Soft Cerclage in Addition to Rigid Fixation for Surgical Management of Displaced Comminuted Midshaft Clavicle Fractures

Midshaft clavicle fractures are one of the most common upper extremity fractures among adults. When displaced, open reduction and internal fixation may be indicated, most commonly performed using single or dual plating. Cerclage techniques can be used in addition to lag screws and plate fixation to better capture and reduce inferior and posterior fracture fragments that are typically difficult to capture using a lag screw technique. Although soft cerclage increases operative time and can pose a risk to neurovascular structures, better reduction of posterior and inferior fragments may promote healing and decrease nonunion rates.