Abstract

• PURPOSE : The nonunion after mid-shaft clavicular fracture is predisposed by refracture, interposition of the soft tissue, complete displacement of the fracture fragment and bony defect with comminuted fracture by the high-energy trauma. Symptomatic nonuions may need surgical treatment. The purpose of this study is to assess the functional and radiological results of the surgical treatment of the symptomatic nonunion of the clavicle. MATERIALS AND METHODS : We reviewed 10 cases of symptomatic clavicular nonunions managed with surgical treatment from January, 1994 to May, 1997. The age at operation ranged from 26 to 60 years old( average 46.5 years ). The average length of follow-up was 1.7 years( range, 1 to 3 years ). According to the scoring system of Rowe, the function of the shoulder was evaluated. RESULTS : All cases were united and radiologic union was obtained at 10.2 weeks on average after surgery. On functional result. average score on pain was 9.9 (3-12), average score on stability was 24.5 (20-25), average score on function was 21.0 (10-25). In motion, average score on abduction and forward flexion was 11.0 (7-15), average score on internal and external rotation were 3.8 (3-5), 3.3 (0-5). According to the scoring system of Rowe, excellent in 6 cases, good in 3 cases, fair in 1 case and the average of the total score were 83.8. CONCLUSION : We concluded that open reduction and internal fixation by plate or intramedullary device with autogenous bone graft could provide the relief of symptom and effective results of shoulder of shoulder function in the symptomatic nonunion of the clavicle

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