Related Experiment Video
Updated: Mar 10, 2026
C-arm-Free Simultaneous OLIF51 and Percutaneous Pedicle Screw Fixation in a Single Lateral Position
Published on: September 16, 2022
Nonunion After Clavicle Osteosynthesis: High Incidence of Propionibacterium acnes
Elizabeth B Gausden1, Jordan Villa, Stephen J Warner
1*Hospital for Special Surgery, New York, NY; and †Department of Orthopaedic Surgery, Weill Cornell Medical College, New York, NY.
Objective:
The objective of this study was to review the etiology of clavicle nonunions after osteosynthesis and investigate the outcomes of a treatment with a single-stage revision.
Design:
Retrospective case series.
Setting:
Orthopaedic specialty hospital.
Patients:
Twenty cases of nonunion after osteosynthesis of the clavicle were identified. The average age was 44 years (±13 years). In 9 cases, there was catastrophic implant failure that prompted the revision surgery. In the 18 cases in which cultures were taken, 15 of the 18 (83%) were treated as infections with a course of antibiotics. In 14 cases, the cultures were positive for Propionibacterium acnes.
Results:
Fifteen patients were treated with a prolonged course of antibiotics. Eighteen patients had follow-up, and the average time to radiographic union was 22 weeks. There were no cases of nonunion after revision surgery.
Conclusions:
There is a high rate of positive cultures in cases of nonunion after osteosynthesis of the clavicle. This suggests the etiology of midshaft clavicle nonunions may result from a combination of suboptimal mechanical fixation and latent infection. Our treatment protocol of superior and anterior plating, interfragmentary fixation, bone grafting, and appropriate antimicrobial treatment of latent infections has resulted in 100% union rate.
Level Of Evidence:
Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
More Related Videos
04:19Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
Published on: November 8, 2024
15:11Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling
Published on: January 5, 2015
Related Concept Videos
01:09Changes in the Appendicular Skeleton with Age
Initially, the limb buds consist of a core of mesenchyme covered by a layer of ectoderm. The ectoderm at the end of the limb bud thickens to form a narrow crest called the apical ectodermal ridge. This ridge stimulates the underlying...
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...