Edgardo Arredondo-Gómez1. 1. Hospital Regional N 1 Ignacio García Téllez Mérida, Yucatán. arredondo61@prodigy.net.mx
Abstract
INTRODUCTION: Post-traumatic clavicular pseudoarthrosis occurs as a complication of mid third fractures, particularly of those with an important displacement that leads to failure of conservative treatment. Most reports on the management of this complication use various plates and grafts. We used the Hunec nail as an implant and an iliac crest graft. MATERIAL AND METHODS: We report the results obtained in 17 patients with a diagnosis of clavicular pseudoarthrosis treated with the Hunec nail and an iliac crest graft. Patients were 9 males and 8 females; mean age was 38 years. Ten pseudoarthrosis were located on the right side and seven on the left side. Eleven were classified as atrophic and six as hypertrophic. Only one case had undergone previous surgery. Regardless of the type of pseudoarthrosis, an iliac crest graft placed as "barrel ribs" was used. RESULTS: In all cases bone healing occurred in a period of approximately 12 weeks; there was complete recovery of the ranges of motion. Only one case had nail migration, but this happened after bone healing and no other complications occurred. The nail was removed from 10 patients one year after surgery. We conclude that the Colchero Hunec nail provides enough stability to achieve healing of the traumatic clavicular pseudoarthrosis.
INTRODUCTION: Post-traumatic clavicular pseudoarthrosis occurs as a complication of mid third fractures, particularly of those with an important displacement that leads to failure of conservative treatment. Most reports on the management of this complication use various plates and grafts. We used the Hunec nail as an implant and an iliac crest graft. MATERIAL AND METHODS: We report the results obtained in 17 patients with a diagnosis of clavicular pseudoarthrosis treated with the Hunec nail and an iliac crest graft. Patients were 9 males and 8 females; mean age was 38 years. Ten pseudoarthrosis were located on the right side and seven on the left side. Eleven were classified as atrophic and six as hypertrophic. Only one case had undergone previous surgery. Regardless of the type of pseudoarthrosis, an iliac crest graft placed as "barrel ribs" was used. RESULTS: In all cases bone healing occurred in a period of approximately 12 weeks; there was complete recovery of the ranges of motion. Only one case had nail migration, but this happened after bone healing and no other complications occurred. The nail was removed from 10 patients one year after surgery. We conclude that the Colchero Hunec nail provides enough stability to achieve healing of the traumatic clavicular pseudoarthrosis.