Supraclavicular Nerve Matters: A Case Series of Three Distinct Outcomes after Clavicle Fixation

Abstract

Aim: Clavicle fractures, accounting for approximately 3% of all fractures, often require surgical intervention, particularly open reduction and internal fixation, to enhance stability and recovery. However, this approach poses risks to the supraclavicular nerve, which innervates the skin over the shoulder and upper chest. This case series aims to highlight the importance of nerve preservation intraoperatively. Presentation of Case: This case series examines three patients with comminuted mid-shaft clavicle fractures treated via locking plate fixation, highlighting different outcomes related to nerve preservation. In the first case, all branches of the supraclavicular nerve were preserved, resulting in full sensory function post-operation. The second case involved temporary numbness due to nerve stretching, with sensation returning by day five. In the third case, the nerve was sacrificed to facilitate surgery, leading to painful neuroma formation and permanent numbness. Discussion: These outcomes underline the importance of preserving the supraclavicular nerve to prevent sensory deficits and improve patient satisfaction. Effective surgical techniques, including careful dissection and the use of magnification, are crucial for minimizing nerve injury. Conclusion: This series reinforces that prioritizing nerve preservation can lead to better functional recovery and overall patient experience in clavicle fracture management. Careful nerve preservation should be prioritized in all cases whenever feasible.