International Orthopaedics

, Volume 43, Issue 8, pp 1977–1982 | Cite as

Surgical approach for open reduction and internal fixation of clavicle fractures: a comparison of vertical and horizontal incisions

  • Ofir Chechik
  • Ron Batash
  • Yariv Goldstein
  • Nimrod Snir
  • Eyal Amar
  • Michael Drexler
  • Eran Maman
  • Oleg DolkartEmail author
Original Paper



This study was designed to compare the results of clavicle fracture open reduction internal fixation (ORIF) with standard horizontal incision versus vertical incision.


ORIF surgery performed between October 2012 and August 2016 was included. The surgical approach was chosen according to surgeon preference as vertical or horizontal. Functional outcomes, fracture union, complications, scar appearance, skin irritation, and denervation around the scar were assessed at a minimum follow-up of three months.


Thirty-eight patients, age 39 ± 12 years, were operated upon, 22 through vertical incisions and 16 through horizontal incisions. There were no significant group differences in functional scores, fracture union, or complications. Two patients in the vertical incision group had a post-operative haematoma. The scar length was significantly shorter when a vertical incision was used (6.75 ± 1.25 cm vs 8.9 ± 2.3 cm, P = 0.001). The typical distribution of hypoesthetic skin area distal and lateral to the scar represented iatrogenic damage to the supraclavicular nerves and was found in 66% of patients. The mean hypoesthetic surface area was smaller in the vertical incision group (38 ± 29 cm2 vs 48 ± 28 cm2, P = non-significant).


Vertical incision results in shorter scars but may be associated with increased incidence of haematomas. Meticulous closure of the subcutaneous tissue is recommended.


Clavicle fractures Open reduction and internal fixation Vertical and horizontal incisions 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This retrospective study was approved by the Institutional Review Board.


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Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  • Ofir Chechik
    • 1
  • Ron Batash
    • 1
  • Yariv Goldstein
    • 1
  • Nimrod Snir
    • 1
  • Eyal Amar
    • 1
  • Michael Drexler
    • 1
  • Eran Maman
    • 1
  • Oleg Dolkart
    • 1
    Email author
  1. 1.Shoulder Unit, Division of Orthopaedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael

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