Fig. 1

 A female patient (54 years old) had a midshaft clavicle fracture (Robinson 2B2) after a fall to ground (a). She received ORIF and achieved bone union (b) and insisted on implant removal though CT scan showed that the bone quality at previous fracture site was not strong as that of surroundings (c, white arrow, 108 weeks after primary operation). She had implant removed and unfortunately refractures occurred at previous fracture site 30 days after implant removal (d). Reoperation with autogenous iliac bone graft (black arrow) was applied (e) and she achieved bone union 3 months later (f)