Operative treatment of clavicular nonunion
M Pedersen1, K A Poulsen, F Thomsen
1Department of Orthopedics, University Hospital of Copenhagen, Hellerup, Denmark.
Acta Orthopaedica Belgica
|January 1, 1994
Summary
Short plates and inadequate immobilization led to high failure rates in treating clavicular nonunion. Plate fixation with bone grafting is effective if sufficient postoperative immobilization is ensured.
Area of Science:
- Orthopedic Surgery
- Traumatology
Background:
- Clavicular nonunion presents a significant challenge in orthopedic practice.
- Effective treatment strategies are crucial for restoring function and reducing patient morbidity.
Purpose of the Study:
- To evaluate the efficacy of plate fixation and bone grafting for treating clavicular nonunion.
- To identify factors contributing to treatment failure in these cases.
Main Methods:
- Retrospective review of twelve patients treated for clavicular nonunion.
- Median follow-up of 41 months (range: 20-117 months).
- Analysis of fixation methods, particularly the use of 4-hole semitubular plates and immobilization techniques.
Main Results:
- Nine out of twelve patients achieved a good outcome.
- Primary treatment failure occurred in 50% of cases.
- Failures were associated with the use of short (4-hole) semitubular plates and insufficient postoperative immobilization.
Conclusions:
- Four-hole semitubular plates are not recommended for clavicular nonunion due to a high risk of failure.
- Adequate postoperative immobilization is essential for successful outcomes.
- Plate fixation combined with bone grafting is a viable treatment option when appropriate fixation and immobilization are employed.
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