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General Orthopaedics

Clavicle non-union: autologous bone graft is not a necessary augment for internal fixation

British Orthopaedic Association/Irish Orthopaedic Association Annual Congress (BOA/IOA)



Abstract

Purpose

The aim of this study was to report the outcomes of a series of patients with clavicle fracture non-union who had undergone open reduction and internal fixation using a contoured locking plate without the use of distant bone graft.

Methods

Patients were identified using the hospital database. Records were reviewed to determine basic demographics, operative findings, and radiological outcome. Patients were contacted and details about initial injury and treatment, and return to work and sport were recorded. Disabilities of Arm, Shoulder and Hand (DASH) for both operated and non-operated shoulders were completed.

Results

15 patients with at least 6 months follow-up (average 12.4) were identified. The average age was 39 years. All patients were initially treated in a broad arm sling. All fractures were fixed with a pre-contoured locking plate and all went on to achieve clinical and radiological union. The average DASH on the operated side was 14.5 and 4.2 on the contralateral. All patients had returned to work and regular sport activities. One patient required plate removal due to local irritation.

Conclusion

The results of this small series suggest that use of distant bone graft is not necessary when performing open reduction and internal fixation for symptomatic non-union of the clavicle with appropriate preparation of fracture ends and adequate fixation.