The “clavicle fracture” is a medical term for a broken collarbone, which joins the ribcage to the shoulder blade. Symptoms include swelling, joint deformation, and a drooping shoulder. It may make daily activities like lifting the arm painful and challenging. Treatment includes conservative options like physical therapy and more invasive interventions like the Rockwood clavicle pin.
To determine the best treatment approach, the surgeon examines the shoulder, applying gentle pressure to determine the extent of the damage. The surgeon may also perform tests to check for blood vessel or nerve damage in the affected area and utilize imaging techniques like X-ray scans to pinpoint the precise location and assess the fracture in detail.
The Rockwood clavicle pin is a metal pin with threaded ends and accompanying nuts. It is inserted into the collarbone to stabilize it. Surgeons favor it for its minimally invasive nature, eliminating the need for extensive implant surgery involving metal plates. Moreover, unlike metal plates, the Rockwood clavicle pin does not leave large holes after removal.
This implant is particularly effective for treating less complex fractures in the middle section of the collarbone. However, it may not offer the same high level of stability as metal plates because it takes time to stabilize fully and necessitates a second surgery for removal.
To initiate the procedure, the surgeon positions the patient with the torso elevated to facilitate access to the back of the shoulder, where the bone is. After preparing the fracture site for surgery, the surgeon makes a small incision, either in a curved line or along the length of the collarbone, to expose the fractured bone.
The surgeon then removes adhesions and soft tissues from the exposed fracture ends to enhance bone contact and carefully aligns the fractured bone ends into their correct anatomical position, a process called reduction. Afterward, they prepare the intramedullary canals, or channels within the bone, where the implant will pass. Preparing this path requires drilling small holes into the clavicle on each side of the fracture, with the drill size depending on the implant size.
Following the drilling, the surgeon proceeds with the pin placement and fixation by inserting it carefully through one of the drilled holes and advancing it across the fracture site until the curved end of the pin reaches the opposite fragment of the clavicle. The surgeon then adjusts the lateral locking nuts on the pin’s outer end to secure them.
If necessary, the surgeon will trim the pin to ensure proper fit and less protrusion. They may also use a compression device to adjust the fractured segment into position and promote stability and bone healing. Afterward, the surgeon seals the incision with stitches or metal clips and applies a sterile dressing to protect the wound.
Patients may experience pain post-surgery, which they can address by taking pain relievers or applying ice. Healing typically takes place within 8 to 12 weeks, during which the surgeon may advise limiting shoulder movement and avoiding heavy lifting with the affected arm. Once this healing period is over, patients should return to the operating room for removal of the clavicle pin.
Alex Burnett 