Clavicle nonunion: plate and graft type do not affect healing rates-a single surgeon experience with 71 cases.

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Abstract

[Indexed for MEDLINE] 3. Cureus. 2019 Aug 25;11(8):e5480. doi: 10.7759/cureus.5480. Acute Surgery vs. Non-union Surgery of Displaced Midshaft Clavicle Fractures: A Case-control Study. Marsalli M(1), Rojas JT(2), Barahona M(3). Author information: (1)Orthopaedic Department, Clínica Universidad De Los Andes, Santiago, CHL. (2)Orthopaedic Department, Hospital San José, Santiago, CHL. (3)Orthopaedic Department, Hospital Clinico Universidad De Chile, Santiago, CHL. Introduction There is a lack of information about the results of surgical treatment and complications in midshaft clavicle fracture non-unions. Our hypothesis was that there is no difference in functional outcomes between the surgical treatment of an acute displaced middle-third clavicle fracture and the surgical treatment of a chronic symptomatic non-union of a displaced middle-third clavicle fracture. Methods This was a case-control study. Fourteen cases were considered with a displaced midshaft clavicle fracture, initially treated non-surgically, but which developed symptomatic non-union and required surgical treatment. The control group was a cohort of 18 patients with a displaced midshaft clavicle fracture, who had surgical treatment in an acute setting ( 0.05). The median time to complete return to work was 3.2 months in the control group and 9.7 months in the case group (p=0.001). Hundred percent of those patients who were initially treated with surgery had bone union without other treatment. Two out of 14 cases required a second surgery with a plate and bone graft to achieve bone union. Conclusion Symptoms from displaced midshaft clavicular fracture non-unions are due to related pain and dysfunctional deficits that result from displacement and shortening. According to our study, patients with a displaced midshaft clavicle fracture non-union who needed surgery achieved similar functional results as compared to patients treated in an acute setting for a displaced midshaft clavicle fracture. The median time to discharge and return to work was more than doubled in the non-union surgery group. Copyright © 2019, Marsalli et al. DOI: 10.7759/cureus.5480 PMCID: PMC6855902