Symptomatic malunion after midshaft clavicle fracture in an adolescent patient: a case report of surgical deformity correction using a 3D printed model

• Published in: Annals of the Royal College of Surgeons of England Vol. 102; no. 6; pp. e1 - e129
• Main Authors: Consigliere, P, Tyler, J, Tennent, D, Pearse, E
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.07.2020; Royal College of Surgeons
• Subjects: Fractures; Online Case Report; Pain; Pediatrics; Rugby; Skin & tissue grafts; Surgical outcomes; 3D model; Malunion; Deformity; Pain; Osteotomy; 3D printing
• ISSN: 0035-8843; 1478-7083
• DOI: 10.1308/rcsann.2020.0046

A 14-year-old boy underwent surgery for symptomatic malunion of the clavicle. This complication, which is uncommon in adults and adolescents, occurred after a displaced midshaft clavicle fracture that had been treated conservatively. Surgery may be considered if functional impairment, pain, weakness, fatigability and neurological symptoms persist in the presence of significant clavicular deformity. Our case was unusual because the patient had a symptomatic malunion and lost range of movement of his shoulder despite a minor degree of clavicular shortening. We adopted an approach used in lower limb deformity correction but not described for the clavicle in which corrective osteotomy was planned and practised using a three-dimensional printed model of the malunited clavicle. A three-dimensional printed model of the mirror image of the opposite clavicle served as a template of normal. Three-dimensional models were printed from the computed tomography data. The patient's symptoms resolved and he recovered full range of movement and shoulder function following the corrective osteotomy.