Managing Recurrent Clavicle Nonunion and Construct Failure: A Case Report

A 36-year-old male who suffered a left midshaft clavicle fracture, following a fall from a mountain bike, was treated unsuccessfully with two ORIF surgeries. Smoking cessation and management of hypovitaminosis was addressed preoperatively before final revision with a dual plate construct and tibial autologous bone graft. Follow-up radiographs taken at 12 months from the initial surgery showed intact hardware and full bone healing. Successful management of clavicle nonunions can be optimized through optimal plate selection, plate positioning, number of plates, construct biomechanics, biologic augmentation, and preoperative risk optimization. Efforts to minimize controllable risk factors for nonunion, such as smoking cessation or vitamin D supplementation, should be utilized both preoperatively and postoperatively.