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Clin Shoulder Elbow > Volume 19(1); 2016 > Article
Clinics in Shoulder and Elbow 2016;19(1):33-38.
DOI: https://doi.org/10.5397/cise.2016.19.1.33    Published online March 31, 2016.
Clavicle Nonunion: Matchstick Bone-grafting and Osteosynthesis
Yong Bok Park, Jae Chul Yoo, Geun Min Park, Dong Ho Kum, Mohammed Tauheed, Jeung Yeol Jeong
1Department of Orthopaedic Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.
2Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. inzaghy@naver.com
Received: 14 January 2016   • Revised: 26 January 2016   • Accepted: 28 January 2016
Abstract
BACKGROUND: This study was conducted to evaluate the surgical outcomes of plate fixation using autologous iliac bone graft shaped in the form of a matchstick in clavicle nonunion resulting from prior surgical or non-surgical management.
METHODS
From May 2005 to February 2013, 17 patients underwent surgery for clavicle nonunion. The mean age at the time of surgery was 48.8 years. The iliac bone was harvested and shaped into slivers approximately 3 cm long, which resembled matchsticks. After opening of the medullary canal, the plate and screws were applied and cancellous bone was placed at the nonunion site. Matchstick bone grafts which were longitudinally placed and encircled on the nonunion site were tied with periosteum using 3?4 stitches. Union was determined via postoperative plane X-ray. Clinical status was evaluated using the visual analogue scale score for pain, and Constant and American Shoulder Elbow Surgeon score.
RESULTS
All patients had a stable radiological union at the follow-up. The mean duration from index operation to nonunion operation was 13.2 months (7?32 months). The mean follow-up period was 20.1 months (8?56 months), and the mean duration until union was 11.2 weeks (8?16 weeks). All clinical scores were improved at the final follow-up (p<0.001). The mean segmental defect was 3.3 ± 2.6 mm (1?18 mm); and the difference in clavicular length between operative and non-operative site was 5.9 ± 6.9 mm.
CONCLUSIONS
Matchstick shaped autologous iliac bone grafting technique in clavicle nonunion is acceptable with a high union rate.
Key Words: Nonunion; Bone graft; Clavicle; Matchstick
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