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. 2010 Feb;130(2):159-64.
doi: 10.1007/s00402-009-0864-2. Epub 2009 Apr 2.

Treatment of midshaft clavicular delayed and non-unions with anteroinferior locking compression plating

Sjoerd A Stufkens  1 , P Kloen
Affiliations

Treatment of midshaft clavicular delayed and non-unions with anteroinferior locking compression plating

Sjoerd A Stufkens et al. Arch Orthop Trauma Surg. 2010 Feb.

Abstract

Introduction: Pain and impaired shoulder function are the predominant symptoms of midshaft clavicle non-unions. Obtaining consolidation and improvement of shoulder function is often successfully achieved with osteosynthesis and bone grafting. Most data in the literature pertain to plate osteosynthesis, placing the plate on the subcutaneous superior aspect of the clavicle. Although union rates are generally high, most patients require hardware removal as the plate is prominent under the skin causing pain and cosmetic problems.

Materials and methods: In the current retrospective study, we followed a cohort of 21 consecutive cases (20 patients) with a midshaft clavicular delayed or non-union, treated with anteroinferior plating using a 3.5 mm locking compression plate (LCP) for a mean of 30 months.

Results: We operated on 10 males and 10 females with a mean age of 48.2 years (range 16-65). There was one early plate failure that needed revision. Two patients required hardware removal because of prominence of the plate. All but two patients were satisfied with the final cosmetic result. The average DASH score at follow up was 22.8.

Discussion and conclusions: Anteroinferior plating with a 3.5 mm LCP is a reliable and reproducible treatment of midshaft clavicular delayed and non-union regarding consolidation, function, cosmesis and reduction of second surgery.

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Figures

Fig. 1
Fig. 1
Postoperative AP-radiograph of a previous midshaft clavicle non-union. There is consolidation achieved with a 7-hole 3.5 mm LCP placed anteroinferiorly
Fig. 2
Fig. 2
a Postoperative conventional photograph of a patient operated on elsewhere, the plate being placed superiorly. Although the direction of the light and slenderness of the patient exaggerate the effect, still the plate will be always visible under the skin. The patient has had the plate removed. b Postoperative conventional photograph of a patient from our series with the plate placed anteroinferiorly. Note that the plate is not visible under the skin. The patient is very satisfied with the cosmetic result
See this image and copyright information in PMC

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