Non-operative treatment of lateral clavicle fractures presents a difficult problem. A high incidence of non-union, residual pain and shoulder girdle instability has been reported. A variety of fixation techniques have been described but the complication rates of these procedures can be high. This retrospective review describes the use of distal radius locking plates for fixation of lateral unstable clavicle fractures.

From January 2006 until December 2007 23 patients (17 males, 5 females; mean age 31 yrs (12–70) presented to our service. 2 patients sustained type 1, 16 patients type 2, 2 patients type 4 and 3 patients type 5 fractures (Neer classification). Patients were reviewed clinically, radiographically and with Constant score assessment.

Union was acchieved at a mean follow up of 7.2 weeks. The mean Constant score at 6 months was 84, the mean DASH score 27.7. The following complications were seen during the follow-up period: 1 superficial infection settling with oral antibiotics and 1 non-union in a type 5 fracture requiring bone grafting.

Clavicle fractures of the lateral aspect are controversial. The mechanism of injury often results in ruptures of the adjacent coracoclavicular ligaments and create instability and increased motion between the proximal and distal fragment. The result of this series of cases are encouraging and we recommend the use of distal radius locking plates to treat unstable lateral clavicle fractures. However a larger study is needed to further evaluate mid- and long-term shoulder function.