Anterior Approach to the Clavicle

  • Anterior Approach to the Clavicle is used for:

1. Open reduction and internal fixation of fractures
2. Reconstruction of the sternoclavicular and the acromioclavicular joints in case of dislocation
3. Drainage of sepsis
4. Biopsy and excision of tumors
5. Osteotomy for malunion

1. Patient supine on the operating table.
2. Break the table and elevate the head end, so as to elevate the shoulder area.
3. Place a sandbag between the medial border of the scapula and the spine.

  • The sternal notch is the most medial landmark of the incision.
  • Make an incision following the S-shaped clavicular anatomy, beginning from the medial end.

  • There is no internervous plane

  • Deepen the skin incision through the platysma to reach the subcutaneous surface of the clavicle.

  • Gently strip soft tissues off the subcutaneous surface of the clavicle in an epi-periosteal plane.

  • The structures at danger in anterior approach to the clavicle are:
    1.  Nerves: The brachial plexus.
    2. Vessels: The subacromial artery and vein.

Anterior Approach to the Clavicle

Skin incision

Anterior Approach to the Clavicle

Dissection

Anterior Approach to the Clavicle

Deep dissection

Images Source:
  • Surgical Exposures in Orthopaedics 4th Edition Book.

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