Table 1.

Pearls and Pitfalls

Pearls	Pitfalls
Carefully incise deltotrapezial fascia in line with the clavicle to facilitate later closure over implants	Without 40 mm whip-stitched on either end of the allograft, there is a risk of screw injuring the graft on insertion
Prepare graft using a minimum of 7 × 240 mm with sutures whip-stitched approximately 40 mm on either end to facilitate interference fixation with screw	Failure to provide adequate bony bridge (>15 mm) between drill holes risks iatrogenic fracture
Use of flexible obturator around the coracoid allows for easier passage of sutures and graft and less soft tissue interposition	Inadequate tension while tying sutures over cortical button risks malreduction of clavicle
The 2.4-mm drill tunnel for suture tapes should be at least 15 mm from the distal edge of the medial clavicle fragment to prevent iatrogenic fracture
Shuttle the suture tapes through the clavicle before passing the graft so that they lie posterior to the graft
Pass free ends of the suture tapes through the anterior deltotrapezial fascia and tie over the top to bury the knots and avoid fascial irritation
The superior cortical edges of the graft tunnel should be rasped to remove any sharp edges to prevent damaging the graft during screw insertion