title: Functional outcome of surgical treatment of symptomatic nonunion and malunion of midshaft clavicle fractures.
abstract: Disability caused by nonunited or malunited fracture of the midshaft clavicle is a rare condition that is expressed by local pain or neurovascular impairment. This condition is usually treated by reduction of the fracture and stable fixation with augmentation by autogenous bone graft. We evaluated the functional outcome in 13 patients who were treated by this method. The mean postsurgical follow-up was 41 months. In all patients, satisfactory osseous union was achieved. Only 46% of the patients returned to their previous professional and recreational activities. There was also evidence that the current Constant scores of the affected shoulders remained significantly lower than those of the normal contralateral side. Ten patients reported various degrees of pain, and only three patients were pain-free. We show that, although solid union after realignment of symptomatic nonunion or malunion of midshaft clavicle fractures is predictable, the patients can remain functionally impaired.
authors.affiliation: Nottingham Shoulder and Elbow Unit, City Hospital, Nottingham, United Kingdom.
authors.forename: Nahum
authors.initials: N
authors.lastname: Rosenberg
authors.forename: Lars
authors.initials: L
authors.lastname: Neumann
authors.forename: Angus W
authors.initials: AW
authors.lastname: Wallace
mesh_terms: D000328:Adult; D001860:Bone Plates; D016025:Bone Transplantation / Q000379:methods; D002968:Clavicle / Q000293:injuries* / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D017759:Fractures, Malunited / Q000000981:diagnostic imaging / Q000601:surgery*; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011859:Radiography; D020127:Recovery of Function; D018570:Risk Assessment; D020069:Shoulder Pain / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome