Non-union of the clavicle. Associated complications and surgical management.

Jupiter, Jesse B.; Leffert, Robert D.

doi:10.2106/00004623-198769050-00018

Cited by 256 publications

(135 citation statements)

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“…Over 25 years ago, Jupiter & Leffert [19] noted that fracture displacement of greater than 2 cm was associated with non-union in their series of patients. Since then, the treatment of displaced midshaft clavicle fractures has evolved.…”

Section: Discussionmentioning

confidence: 99%

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Clavicle Fracture Open Reduction Internal Fixation: Results of Modern Technique

Simonian¹

2017

MOJOR

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Section: Discussionmentioning

confidence: 99%

“…This traditional treatment is not without complications, including shortening, nonunion, deformity and unsatisfactory patient outcomes [7][8][9][10][11][12][13][14]. More recently, modern operative treatment has demonstrated superior results [15][16][17][18][19][20][21][22][23][24][25][26].…”

Section: Introductionmentioning

confidence: 99%

Clavicle Fracture Open Reduction Internal Fixation: Results of Modern Technique

Simonian¹

2017

MOJOR

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“…The success results in achieving union were varying from 89% to 100%. Those methods, including the intramedullary fixation with Key wire, Knowle's pins, Haige pins, Rockwood pins and titanium nails and the extramedullary including semitubular plates, reconstruction plates, Dynamic Compression Plate (DCP), Limited Contact Dynamic Compression 5 . Despite of the intramedullary fixation of the clavicle can be placed with smaller incisions, removing these devices also can be easier, with smaller surgical incisions which is more cosmetic.…”

Section: Discussionmentioning

confidence: 99%

“…lavicle fractures occur commonly; accounting for 5% to 10% of all fractures, more than 75% up to 80% are located in the mid-shaft, most of these fractures can be treated nonoperatively and will heal without surgical intervention 5 . Mukhopadhaya 7 and Rowe 9 considers a delayed union of clavicle fractures to be defined as the absence of clinical and radiological signs of union at six weeks, and they considered the nonunion in patients to be defined as the absence of clinical and radiological signs of union after three months, double the time required for union.…”

Section: Introductionmentioning

confidence: 99%

Symptomatic Nonunion After Fracture Clavicle, What Is the Functional Outcome After Open Reduction and Internal Fixation With a Curved Reconstruction Plate?

Elzohairy

2014

Zagazig University Medical Journal

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Background: Although fracture mid shaft clavicle always united with a good functional outcome, nonunion of fracture clavicle always leads to impaired shoulder joint functions with a significant disability that can cause poor functional outcome and limitations of shoulder joint activities due to pain and stiffness. Materials and Methods: From July 2005 through October 2011, twenty (20) patients (13 males and 7 females) were suffering from symptomatic nonunion of the mid-shaft clavicle (no union for more than three months). They had treated operatively in 14 patients who had suffered from the atrophic nonunion by using a curved reconstruction plate and autologous iliac bone grafting and in six patients with hypertrophic nonunion of mid-shaft clavicle fracture by using a curved reconstruction plate and "local bone grafting" from local callus, bone chips. The American Academy of Orthopedic Surgeons (AAOS) disabilities of the arm, shoulder and hand (DASH) questionnaire was used for the outcome results evaluation. Results: The patients were followed-up for an average of 15 months (range from one year to four years). All fractures were united within three months. The preoperative DASH score was varied from 80 to 70, mean (75). The postoperative DASH score was varied from, 10 to 25, mean (12.7) in our series. Functionally, this was very much acceptable. Conclusion: Based on the results of our and other studies, we recommended open reduction and internal fixation with using a curved reconstruction plate and autologous iliac bone grafting in patients whom suffering from the atrophic nonunion. For treating patients whom suffering from hypertrophic nonunion of mid-shaft clavicle fracture we recommended using a curved reconstruction plate and local bone graft as a sufficient procedure to achieve necessary union, and autologous bone graft from other sites of the body appears to be unnecessary. This successful procedure had a good functional outcome and most of the patients had promising results, as regard to return to a near normal level of function.

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“…Overall advantages of plate and screw osteosynthesis over other methods of fixation include excellent control of rotation and ability to restore the normal length of the clavicle. According to Jupiter and Leffert, 33 the apex of deformity in a clavicular non-union is superior; and a plate applied to the superior surface can act as a tension band, which enhances compression across the fracture. The high rate of success with plate fixation in various series lends support to these theoretical advantages.…”

Section: Discussionmentioning

confidence: 99%

Midshaft Clavicular Non-Unions Treated with the Herbert Cannulated Bone Screw

Proubasta

Itarte

Lamas

et al. 2004

J Orthop Surg (Hong Kong)

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Purpose. To assess an alternative technique for the treatment of midshaft non-unions of the clavicle. Methods. Five patients with symptomatic non-unions of the clavicle were treated with open reduction and intramedullary fixation by using a Herbert cannulated bone screw. Autogenous bone grafting was applied in one case and decortication in the other 4 cases. Results. Review of the clinical and radiological documentation at a mean time of 13 months (range, 9–26 months) postoperatively shows that union was achieved in all 5 cases. There were no complications related to the operation, and no patient needed removal of the implant for protrusion, loosening, or any other cause. Conclusion. Midshaft non-unions of the clavicle can be treated successfully using the Herbert cannulated bone screw, which avoids the need for a second operation to remove the implant after bone union.

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Non-union of the clavicle. Associated complications and surgical management.

Cited by 256 publications

References 0 publications

Clavicle Fracture Open Reduction Internal Fixation: Results of Modern Technique

Clavicle Fracture Open Reduction Internal Fixation: Results of Modern Technique

Symptomatic Nonunion After Fracture Clavicle, What Is the Functional Outcome After Open Reduction and Internal Fixation With a Curved Reconstruction Plate?

Midshaft Clavicular Non-Unions Treated with the Herbert Cannulated Bone Screw

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