Home Trauma & Fracture CareClavicle Fracture Surgery (Collarbone Fixation) in India

Clavicle Fracture Surgery (Collarbone Fixation) in India

Surgical fixation of broken collarbone using plates, screws or intramedullary nails to restore shoulder function and alignment.

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Overview

Clavicle fracture surgery, also known as collarbone fixation, is a surgical procedure to repair a broken clavicle that has failed to heal properly with conservative treatment or requires surgical intervention due to displacement, comminution, or specific fracture patterns. The clavicle (collarbone) is one of the most commonly fractured bones, especially among athletes and trauma patients in Bihar, often resulting from falls, sports injuries, or road traffic accidents. Clavicle fractures are classified using the Allman classification into three groups: Group I (midshaft fractures - 80% of cases), Group II (lateral/distal third fractures - 15%), and Group III (medial/proximal third fractures - 5%). While many clavicle fractures heal well with conservative treatment using a sling or figure-of-8 bandage, surgery is indicated for significantly displaced fractures (>2cm shortening), open fractures, neurovascular compromise, non-union, malunion, or fractures with multiple fragments. Surgical options include open reduction and internal fixation (ORIF) with plates and screws or intramedullary nailing, depending on fracture location and pattern. At Arthroscenter, Dr. Gurudeo Kumar has extensive experience in clavicle fracture management, having successfully treated hundreds of cases using modern fixation techniques. Our approach emphasizes anatomical reduction, stable fixation, and early mobilization to optimize functional outcomes. The procedure typically takes 1-2 hours and most patients achieve excellent healing with restoration of shoulder function within 3-6 months. We serve patients from across Bihar, including Patna, Muzaffarpur, Gaya, and surrounding regions, providing comprehensive trauma care with advanced surgical expertise.

Symptoms & Indications

This surgery may be recommended if you experience:

Severe pain and tenderness over the collarbone

Visible deformity or bump at the fracture site

Inability to lift the arm or move the shoulder

Swelling and bruising around the shoulder and upper chest

Grinding or crepitus sensation with shoulder movement

Shortening of the shoulder (affected shoulder appears lower)

Tenting of skin with bone fragments pushing outward

Numbness or tingling in arm (indicating nerve involvement)

Open wound with bone visible (open fracture)

Difficulty breathing if fracture fragments impinge on underlying structures

Procedure Details

Duration

1-2 hours

Anesthesia

General Anesthesia or Regional Block

Preparation for Surgery

Before surgery, patients undergo thorough clinical examination, X-rays (AP and 30-degree cephalic tilt views), and CT scan if needed for complex fractures. Pre-operative assessment includes blood tests, ECG, and anesthesia consultation. Patients are instructed to fast for 6-8 hours before surgery and discontinue blood thinners as directed.

Surgical Steps

General anesthesia or regional nerve block is administered

Patient is positioned in beach chair or supine position with bump under shoulder

Incision is made over the fracture site (typically 6-10 cm for ORIF)

Fracture fragments are carefully exposed and soft tissue attachments preserved

Fracture is reduced anatomically and temporarily held with reduction clamps

Pre-contoured clavicle plate or intramedullary nail is applied and secured with screws

Fluoroscopy (X-ray imaging) confirms proper alignment and hardware position

Wound is irrigated, hemostasis achieved, and incision closed in layers with sutures

Recovery Timeline

What to expect during your recovery journey

Week 1-2

Initial Healing & Immobilization

Arm supported in sling, gentle pendulum exercises, pain management with medications, wound care and monitoring for infection signs.

Week 2-6

Early Mobilization

Gradual reduction in sling use, passive range of motion exercises for shoulder and elbow, avoiding lifting or overhead activities.

Week 6-12

Active Rehabilitation

Progressive active range of motion exercises, gentle strengthening with resistance bands, return to light daily activities, avoiding contact sports.

Month 3-4

Strengthening Phase

Advanced strengthening exercises, increased functional activities, gradual return to work for non-contact occupations, bone healing confirmed on X-rays.

Month 4-6

Return to Activity

Progressive return to sports and physical activities, continued strengthening program, assessment for hardware removal if needed.

Month 6-12

Full Recovery

Complete bone union, return to all activities including contact sports, plate removal considered if causing symptoms (typically after 12-18 months).

Tips for Faster Recovery

Wear sling as directed to protect healing bone

Follow physical therapy exercises consistently

Apply ice to reduce swelling in first few weeks

Avoid lifting heavy objects for 3 months

Sleep in semi-reclined position initially

Report any numbness, increased pain, or wound drainage

Attend all follow-up appointments for X-ray monitoring

Gradually progress activities as healing advances

Frequently Asked Questions

Common questions about this procedure

Q1.When is surgery necessary for a clavicle fracture versus conservative treatment with a sling?

Surgery is typically indicated when the fracture has significant displacement (>2cm shortening), involves multiple bone fragments (comminuted fracture), is an open fracture with skin penetration, causes neurovascular compromise, or involves the lateral third with ligament disruption. Conservative treatment with a sling or figure-of-8 brace is appropriate for minimally displaced midshaft fractures, medial third fractures, and pediatric cases. At Arthroscenter, Dr. Gurudeo Kumar performs detailed examination and imaging to determine the optimal treatment approach. Studies show that surgical fixation of significantly displaced fractures results in faster return to function, lower non-union rates (2-3% vs 15-20%), and better cosmetic outcomes compared to conservative management in selected cases.

Q2.What is the difference between plate fixation and intramedullary nailing for clavicle fractures?

Plate fixation (ORIF) involves placing a pre-contoured plate along the superior or anteroinferior surface of the clavicle, secured with multiple screws. This provides excellent stability, allows anatomical reduction, and is suitable for most midshaft and distal fractures. Intramedullary (IM) nailing involves inserting a titanium nail through the bone canal, requiring smaller incisions and causing less soft tissue disruption. IM nails are ideal for simple midshaft fractures but may not control rotation as well as plates. At Arthoscenter, Dr. Kumar selects the technique based on fracture pattern, patient age, activity level, and cosmetic preferences. Both methods achieve excellent healing rates (95-98%) when properly indicated.

Q3.How long before I can return to sports after clavicle fracture surgery?

Return to sports depends on the type of sport, fracture healing, and hardware stability. Light activities like swimming and cycling can typically resume at 6-8 weeks. Non-contact sports like golf or tennis can begin at 3-4 months once X-rays confirm bone healing. Contact sports like cricket, football, kabaddi, or wrestling should wait until 4-6 months with complete bone union and full strength recovery. At Arthroscenter, we provide sport-specific rehabilitation protocols. Athletes in Bihar commonly involved in cricket, football, and kabaddi receive tailored guidance to ensure safe return to their sport. Premature return to contact sports risks re-fracture or hardware failure, so adherence to your surgeon's clearance is essential.

Q4.Will the plate and screws need to be removed eventually?

Plate removal is not mandatory but is commonly performed 12-18 months after surgery if the hardware causes discomfort, prominence under the skin, or cosmetic concerns. Removal is a simpler, shorter procedure (30-45 minutes) performed as outpatient surgery. Some patients, particularly those with low symptoms and minimal hardware prominence, choose to keep the plate permanently without issues. At Arthoscenter, Dr. Kumar discusses plate removal during follow-up visits based on individual patient factors. Plate removal is more common in younger, active patients or those with thin soft tissue coverage. After removal, patients typically resume activities within 4-6 weeks.

Q5.What is the risk of non-union (bone not healing) after clavicle fracture surgery?

Surgical fixation significantly reduces non-union risk compared to conservative treatment. With modern plating techniques, non-union rates are only 2-3% versus 15-20% with non-operative management of displaced fractures. Factors that increase non-union risk include smoking, diabetes, inadequate fixation, infection, and poor nutrition. At Arthoscenter, Dr. Gurudeo Kumar uses rigid fixation with adequate screw purchase, preserves soft tissue blood supply, and encourages early smoking cessation to minimize non-union risk. If non-union occurs, revision surgery with bone grafting (using autograft from iliac crest or bone graft substitute) achieves healing in over 90% of cases. Regular follow-up with serial X-rays ensures early detection of healing problems.

Q6.Can I sleep on the operated shoulder side after clavicle surgery?

You should avoid sleeping directly on the operated shoulder for at least 6-8 weeks after surgery to protect the healing bone and prevent hardware irritation. Initially, sleep in a semi-reclined position (beach chair position) or on your back with pillows supporting the arm. After 6-8 weeks, you can gradually transition to side sleeping on the non-operative side, and eventually to the operative side once bone healing is confirmed (typically 3-4 months). Some patients with prominent hardware may always find sleeping on that shoulder uncomfortable until the plate is removed. At Arthoscenter, our physiotherapy team provides guidance on optimal sleeping positions throughout your recovery.

Q7.What are the signs of infection after clavicle fracture surgery?

Infection is rare (<2%) but requires prompt attention. Warning signs include increasing redness, warmth, or swelling around the incision; persistent or worsening pain despite medications; drainage of pus or cloudy fluid from the wound; fever above 101°F (38.3°C); foul odor from the incision; or separation of wound edges. If you notice any of these signs, contact Arthoscenter immediately. Early infections (within 2 weeks) are typically superficial and respond to antibiotics. Deep infections may require surgical debridement and hardware retention if bone healing is incomplete, or hardware removal if healing is solid. Dr. Kumar uses meticulous sterile technique, prophylactic antibiotics, and careful wound closure to minimize infection risk.

Q8.How does clavicle fracture surgery affect shoulder strength and function long-term?

When properly performed with anatomical reduction and stable fixation, clavicle fracture surgery restores near-normal shoulder function in 90-95% of patients. Studies show that surgical fixation of displaced fractures results in better shoulder strength, range of motion, and patient satisfaction compared to non-operative treatment. Most patients regain full overhead motion and strength for daily activities by 4-6 months. Athletes typically recover 95-100% of pre-injury strength by 6-9 months with dedicated rehabilitation. At Arthoscenter, our structured physical therapy protocol focuses on scapular stabilization, rotator cuff strengthening, and functional movement patterns. Factors affecting outcome include fracture displacement, soft tissue injury, patient compliance with therapy, and timing of treatment.

Q9.Is clavicle fracture surgery covered by health insurance in Bihar?

Clavicle fracture surgery is typically covered by health insurance when medically indicated, as it is considered necessary trauma care for significantly displaced or complex fractures. Coverage includes hospitalization, surgical fees, implants (plates/screws), and rehabilitation. At Arthroscenter, our administrative team assists with insurance pre-authorization, claim processing, and documentation for cashless treatment under policies like PMJAY (Ayushman Bharat), ECHS, CGHS, and private insurers. For patients without insurance or requiring out-of-pocket payment, we offer transparent pricing and affordable payment plans. Contact our office for detailed cost estimates and insurance guidance specific to your policy.

Q10.What happens if the clavicle heals in a shortened or malunited position?

Clavicle malunion (healing in abnormal position) can cause persistent pain, weakness, neurological symptoms from thoracic outlet compression, or cosmetic deformity. Shortening >2cm may lead to shoulder drooping, scapular winging, and reduced overhead strength. Symptomatic malunions may require corrective osteotomy (surgically re-breaking the bone), realignment, and plate fixation with or without bone grafting. Prevention through early surgical intervention for significantly displaced fractures is preferable to later reconstructive surgery. At Arthoscenter, Dr. Kumar evaluates fracture displacement carefully using X-rays and CT scans to determine when surgical fixation is needed to prevent malunion. Most surgically treated fractures heal in anatomical position with excellent functional outcomes.

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