The Difficulties of Ensuring Proper Healing in the Clavicle

Dr Nabil Ebraheim

Dr. Nabil Ebraheim guides the University of Toledo Medical Center’s Department of Orthopedic Surgery as its chairman and a professor and has experience treating a variety of complex fracture cases. Maintaining a popular educational YouTube channel, Dr. Nabil Ebraheim discusses issues such as malunion of the clavicle.

Given the complexity of the collarbone, it is difficult to reduce fractures and maintain unity in healed bone. Whether or not a figure-eight strap or sling is employed, the clavicle heals quickly and overcomes issues such as fracture displacement. However, the clavicle’s midshaft area is subject to deforming forces, which involve the counteracting forces of gravity and the weight of the arm on the one hand and a superior pull by the sternocleidomastoid muscle on the other.

The result is non-alignment of the clavicle and the formation of a bony callus around the fracture, as well as shortening. This often results in decreased shoulder strength and overall endurance in the injured patient. To counteract this, surgery is often undertaken to perform fraction reduction and set a fixating plate in place.

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