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Fixação da clavícula

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Clavicle fixation (ORIF) — restoring alignment and stability for displaced clavicle fractures.

Updated May 2026
Ilustração de uma pessoa em pé com boa postura, o braço apoiado em uma tipóia.
Uma fratura da clavícula (osso da clavícula). Quando os extremos ósseos estão desalinhados, a fixação com uma placa e parafusos restaura a forma normal. Kieran Hirpara 4.0

Esta página foi traduzida automaticamente e ainda não foi verificada por um médico. A versão em inglês é a versão oficial.

Por que esta operação foi sugerida

Seu cirurgião pode sugerir esta operação para corrigir uma clavícula fraturada, também chamada de fratura da clavícula. Esta cirurgia é geralmente oferecida quando o osso está severamente deslocado, encurtado em mais de 2 cm, ou se a pele está em risco de se romper. Embora a maioria das fraturas cure bem com o uso de uma atadura, a cirurgia é escolhida quando o tratamento não cirúrgico é improvável de restaurar a função normal ou prevenir um inchaço permanente.

O principal objetivo desta operação é reunir os fragmentos ósseos para que eles curem firmemente. Isso ajuda a reduzir a dor, impede que o osso cure em uma posição torta e permite que você retorne às suas atividades diárias e ao trabalho mais cedo. Ao estabilizar o osso, seu cirurgião visa restaurar a estabilidade do ombro e melhorar seu movimento a longo prazo.

Antes da cirurgia

Você precisará jejuar por várias horas antes da sua cirurgia e suspender certos medicamentos conforme orientado pelo seu cirurgião. Por favor, organize para que alguém o leve para casa e traga uma lista de todos os medicamentos atuais. Você pode precisar de raios-X, uma ressonância magnética ou exames de sangue para avaliar sua lesão e saúde geral. Seu cirurgião também revisará esses resultados com você. Utilizamos uma única incisão aberta sobre o local da fratura para fixar o osso. Vista roupas confortáveis para sua consulta. A maioria dos pacientes tem uma boa recuperação com essa abordagem, embora alguns possam precisar da remoção do material de fixação mais tarde.

No dia da cirurgia

Você chegará ao hospital e encontrará seu anestesiologista para discutir os cuidados com sua saúde. Esta cirurgia será realizada sob anestesia geral. Você estará completamente adormecido durante o procedimento. Alguns pacientes também podem receber um bloqueio nervoso regional para alívio da dor pós-operatória; o anestesiologista decidirá no dia, com base nas suas circunstâncias individuais.

Seu cirurgião fará uma única incisão sobre o local da fratura para fixar o osso. Em seguida, você será transferido para a área de recuperação, onde despertará de forma segura. A maioria dos pacientes sente-se sonolenta no início, mas será monitorada de perto até estar pronta para ir para casa ou para uma enfermaria.

O que a cirurgia envolve

O seu cirurgião fará um único corte na parte frontal do ombro para alcançar o osso fraturado. Esta abordagem aberta permite acesso direto ao local da fratura. O cirurgião liberta cuidadosamente os tecidos na parte inferior da clavícula para proteger os nervos e os vasos sanguíneos próximos. Esta etapa é realizada para garantir que não ocorra encurtamento durante a reparação.

Uma vez que o osso esteja visível, o seu cirurgião realinhará os fragmentos fraturados para a sua posição correta. Uma placa metálica é então colocada sobre o osso para o manter estável. Parafusos são utilizados para fixar firmemente a placa aos fragmentos ósseos. Se o osso não tiver cicatrizado no passado, pode ser adicionado um pequeno fragmento de osso saudável para ajudar na sua regeneração.

Após o osso estar fixado no lugar, o corte é suturado. O cirurgião pode utilizar suturas absorvíveis sob a pele ou suturas removíveis na superfície. Uma curativo é aplicado para proteger a área à medida que inicia a cicatrização. Este procedimento restaura o comprimento e o alinhamento da sua clavícula para ajudar o ombro a funcionar normalmente.

Após a cirurgia

Você acordará em uma enfermaria de recuperação, onde sua equipe cuidará da sua dor. Seu braço estará em uma tipóia para proteger o reparo, e um curativo cobrirá a única incisão sobre seu ombro. A maioria dos pacientes permanece uma noite no hospital após esta cirurgia, embora alguns possam ir para casa no mesmo dia. Você deve ter alguém com você nas primeiras 24 horas para ajudá-lo. A maioria dos pacientes começa a realizar movimentos suaves dos dedos e do pulso imediatamente. Seu cirurgião orientará quando começar a usar seu braço mais plenamente à medida que a cicatrização começar.

Recuperação

Nos primeiros dias, você sentirá dor e inchaço ao redor da clavícula. Isso é normal. Seu cirurgião prescreverá medicamentos para ajudá-lo a manter o conforto. Você usará uma tipóia para apoiar o braço e proteger o osso em processo de cicatrização. Tente dormir apoiado em travesseiros para reduzir o inchaço e facilitar a respiração.

À medida que o inchaço diminui, você começará a realizar movimentos suaves. Seu fisioterapeuta irá guiá-lo por meio de exercícios para manter o ombro em movimento sem sobrecarregar a reparação. Você pode realizar tarefas diárias leves, como comer ou escovar os dentes, mas evite levantar qualquer objeto pesado. Seu cirurgião informará quando for seguro dirigir assim que você tiver controle total do braço.

A maioria das pessoas retorna às atividades normais à medida que a força melhora. Se você teve uma fratura deslocada, a cirurgia ajuda a cicatrizar mais rapidamente e a retornar ao trabalho mais cedo do que o tratamento não cirúrgico. No entanto, seu cronograma pessoal pode ser diferente. Seu cirurgião e fisioterapeuta irão orientá-lo com base na forma como seu osso está cicatrizando.

O que pode dar errado

A maioria dos pacientes tem uma boa evolução, mas problemas podem ocorrer ocasionalmente. O seu cirurgião e a equipa monitorizam-no de perto para detetar qualquer problema precocemente.

Pode notar uma dor profunda e pulsante que não melhora com analgésicos simples. Isto pode significar que o osso não cicatrizou, uma condição conhecida como não união. Se sentir um estalido ou atrito súbito no ombro, ou se observar um inchaço visível que irrita a sua pele, informe o seu cirurgião. Embora uma ligeira deformidade seja comum em adultos, um inchaço muito estético pode necessitar de atenção.

Vermelhidão que se espalha a partir da ferida ou febre podem sinalizar uma infeção. Também pode sentir uma dor aguda se a placa metálica ou os parafusos irritarem a pele sobre o osso. Por vezes, o material de fixação parece mover-se sob a pele. Se notar estes sinais, ligue para a clínica imediatamente. O seu cirurgião pode precisar de remover o material de fixação para cessar a irritação.

Em casos raros, pode ocorrer dano ao pulmão ou aos vasos sanguíneos sob a clavícula. Pode sentir falta de ar súbita ou dor torácica grave. Isto é uma emergência médica, por isso dirija-se à urgência imediatamente. O seu cirurgião toma medidas para evitar isto, mas é importante conhecer os sinais.

A maioria das complicações e a necessidade de procedimentos adicionais estão relacionadas com o material de fixação utilizado. O seu cirurgião utiliza uma única incisão sobre o local operatório para fixar o osso. Se tiver preocupações sobre cicatrizes ou a aparência do osso, discuta isto com a sua equipa.

A tabela de complicações nesta página lista as taxas típicas se desejar os detalhes específicos.

Quando ligar para nós

Ligue para nós se você tiver febre, vermelhidão crescente ou secreção na ferida. Vá para o pronto-socorro se sentir dor súbita e intensa, inchaço na panturrilha ou dificuldade para respirar. Procure ajuda imediatamente se perder a sensibilidade ou não conseguir mover o braço. Embora o dano ao pulmão ou aos vasos sanguíneos seja muito raro, esses sinais exigem avaliação urgente.


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