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Clin Shoulder Elbow > Volume 15(1); 2012 > Article
Clinics in Shoulder and Elbow 2012;15(1):32-36.
DOI: https://doi.org/10.5397/CiSE.2012.15.1.32    Published online June 30, 2012.
Intercalary Tricortical Iliac Bone Graft in the Surgical Treatment of Nonunion of Midshaft Clavicular Fractures
Chul Hyun Cho, Hyung Gyu Jang
Department of Orthopedic Surgery, School of Medicine, Keimyung University, Daegu, Korea. oscho5362@dsmc.or.kr
쇄골 간부 불유합에서의 개재 삼면피질 장골 이식술
조철현·장형규
계명대학교 의과대학 정형외과학교실
Abstract
PURPOSE
The purpose of this study was to evaluate the radiologic and clinical outcomes after intercalary tricortical iliac bone graft with plate fixation for the nonunion of midshaft clavicular fractures. MATERIALS AND METHODS: Between September 2007 and May 2011, 10 patients who were treated by the intercalary tricortical iliac bone graft, with plate fixation for clavicle nonunion, were studied. The mean follow-up period was 30.7 (12~57) months. After the sclerotic bone was excised to the bleeding cortical bone, we interposed the tricortical iliac bone to provide structural support and restore clavicle length, and then fixed the plate and screws. The radiologic outcomes on the serial plain radiographs and clinical outcomes, according to UCLA, ASES and Quick DASH scores, were analyzed.
RESULTS
Bony union was obtained in all cases (100%) and the average union time was 18.4 (14~24) weeks. The average respective UCLA and ASES scores improved from 16.7 and 52.1 preoperatively to 27.4 and 83.6 postoperatively (p<0.05). The average Quick DASH score was 40.5, at the final follow-up. Complications were 2 shoulder stiffness, and one case had removal of device and arthroscopic surgery at 11 months, postoperatively. There were no implant failure or infection.
CONCLUSION
Intercalary tricortical iliac bone graft, with plate fixation for the nonunion of midshaft clavicular fractures, is a good option that can provide structural support and restore clavicle length, as well as high union rate.
Key Words: Clavicle; Nonunion; Bone graft; Tricortical; Intercalary


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