Neurovascular Complications in Clavicle Fractures Plating: A Simple Procedure to Avoid Them

Open reduction and internal fixation of clavicle displaced fractures is a well-known procedure in trauma surgery but it is not without risks including injuries to major neurovascular structures. Our goal is to share the simple and effective method to avoid neurovascular complications in clavicle fractures plating used in our center. As part of the surgical planning, we performed a digital measurement of the cephalad-caudad length of fracture fragments. We confirmed our measurement intraoperative with a sterile ruler and we adjusted the length of the drill adding 3 mm to our estimation. Knowing that the closest neurovascular structure to the clavicle is positioned at least 4.8 mm caudal to the inferior border of the clavicle, we performed the drilling knowing that we will not get >3 mm caudal to the lower border of the clavicle and, consequently, we carried out a safer surgery. We believe that this simple procedure is a valid option to help mainly young surgeons to avoid these major complications in clavicle fractures plating.