Corrective osteotomy in symptomatic midshaft clavicular malunion using elastic stable intramedullary nails.
BACKGROUND
It is our goal to present an alternative, less invasive surgical technique for corrective osteotomy in symptomatic midshaft clavicular malunion using elastic stable intramedullary nails (ESIN) and to present our results in a consecutive patients series.


METHODS
Between January 2003 and December 2006, five patients aged between 23 and 44 years presented with a symptomatic malunion after nonoperative treatment of displaced midshaft clavicular fractures. Corrective osteotomy was performed without bone grafting.


RESULTS
The osteotomy sites united in all patients after a mean of 4.4 months. The nails were removed in all patients after 7 months. At final follow-up, DASH and Constant Scores were significantly improved compared to preoperative values. Patients were significantly more satisfied with cosmetical appearance and overall outcome. Clavicular shortening was also significantly improved. Elastic stable intramedullary nailing leads to favourable results in corrective osteotomy of malunited midshaft clavicular fractures.


CONCLUSIONS
We therefore recommend this technique for corrective osteotomy of symptomatic midshaft clavicular malunions.
Smekal
Vinzenz
V
Department of Trauma Surgery and Sports Medicine, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria. Vinzenz.Smekal@uki.at
Deml
Christian
C
Kamelger
Florian
F
Dallapozza
Christian
C
Krappinger
Dietmar
D
D000328:Adult; D002968:Clavicle / Q000293:injuries*; D004954:Esthetics; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D017759:Fractures, Malunited / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D010027:Osteotomy / Q000295:instrumentation* / Q000379:methods; D017060:Patient Satisfaction; D011859:Radiography