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Published in: Archives of Orthopaedic and Trauma Surgery 6/2006

01-08-2006 | Case Report

Preliminary results of the use of Ilizarov fixation in clavicular non-union

Authors: B. Demiralp, A. S. Atesalp, A. Sehirlioglu, Y. Yurttas, E. Tasatan

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 6/2006

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Abstract

Although clavicular fractures are common, nonunion of clavicle is a rare complication. Clavicular nonunion that occurs due to insufficient stabilization is usually painful and necessitates operative treatment. Seven cases with oligotrophic clavicular nonunion that developed after a conservative process were treated with Ilizarov between January 2000 and December 2002. In all of them, the middle one-third of the clavicle was affected. Details of the cases regarding sex, age information, reason of fracture, previous treatment methods that were applied, nonunion area, nonunion, and duration of frame application were recorded. Two of the cases were female and five of them were male with age mean of 27.1 (19–32 years). Five of these cases had right clavicular injury and two of them had left clavicular injury. Mean nonunion duration was 18 months (range was 6–36 months). All nonunion were fixed and went through acute compression by means of Ilizarov’s external fixators without grafting. The duration between the frame application and union was mean 2.7 months (range was 2.5–3.5 months). Mean follow-up period was 31 months (range was 22–48 months). Cases were evaluated in accordance with the Constant Scoring system. They were able to return to their normal daily activities in 10–15 days. All of them regained full shoulder movement and extension ability. Patients have also been evaluated by using Dash-Score. Union existed for all patients and none of them had any complaints of pain after treatment. Since circular external fixator allows acute compression, early shoulder movements, and requires no such additional procedure as grafting, it is an alternative method which can be used in treating nonunion of clavicle.
Literature
1.
go back to reference Ballmer FT, Lambert SM, Hertel R (1998) Decortication and plate osteosynthesis for nonunion of the clavicle. J Shoulder Elbow Surg 7(6):581–585PubMedCrossRef Ballmer FT, Lambert SM, Hertel R (1998) Decortication and plate osteosynthesis for nonunion of the clavicle. J Shoulder Elbow Surg 7(6):581–585PubMedCrossRef
2.
go back to reference Boehme D, Curtis RJ, DeHaan JT et al (1991) Non-union of fractures of the mid—shaft of the clavicle. J Bone Joint Surg Am 73:1219PubMed Boehme D, Curtis RJ, DeHaan JT et al (1991) Non-union of fractures of the mid—shaft of the clavicle. J Bone Joint Surg Am 73:1219PubMed
3.
go back to reference Bradbury N, Hutchinson J, Hahn D, Colton CL (1996) Clavicular nonunion: 31/32 healed after plate fixation and bone grafting. Acta Orthop Scand 67(4):367–370PubMed Bradbury N, Hutchinson J, Hahn D, Colton CL (1996) Clavicular nonunion: 31/32 healed after plate fixation and bone grafting. Acta Orthop Scand 67(4):367–370PubMed
4.
go back to reference Connolly JF, Dehne R (1989) Nonunion of the clavicle and thoracic outlet syndrome. J Trauma 29:1127PubMed Connolly JF, Dehne R (1989) Nonunion of the clavicle and thoracic outlet syndrome. J Trauma 29:1127PubMed
5.
go back to reference Constant CR, Murley AHG (1987) A clinical method functional assessment of the shoulder. Clin Orthop 214:160–164PubMed Constant CR, Murley AHG (1987) A clinical method functional assessment of the shoulder. Clin Orthop 214:160–164PubMed
6.
go back to reference Davids PHP, Luitse JSK, Strating RP, van der Hart C (1996) Operative treatment for delayed union and nonunion of midshaft clavicular fractures: AO reconstruction plate fixation and early mobilization. J Trauma 40(6):985–986 PubMed Davids PHP, Luitse JSK, Strating RP, van der Hart C (1996) Operative treatment for delayed union and nonunion of midshaft clavicular fractures: AO reconstruction plate fixation and early mobilization. J Trauma 40(6):985–986 PubMed
7.
go back to reference Ebraheim NA, Mekhail AO, Ortho MS, Darwich M (1997) Open reduction and internal fixation with bone grafting of clavicular nonunion. J Trauma 42(4):701–704PubMedCrossRef Ebraheim NA, Mekhail AO, Ortho MS, Darwich M (1997) Open reduction and internal fixation with bone grafting of clavicular nonunion. J Trauma 42(4):701–704PubMedCrossRef
8.
go back to reference Enneking TJMQ, Hartlief MT, Fontijne PJ (1999) Rushpin fixation for midshaft clavicular nonunions. Acta Orthop Scand 70(5):514–516PubMedCrossRef Enneking TJMQ, Hartlief MT, Fontijne PJ (1999) Rushpin fixation for midshaft clavicular nonunions. Acta Orthop Scand 70(5):514–516PubMedCrossRef
9.
go back to reference Hoe-Hansen CE, Norlin R (2003) Intramedullary cancellous screw fixation for nonunion of midshaft clavicular fractures. Acta Orthop Scand 74(3):361–364PubMedCrossRef Hoe-Hansen CE, Norlin R (2003) Intramedullary cancellous screw fixation for nonunion of midshaft clavicular fractures. Acta Orthop Scand 74(3):361–364PubMedCrossRef
10.
go back to reference Jupıter JB, Leffert RD (1987) Nonunion of the clavicle: associated complications and surgical management. J Bone Joint Surg (Am) 69:753–769 Jupıter JB, Leffert RD (1987) Nonunion of the clavicle: associated complications and surgical management. J Bone Joint Surg (Am) 69:753–769
11.
go back to reference Kitsis CK, Marino AJ, Krikler SJ, birch R (2003) Late complications following clavicular fractures and their operative management. Injury Int J Care Injured 34:69–74 Kitsis CK, Marino AJ, Krikler SJ, birch R (2003) Late complications following clavicular fractures and their operative management. Injury Int J Care Injured 34:69–74
12.
go back to reference Manske DJ, Szabo RB (1985) The operative treatment of mid shaft clavicular non unions. J Bone Joint Surg 67(A):1367–1371PubMed Manske DJ, Szabo RB (1985) The operative treatment of mid shaft clavicular non unions. J Bone Joint Surg 67(A):1367–1371PubMed
13.
go back to reference Marti RK, van der Werken C (1991) The AO plate for external fixation in 12 cases. Acta Orthop Scand 62(1):60–62PubMed Marti RK, van der Werken C (1991) The AO plate for external fixation in 12 cases. Acta Orthop Scand 62(1):60–62PubMed
14.
go back to reference Marti RK, Nolte PA, Kerkhoffs GMMJ, Besselaar PP, Schaap GR (2003) Operative treatment of midshaft clavicular nonunion. Int Orthop 27:131–135PubMed Marti RK, Nolte PA, Kerkhoffs GMMJ, Besselaar PP, Schaap GR (2003) Operative treatment of midshaft clavicular nonunion. Int Orthop 27:131–135PubMed
15.
go back to reference McKee MD, Wild LM, Schemitsch EH (2003) Mıdshaft malunions of the clavicle. J Bone Joint Surg 85(A):790–797PubMed McKee MD, Wild LM, Schemitsch EH (2003) Mıdshaft malunions of the clavicle. J Bone Joint Surg 85(A):790–797PubMed
16.
go back to reference Mullaji AB, Jupiter JB (1994) Low contact dynamic compression plating of the clavicle. Injury Int J Care Injured 25:41–45 Mullaji AB, Jupiter JB (1994) Low contact dynamic compression plating of the clavicle. Injury Int J Care Injured 25:41–45
17.
go back to reference Pedersen M, Poulsen KA, Thomsen F, Kristiansen B (1994) Operative treatment of clavicular nonunion. Acta Orthop Belgica 60:303–306 Pedersen M, Poulsen KA, Thomsen F, Kristiansen B (1994) Operative treatment of clavicular nonunion. Acta Orthop Belgica 60:303–306
18.
go back to reference Poigenfürst J, Rappold G, Fischer W (1992) Plating of fresh clavicular fractures: results of 122 operations. Injury Int J Care Injured 23:337–341 Poigenfürst J, Rappold G, Fischer W (1992) Plating of fresh clavicular fractures: results of 122 operations. Injury Int J Care Injured 23:337–341
19.
go back to reference Robinson CM (1998) Fractures of the clavicle in the adult. Epidemiology and classification. J Bone Joint Surg 80(B):476–484CrossRef Robinson CM (1998) Fractures of the clavicle in the adult. Epidemiology and classification. J Bone Joint Surg 80(B):476–484CrossRef
20.
go back to reference Schuind F, Pay-Pay E, Andrianne Y, Donkerwolcke M, Rasquin C, Burny F (1988) External fixation of the clavicle for fracture or nonunion in adults. J Bone Joint Surg 70(A):692–695PubMed Schuind F, Pay-Pay E, Andrianne Y, Donkerwolcke M, Rasquin C, Burny F (1988) External fixation of the clavicle for fracture or nonunion in adults. J Bone Joint Surg 70(A):692–695PubMed
21.
go back to reference Tavitian JD, Davison JNS, Dias JJ (2002) Clavicular fracture nonunion surgical outcome and complications. Injury Int J Care Injured 33:135–143 Tavitian JD, Davison JNS, Dias JJ (2002) Clavicular fracture nonunion surgical outcome and complications. Injury Int J Care Injured 33:135–143
22.
go back to reference Wu CC, Shih CH, Chen WJ, Tai cl (1998): Treatment of clavicler aseptic nonunion: comparison of plating and intramedullary nailing techniques. J Trauma 45(3):512–516PubMed Wu CC, Shih CH, Chen WJ, Tai cl (1998): Treatment of clavicler aseptic nonunion: comparison of plating and intramedullary nailing techniques. J Trauma 45(3):512–516PubMed
Metadata
Title
Preliminary results of the use of Ilizarov fixation in clavicular non-union
Authors
B. Demiralp
A. S. Atesalp
A. Sehirlioglu
Y. Yurttas
E. Tasatan
Publication date
01-08-2006
Publisher
Springer-Verlag
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 6/2006
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-006-0137-2

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