title: Corrective osteotomy in symptomatic midshaft clavicular malunion using elastic stable intramedullary nails.
abstract: 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.
authors.affiliation: Department of Trauma Surgery and Sports Medicine, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria. Vinzenz.Smekal@uki.at
authors.forename: Vinzenz
authors.initials: V
authors.lastname: Smekal
authors.forename: Christian
authors.initials: C
authors.lastname: Deml
authors.forename: Florian
authors.initials: F
authors.lastname: Kamelger
authors.forename: Christian
authors.initials: C
authors.lastname: Dallapozza
authors.forename: Dietmar
authors.initials: D
authors.lastname: Krappinger
mesh_terms: 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