Journal of Musculoskeletal Trauma

Original Articles

Interpositional tricortical iliac bone graft in nonunion of midshaft clavicular fractures: Eun-Seok Son, Bum-Soon Park, Chang-Jin Yon, Chul-Hyun Cho; J Musculoskelet Trauma 2025;38(1):23-31. Published online January 24, 2025; DOI: https://doi.org/10.12671/jmt.2025.00004

Abstract PDF: Background
The purpose of this study was to investigate the radiological and clinical outcomes after interpositional tricortical iliac bone graft with plate fixation for the nonunion of clavicle midshaft fractures. Methods: Between 2007 and 2020, 17 cases who were treated by interpositional tricortical iliac bone graft with plate fixation for the clavicle midshaft nonunion combined with bone defect were investigated. The mean age was 53 years (range, 22–70 years). The mean follow-up period was 102.2 months (range, 18–193 months). Serial plain radiographs were used to evaluate radiological outcomes. The University of California, Los Angeles (UCLA) score, American Shoulder and Elbow Surgeons (ASES) score, and Quick-disabilities of the arm, shoulder, and hand (DASH) score were used to evaluate clinical outcomes. Complications were also evaluated. Results: All cases achieved complete bony union with mean healing time of 17.6 weeks (range, 14–22 weeks). The mean clavicle length difference was significantly decreased from 9.1 mm preoperatively to 2.6 mm postoperatively (P<0.001). The mean UCLA and ASES scores were significantly improved from 18.1 and 52.2 before surgery to 30.6 and 88.6 after surgery (both P<0.001), respectively. The mean final Quick-DASH score was 18.0. Three cases (17.6%) developed postoperative complications including two cases of shoulder stiffness and one case of screw irritation. Conclusions: Interpositional tricortical iliac bone graft with plate fixation for the clavicle midshaft nonunion demonstrated excellent radiological and clinical outcomes. In cases of atrophic nonunion combined with bone defect, this technique is an effective option that can provide structural support and restore clavicle length. Level of evidence: Level IV, case series.

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Comparison of Plate Versus Threaded K-wire for Fixation of Midshaft Clavicular Fractures: Young Jin Ko, Chul Hyun Park, Oog Jin Shon, Jae Sung Seo; J Korean Fract Soc 2012;25(2):123-128. Published online April 30, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.2.123

PURPOSE
To compare clinical outcomes of the plate and threaded K-wire for fixation of midshaft clavicular fractures.
MATERIALS AND METHODS
From 2005 Jan to 2009 May, medical records of 18 patients who underwent open reduction and internal fixation with plate (group 1) and 13 others who underwent intramedullary fixation with threaded K-wire (group 2) were reviewed. The mean follow up periods were 21.9 and 18.9months. The Functional results were evaluated with The Disabilities of the Arm, Shoulder and Hand (DASH) score and Constant shoulder score. The statistical evaluation was assessed with Paired T-test, Chi-square test.
RESULTS
The DASH score were 11.5+/-2.7 in group 1 and 12.4+/-4.3 in group 2. The constant shoulder score were 92.0+/-3.1 in group 1 and 87.1+/-2.8 in group 2. Length of surgical wound (cm) were 10.6+/-3.4 in group 1 and 4.8+/-1.5 in group 2. Postoperative pain and range of motion change were superior in group 1.
CONCLUSION
There was no significant difference between the two groups in functional and radiological results. But, there were patient's complaints about length of surgical wound in group 1 and hardware irritation in group 2.

Citations

Citations to this article as recorded by

A Comparison between Minimally Invasive Percutaneous Plate Osteosynthesis and Plate Fixation in the Treatment of Clavicle Midshaft Fracture
Seong-Ho Yoo, Suk-Woong Kang, Bu-Hwan Kim, Moo-Ho Song, Yeong-Joon Kim, Gyu-Taek Park, Chang-Hun Kwack
Journal of the Korean Orthopaedic Association.2017; 52(1): 1. CrossRef
Plate fixation versus intramedullary fixation for midshaft clavicle fractures: Meta-analysis of complications and functional outcomes
Hao Xiao, Hengbo Gao, Tuokang Zheng, Jianhui Zhao, Yingping Tian
Journal of International Medical Research.2016; 44(2): 201. CrossRef
Meta-analysis of plate fixation versus intramedullary fixation for the treatment of mid-shaft clavicle fractures
Bing Zhang, Yanbin Zhu, Fei Zhang, Wei Chen, Ye Tian, Yingze Zhang
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.2015;[Epub] CrossRef

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