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Title:

Mid-term outcome following revision surgery of clavicular non- and malunion using anatomic locking compression plate and iliac crest bone graft.

Document type:
Journal Article; Article
Author(s):
Beirer, Marc; Banke, Ingo J; Harrasser, Norbert; Crönlein, Moritz; Pförringer, Dominik; Huber-Wagner, Stefan; Biberthaler, Peter; Kirchhoff, Chlodwig
Abstract:
Treatment of clavicular non- and malunion is still challenging. Current surgical procedures often result in frustrating functional outcome along with high-grade subjective impairment and increased rates of revision surgery. However, the combination of biological augmentation with vital bone graft and a biomechanically sufficient fixation system seems to be a promising concept of treatment.In this retrospective study, 14 patients with a mean age of 44 years (26-67 years) suffering from non-union (n = 11) and/or malunion (n = 3) of the clavicle were enrolled. All patients were surgically treated using an anatomical precontoured locking compression plate (LCP) and autologous iliac crest bone graft. Functional outcome was assessed using the age- and sex-specific relative Constant Score.Mean follow-up was 27 months (range 12-44 months). The relative Constant Score significantly improved from preoperative 61 ± 8 (43-72) to 82 ± 10 (65-100) points at the final follow-up examination (p < 0.05). All patients showed bony union radiographically. One patient presented with a re-fracture of the clavicle nearly 3 years after revision surgery and 5 weeks after implant removal. Secondary fractures at the donor site of the anterior superior iliac spine were recorded in two patients.Iliac crest bone graft and anatomic locking plate fixation allow for a safe and adequate stabilization and radiographical bony union in non- and malunions of the clavicle with a high degree of patient satisfaction. However, secondary fractures of the anterior superior iliac spine constitute relevant complications and the time of hardware removal should be considered carefully.
Journal title abbreviation:
BMC Musculoskelet Disord
Year:
2017
Journal volume:
18
Journal issue:
1
Pages contribution:
129
Language:
eng
Fulltext / DOI:
doi:10.1186/s12891-017-1488-2
Pubmed ID:
http://view.ncbi.nlm.nih.gov/pubmed/28356152
Print-ISSN:
1471-2474
TUM Institution:
Klinik und Poliklinik für Orthopädie und Sportorthopädie; Klinik und Poliklinik für Unfallchirurgie
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