Operative treatment for delayed union and nonunion of midshaft clavicular fractures: AO reconstruction plate fixation and early mobilization.

Fourteen patients were treated operatively for delayed union and nonunion of midshaft clavicular fractures from 1986 to 1994. Radiographically, nine nonunions were atrophic and five hypertrophic. The operative technique included opening the medullary canal, bone grafting, and fixation with an AO reconstruction plate. Postoperative mobilization started within one week. The mean follow-up was 60 months (range, 16 to 101 months). Consolidation was observed radiologically after 10 to 30 weeks. All patients were asymptomatic after 10 weeks and had a normal range of shoulder motion. One patient sustained a fractured clavicle following adequate trauma. Operative treatment for delayed union and nonunion of clavicular fractures with AO reconstruction plate fixation, bone grafting, and early postoperative mobilization yields excellent results.