# Ultrasound-Guided Clavipectoral Fascial Plane Block Combined With Intermediate Cervical Plexus Block for Surgery on a Displaced Midshaft Clavicular Fracture in an Adolescent Athlete: A Case Report

## TL;DR

A 16-year-old athlete successfully underwent surgery for a clavicle fracture using a combination of ultrasound-guided nerve blocks, resulting in minimal postoperative pain.

## Contribution

This case report demonstrates the safe and effective use of combined ultrasound-guided CPB and ICPB for clavicular surgery in adolescents.

## Key findings

- Ultrasound-guided CPB and ICPB were safely used in a 16-year-old for clavicular fracture surgery.
- The procedure resulted in smooth surgery and minimal postoperative pain.
- This approach may be a viable option for adolescents requiring clavicular surgery.

## Abstract

Ultrasound-guided clavipectoral fascial plane block (CPB) and intermediate cervical plexus block (ICPB) have been used as novel approaches for clavicular fracture surgery in adults. However, there are few reports of ultrasound-guided CPB combined with ICPB for clavicular surgery in children under 18 years of age. A 16-year-old male baseball player (weight, 57 kg; height, 160 cm) was scheduled to undergo open reduction and internal fixation with superior plate placement for a left-sided displaced midshaft clavicular fracture. We performed ultrasound-guided CPB using 0.25% ropivacaine (10 mL each) on the medial and lateral sides of the clavicle fracture between the periosteum of the clavicle and the clavipectoral fascia and ICPB using 0.25% ropivacaine (5 mL) under general anesthesia. The surgery proceeded smoothly, and the postoperative pain was minimal. In this case, ultrasound-guided CPB combined with ICPB was used effectively and safely to treat clavicular fractures in an adolescent athlete.