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. 2021 Mar 2;11:4949. doi: 10.1038/s41598-021-84601-2

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© The Author(s) 2021

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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(A,B) The guide was inserted through the tunnel. (C,D) A titanium cable was inserted and the clavicle distal locking plate was fix. (E–H) A 27 years old man with right distal clavicle fracture. The distal fragment more than 2.5 cm, a titanium cable was inserted and the clavicle distal locking plate was fix. (E) Preoperative X-ray of the shoulder; (F) postoperative X-ray, (G) 3 months after operate and fracture healing, (H) the final follow-up 12 months after surgery and the implant removed.