CASE: An 80-year-old man with osteoporosis sustained a complex, comminuted medial clavicle (MC) fracture that failed nonoperatively. A novel reconstruction involved MC resection, midclavicle distraction osteoplasty (DO) with iliac crest bone graft, and sternoclavicular (SC) joint reconstruction using a semitendinosus tendon allograft. By 1 year, the patient achieved successful healing and functional recovery.
CONCLUSION: Patients with excessive MC bone loss may require a clavicular lengthening to approximate the MC to the manubrium. Restoring clavicular length through a DO in conjunction with a SC joint reconstruction using a tendon allograft is a salvage maneuver which can yield a successful outcome.