Functional outcome of surgical treatment of clavicle non-union

Background: Recently, the treatment of non-union of clavicle by using compressive locked plate internal fixation with bone graft is to improve the healing process without any complications. This study assessed the functional and radiologic results of fixation by locking compression plate (LC-CDP) with bone graft for the treatment of clavicular non-union.

Methods: A prospective clinical study was conducted. Two-year follow from January 2017 to December 2019 of 14 participants (5 men and 9 women) with age vary from 24 to 40 years. The demographic data, side of the fracture, injury-surgery period, clavicular non-union type, and emerge treatment were recorded. The Disabilities of the Arm, Shoulder, and Hand (DASH) score was used. The reduction and provisional fixation by smooth K wires and bone clamp, the anatomical Low-Contact Dynamic Compression Plating (LC-DCP) placed anterosuperior of the clavicle and placed 2-3 screws on both sides of the fracture, cancellous bone harvested from the iliac crest was kept.

Results: The mean age was 33.79 ± 5.75 years. The left clavicular fracture recorded more than the right side (57.1% vs 42.9%). All patients treated by open reduction and internal fixation by anatomical LC-DCP with iliac crest cancellous bone graft, and all patients committed to following up of 12 months duration. The mean DASH score show improvement from 63.16 ± 7.14 points preoperatively to 9.51 ± 2.19 points postoperatively, which was strongly statistically different (Paired t-test=29.05; 95% CI=49.65-57.63; p<0.0001). Radiographically, all fractures show fully healing and union, with no added complications, were noted.

Conclusion: We concluded that use the anatomical LC-DCP and put 2-3 screws on both sides of the fracture, in addition to cancellous bone harvested from the iliac crest, lead to gain better outcome of completely healing clavicular non-union, with no further complications related to the clavicle and their associated joints.

Keywords

clavicular non-union, clavicle fracture, LC-DCP, DASH score