Standard straight compression plates provide sufficient strength, but they are difficult to contour. Caution is warranted when considering plates with cutouts that make them easier to contour, as they may be weaker at these points, particularly after bending the plate (Figure 1-2). There are plates available that are designed to match the superior or anterior contour of the clavicle (Figure 1-3A). Superior plates may act as a tension band, converting the distal clavicle tendency to fall inferior into compression forces at the fracture (Figure 1-3B). Anterior plate placement is intended to reduce implant prominence, although the lateral aspect can occasionally be prominent (Figure 1-3C). Anterior plating may require greater stripping of muscle for application. One study of plate fixation of 105 displaced diaphyseal fractures of the clavicle found twice the amount of patient-reported implant prominence with superior plates (54% vs 29%), and union was 95% for both techniques.¹² Combined anterior and superior, orthogonal plate fixation, can be useful when a shorter construct is desired, or for bridging large areas of fragmentation. Anterior plates have long lateral screws, where the bone is less strong. Locking screws have limited benefits and may be prone to axial pull-out in the lateral part of a superiorly applied plate¹³ (Figure 1-4).