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- Title
Mid-term outcome following revision surgery of clavicular non- and malunion using anatomic locking compression plate and iliac crest bone graft.
- Authors
Beirer, Marc; Banke, Ingo J.; Harrasser, Norbert; Crönlein, Moritz; Pförringer, Dominik; Huber-Wagner, Stefan; Biberthaler, Peter; Kirchhoff, Chlodwig
- Abstract
<bold>Background: </bold>Treatment of clavicular non- and malunion is still challenging. Current surgical procedures often result in frustrating functional outcome along with high-grade subjective impairment and increased rates of revision surgery. However, the combination of biological augmentation with vital bone graft and a biomechanically sufficient fixation system seems to be a promising concept of treatment.<bold>Methods: </bold>In this retrospective study, 14 patients with a mean age of 44 years (26-67 years) suffering from non-union (n = 11) and/or malunion (n = 3) of the clavicle were enrolled. All patients were surgically treated using an anatomical precontoured locking compression plate (LCP) and autologous iliac crest bone graft. Functional outcome was assessed using the age- and sex-specific relative Constant Score.<bold>Results: </bold>Mean follow-up was 27 months (range 12-44 months). The relative Constant Score significantly improved from preoperative 61 ± 8 (43-72) to 82 ± 10 (65-100) points at the final follow-up examination (p < 0.05). All patients showed bony union radiographically. One patient presented with a re-fracture of the clavicle nearly 3 years after revision surgery and 5 weeks after implant removal. Secondary fractures at the donor site of the anterior superior iliac spine were recorded in two patients.<bold>Conclusions: </bold>Iliac crest bone graft and anatomic locking plate fixation allow for a safe and adequate stabilization and radiographical bony union in non- and malunions of the clavicle with a high degree of patient satisfaction. However, secondary fractures of the anterior superior iliac spine constitute relevant complications and the time of hardware removal should be considered carefully.
- Subjects
REOPERATION; BONE grafting; BIOMECHANICS; FRACTURE fixation; OSTEORADIOGRAPHY; CLAVICLE surgery; ILIUM; CLAVICLE; LONGITUDINAL method; ORTHOPEDIC implants; TREATMENT effectiveness; RETROSPECTIVE studies; EQUIPMENT &; supplies; TRANSPLANTATION of organs, tissues, etc.
- Publication
BMC Musculoskeletal Disorders, 2017, Vol 18, p1
- ISSN
1471-2474
- Publication type
journal article
- DOI
10.1186/s12891-017-1488-2