Role of autologous bone graft in the surgical treatment of atrophic nonunion of midshaft clavicular fractures.
A retrospective study was conducted to evaluate the role of autologous bone graft in treating atrophic nonunion of midshaft clavicle fracture with a limited-contact dynamic compression plate (LC-DCP). Between 1995 and 2008, sixty cases of atrophic nonunion of midshaft clavicle fractures were managed with open reduction and internal fixation with an LC-DCP. The cases were separated into 2 groups to evaluate the effect of autologous bone graft in the enhancement of bone union. In group 1 (n=24), autologous bone graft was not used; in group 2 (n=36), autologous bone graft was used. Pre- and postoperative management were the same in both groups. Radiographic results and functional outcomes according to the Quick Disability of Arm, Shoulder, and Hand score were evaluated. Average follow-up was 25.2 months (range, 24-48 months).No statistically significant difference was found between the 2 groups regarding demography and preoperative functional scores (P>.05). Operative time and hospital stay were statistically significant longer in group 2 (P<.001), and donor site pain was apparent in group 2. All 60 patients had uneventful union. No statistically significant differences were found between the 2 groups regarding union time (average, 9.8 weeks in group 1 and 9.2 weeks in group 2) and postoperative functional scores (P>.05). Limited-contact dynamic compression plate fixation is an effective method for treating atrophic nonunion of midshaft clavicle fractures. Autologous bone graft was not needed.
Department of Orthopaedics & Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan.
Hui-Kuang
HK
Huang
Chao-Ching
CC
Chiang
Yu-Ping
YP
Su
Chi-Kuang
CK
Feng
Fang-Yao
FY
Chiu
Chien-Lin
CL
Liu
Tain-Hsiung
TH
Chen
D000293:Adolescent; D000328:Adult; D000368:Aged; D001284:Atrophy / Q000601:surgery; D016025:Bone Transplantation / Q000379:methods*; D002968:Clavicle / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D017759:Fractures, Malunited / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult