provide temporary support while allowing for natural bone healing without the need for a second surgery to remove the hardware.

Recovery and Rehabilitation
Post-surgery, it is essential to follow a structured rehabilitation program to regain strength and mobility in the shoulder. Physical therapy can help in gradually increasing the range of motion and strengthening the surrounding muscles to support the clavicle and shoulder joint.

Conclusion
In summary, clavicle fractures, especially those requiring surgical intervention, can lead to complications such as hardware failure. It is crucial to communicate openly with your orthopedic surgeon about your concerns and the best course of action moving forward. Ensure that you adhere to post-operative care instructions and engage in rehabilitation to facilitate a successful recovery. If you have any doubts about the treatment options or the necessity of further surgeries, seeking a second opinion from another orthopedic specialist may also be beneficial.

Similar Q&A

Clavicle Fracture Complications: Plate Penetration and Surgical Solutions

Hello Doctor, I was in a car accident on March 17, 2015, which resulted in a mid-shaft fracture of my left clavicle, causing the bone to break into two displaced segments. In early April, I underwent surgery to place a plate for stabilization, with six screws used for fixation. B...

Dr. Shi Guozheng reply Orthopedics
The fixation method you mentioned may involve the use of intramedullary nails. This is not a minimally invasive surgery, but the incision can be smaller. After healing, in some cases, a small incision can be made from the lateral side to remove the bone screws. Whether a second s...

Understanding Clavicle Fractures: Recovery Challenges and Treatment Options

I had a car accident on March 12 and suffered a clavicle fracture. I underwent surgery on March 15 to have a plate inserted, and the plate was removed on June 2. However, even after more than three months, I still cannot lift my arm. My muscles seem to have contracted. Initially,...

Dr. Shi Guozheng reply Orthopedics
We can continue to monitor the situation, and if the fracture does not heal, a second surgery may be necessary.

Understanding Clavicle Fractures: Pain Management After Surgery

Doctor, I had a car accident on February 29th that resulted in a 0.5 cm displaced fracture of my right clavicle. I have already undergone surgery to insert a bone screw, but recently the area around the bone has been extremely painful, and the back of my right side has swollen up...

Dr. Ye Qingnian reply Orthopedics
After a clavicle fracture surgery, if there is severe pain and swelling, it is recommended to return to the orthopedic department for an X-ray examination to check if there is any displacement at the site of the plate fixation.

Clavicle Surgery: What to Do If Your Plate Becomes Dislodged?

Doctor: Hello! I had a car accident on June 3rd that resulted in a displaced fracture of my right clavicle. I underwent surgery at National Taiwan University Hospital's Douliou branch on June 5th and was discharged on June 7th. Today, June 30th, I had my second follow-up app...

Dr. Shi Guozheng reply Orthopedics
After a fracture surgery, if there is a displacement, it will necessitate another surgery to re-fix the bone; otherwise, the fracture will not heal properly. You can return to the outpatient clinic to have the physician explain this clearly.