Orthopaedic Surgery: IM screw fixation of # clavicle M/3

Procedure:

A 4'" long transverse incision is made along the inferior border of clavicle and superficial & deep fascia is divided in the same line. The Superficial surface of the clavicle is viewed by retracting the skin proximally..The fracture-ends of medial & lateral fragments are exposed and mobilized by clearing muscle and fascial attachments extraperiosteally.

A trial reduction of the fracture fragments is made to check the straightness of the middle third of the clavicle. Using non elastic 3.5 mm K-wire, an intra medullary straight pathway is drilled through fracture-ends in both the fragments of the clavicle piercing anterior cortex of the medial fragment and posterior cortex of the distal fragment; and the pathways in both the fragments are tapped from medial to lateral direction with a 4.5 mm tap. The combined length of tapped medullary canal of both the fragments is measured and the fracture after reduction is fixed from medial to lateral fragment with a cortical screw of proper length. Bone grafting is done in old ununited fractures.

 Post op.a cuff & collar is given for 3 weeks for pain to subside. It takes almost 3 months for the fracture to consolidate.