Sungjoon Lim1, Euihwan Cho1, Jae-Myeung Chun2, In-Ho Jeon3. 1. Department of Orthopaedic Surgery, National Police Hospital, Seoul, South Korea. 2. Department of Orthopaedic Surgery, Korean Armed Forces Capital Hospital, Seongnam, South Korea. 3. Department of Orthopaedic Surgery, Asan Medical Center, College of Medicine, University of Ulsan, 86 Asanbyeongwon-gil, Songpa-gu, Seoul, 05505, South Korea. jeonchoi@gmail.com.
Abstract
PURPOSE: This study evaluated the clinical and radiological results of plate osteosynthesis with autologous cortical and cancellous bone graft for nonunion of midshaft clavicle fracture. METHODS: A retrospective review was performed for all patients who underwent surgery for midshaft clavicle nonunion at a Level I trauma center. Visual analog scales (VAS) for pain and Quick-DASH (Disabilities of Arm, Shoulder, and Hand) score were assessed. Bone union rate, change in length of affected clavicle, complications, and reoperation were determined. Risk factors were identified to determine the effect on the healing. RESULTS: Thirty-four patients were included for analysis. All patients achieved solid bone union at mean 16 weeks (range 8-36) after surgery. The mean shortening of affected clavicle decreased significantly postoperatively (P < 0.001). There was significant improvement in both pain VAS and Quick-DASH score (P < 0.001). There was no wound complication, infection, or major neurovascular injury. Ten patients (29%) complained of plate irritation and underwent removal of implant without any subsequent adverse event. Multiple regression analysis demonstrated that high-energy trauma and previous surgery were the independent risk factors that significantly delayed time to union (P < 0.05). CONCLUSION: Osteosynthesis with autologous dual bone graft for nonunion of midshaft clavicle produced an excellent union rate with good clinical outcome and minimal complications.
PURPOSE: This study evaluated the clinical and radiological results of plate osteosynthesis with autologous cortical and cancellous bone graft for nonunion of midshaft clavicle fracture. METHODS: A retrospective review was performed for all patients who underwent surgery for midshaft clavicle nonunion at a Level I trauma center. Visual analog scales (VAS) for pain and Quick-DASH (Disabilities of Arm, Shoulder, and Hand) score were assessed. Bone union rate, change in length of affected clavicle, complications, and reoperation were determined. Risk factors were identified to determine the effect on the healing. RESULTS: Thirty-four patients were included for analysis. All patients achieved solid bone union at mean 16 weeks (range 8-36) after surgery. The mean shortening of affected clavicle decreased significantly postoperatively (P < 0.001). There was significant improvement in both pain VAS and Quick-DASH score (P < 0.001). There was no wound complication, infection, or major neurovascular injury. Ten patients (29%) complained of plate irritation and underwent removal of implant without any subsequent adverse event. Multiple regression analysis demonstrated that high-energy trauma and previous surgery were the independent risk factors that significantly delayed time to union (P < 0.05). CONCLUSION: Osteosynthesis with autologous dual bone graft for nonunion of midshaft clavicle produced an excellent union rate with good clinical outcome and minimal complications.
Authors: Michael D McKee; Elizabeth M Pedersen; Caroline Jones; David J G Stephen; Hans J Kreder; Emil H Schemitsch; Lisa M Wild; Jeffrey Potter Journal: J Bone Joint Surg Am Date: 2006-01 Impact factor: 5.284
Authors: C M Robinson; E B Goudie; I R Murray; P J Jenkins; M A Ahktar; E O Read; C J Foster; K Clark; A J Brooksbank; A Arthur; M A Crowther; I Packham; T J Chesser Journal: J Bone Joint Surg Am Date: 2013-09-04 Impact factor: 5.284
Authors: Braden McKnight; Nathanael Heckmann; J Ryan Hill; William C Pannell; Amir Mostofi; Reza Omid; George F Rick Hatch Journal: J Shoulder Elbow Surg Date: 2016-04-07 Impact factor: 3.019