Clavicular nonunion: 31/32 healed after plate fixation and bone grafting

Abstract

We report the long-term results in 32 patients with established nonunion of the clavicle; 15 treated with AO Dynamic Compression Plate and autologous cancellous bone graft and 17 treated with an AO reconstruction plate and autologous cancellous bone graft. The patients were followed up for a mean of 8 (4-21) years from injury and 7 (4-12) from non-union operation, both by clinical review and radiographs. 31/32 nonunions united successfully. One fracture which initially failed to unite was replated and subsequently united. 6 compression plates and 7 reconstruction plates were removed for discomfort or cosmesis. None broke. Both plates give equally good results, but we feel that the reconstruction plate is easier to contour to the complex form of the clavicle.

Rushpin fixation for midshaft clavicular nonunions Good: Results in 13/14 cases

“…Compression plating, bone grafting and early mobilization have been successful in several small series: Jupiter and Leffert (1987) reported 17/19 healed nonunions, Bradbury et al (1996) 31/32, Eskola et al (1986) 20122, Manske and Szabo (1985) 10/10 and Sanderhoff Olsen et al (1995) 15/16. We found comparably good function after Rushpin fixation and autogenous bone grafting, with only I failure in 14 patients.…”

Bone Marrow Stromal Cells: Characterization and Clinical Application

“…In humans, blood and bone marrow are the most frequently transplanted materials (Allard et al, 1987;Pedrosa et at., 1989;Aglietti et al, 1991;Eggers and Meeder, 1994;Friend et al, 1995;Olsen et al, 1995;Arrington et al, 1996;Bradbury et al, 1996). Fresh autogenous bone grafts are preferred in orthotopic procedures because of their compatibility and efficacy.…”

A Prospective Study of Fracture Nonunion of Clavicle Managed by Internal Fixation With or Without Bone Grafting

“…Both dynamic compression plate and reconstruction plate have given equally good results, but with latter it is easier to give contour to the complex form of the clavicle. 18 Low-contact dynamic compression plates appeared to be associated with significantly better upper-limb function throughout the year following surgery, earlier fracture union and return to work, and a reduced incidence of implantassociated symptoms when compared with a standard dynamic compression plate in 36 adults with symptomatic nonunion of the middle third of the clavicle. 13 Endrizziet al 23 concluded that a bone graft might not be necessary in most cases of clavicle nonunion.…”

“…The time between injury and surgery for nonunion was 8.13 months (range 4 months to 24 months). Preoperative radiographic score was done as per Lane and Sandhu scoring system 18 (Table 1).…”