Partial claviculectomy after non-union of proximal clavicle fracture

Abstract

SUMMARYNon-union of a proximal clavicle fracture is rare. When it does occur, it poses a difficult problem causing severe pain and shoulder impairment that must be dealt with surgically. We report a 29-year-old woman who suffered a proximal clavicle fracture and received plate and screws fixation. Six months later, after constant pain and a diminished range of shoulder motion, she sought help at our clinic and was diagnosed with symptomatic nonunion. Reconstruction with bone graft and interosseous sutures was performed in vain as pain persisted and follow-up radiograph showed no healing. A salvage procedure with partial claviculectomy was then carried out. The patient has been pain free after 3.5 years of follow-up, a full range of motion and is quite satisfied with the cosmetics. This outcome demonstrates that claviculectomy can be used successfully in a clinical situation where restoration of clavicular non-union fails. BACKGROUND

Reconstruction of the Sternoclavicular Joint After Excessive Medial Clavicle Resection

“…Not following these recommendations could lead to failure. 21 To our knowledge, this is the first description in the literature reporting an anatomic…”

Displaced medial clavicle fractures: a systematic review of outcomes after nonoperative and operative management

“…Treatment of established nonunion of the medial end clavicle has rarely been reported but some studies suggest that successful union can be achieved with surgical plate fixation and bone grafting. 7 , 16 , 24 , 25 , 27 However, when symptomatic nonunion occurs after plate fixation, case reports have shown that partial medial claviculectomy with, 4 or without, 32 reconstruction can lead to satisfactory outcomes.…”

A novel surgical method for treating medial‑end clavicle fractures

“…However, conservative treatment of these fractures can lead to serious complications, including nonunion, malunion, and functional disability (9). With continuous improvement at the clinical level, surgical methods, including open reduction and internal fixation, partial claviculectomy, and fusion of the sternoclavicular joints, have been reported in the available literature (3,5,10,11). Due to the high rate of the postoperative complications, partial claviculectomy and fusion of the sternoclavicular joints have gradually been avoided.…”