ArticleJournal of orthopaedic surgery and research2015
Additional bone graft accelerates healing of clavicle non-unions and improves long-term results after 8.9 years: a retrospective study.
Article in Journal of orthopaedic surgery and research, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed.
- Long-term clinical and radiological outcomes following non-union surgery: ongoing remodeling and improvement in clinical findings after five years.Journal of orthopaedic surgery and research · 2026Article
- Excellent clinical and radiological outcome of disabled upper extremity after humerus hypertrophic nonunion with implant failure in geriatric patient treated with compression plate: A case report.Trauma case reports · 2026Article
- Surgical treatment of non-unions in the ulna and radius: a one-year outcome study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Osteosynthesis using a scorpion plate and a shaped bone graft for distal clavicle nonunion with bone defect: a case report.Journal of surgical case reports · 2025Article
- Two-stage surgical management of septic pseudoarthrosis of the clavicle using a tricortical iliac crest autograft: a report of two cases.JSES reviews, reports, and techniques · 2025Article
- Step-Cut Clavicle Osteotomy and T-Shaped Iliac Crest Graft for Clavicle Nonunion Using 3-Dimensionally Planned Custom-Made Surgical Guides and Plate Fixation.Arthroscopy techniques · 2025Article
- Osteosynthesis using scorpion plate for nonunion of distal clavicle fracture with small distal bone fragment: A case report.Trauma case reports · 2023Article
- Use of Autologous Bone Graft with Bioactive Glass as a Bone Substitute in the Treatment of Large-Sized Bone Defects of the Femur and Tibia.Journal of personalized medicine · 2023Article
- Malunion of a Clavicle Fracture in a Young Adult: A Case Report and Surgical Intervention.Cureus · 2023Article
- Plate fixation using parallelogram prism iliac bone grafts for clavicle oblique nonunion with shortening deformity: a case report.BMC musculoskeletal disorders · 2023Article
- Large segmental defects in midshaft clavicle nonunion treated with autologous tricortical iliac crest bone graft.Shoulder & elbow · 2023Article
- Osteosynthesis with autologous dual bone graft for nonunion of midshaft clavicle fractures: clinical and radiological outcomes.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2022Article
- Surgical Treatment of Clavicular Fractures, Refractures, Delayed and Non-Unions Using a Resorbable, Gentamicin-Eluting Calcium Sulphate/Hydroxyapatite Biocomposite.Therapeutics and clinical risk management · 2022Article
- Addition of Bone Marrow Aspirate Concentrate Resulted in High Rate of Healing and Good Functional Outcomes in the Treatment of Clavicle Fracture Nonunion: A Retrospective Case Series.Journal of clinical medicine · 2021Article
- The treatment of the atrophic clavicular nonunion by double-plate fixation with autogenous cancellous bone graft: a prospective study.Journal of orthopaedic surgery and research · 2021Article
- Combined iliac crest graft and short-scar pectoralis major flap for clavicular non-union reconstruction.Case reports in plastic surgery & hand surgery · 2021Article
- Plating and cortical bone grafting of clavicular nonunions: clinical outcome and its relation to clavicular length restoration.JSES international · 2020Article
- Clavicular non-union treated with fixation using locking compression plate without bone graft.Journal of orthopaedic surgery and research · 2018Article
- Repair of bone defects with prefabricated vascularized bone grafts and double-labeled bone marrow-derived mesenchymal stem cells in a rat model.Scientific reports · 2017Article
- Risk profile of patients developing nonunion of the clavicle and outcome of treatment--analysis of fifty five nonunions in seven hundred and twenty nine consecutive fractures.International orthopaedics · 2016Article
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Authors and funding
11 authors.
Funding
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Abstract
backgroundClavicle non-unions can occur after both conservative and operative treatment failure. Here, we investigated the outcome of patients with delayed fracture healing or non-unions of the clavicle. Patients underwent revision surgery by plate osteosynthesis of the clavicle with or without bone grafting. Our aim was to determine rates of bone healing and the functional long-term outcome.
methodsThe study population of 58 consecutive patients was divided into group 1 (n = 25; no bone graft) and group 2 (n = 33; iliac crest bone graft). Bone consolidation was determined by the Lane-Sandhu score preoperatively and after 2.2 ± 1.8 years, respectively. The functional long-term outcome was determined after 8.9 ± 2.7 years in all available patients (n = 30) by the Constant score, DASH (Disabilities of the Arm, Shoulder and Hand) score and SF-36, and clavicle length was measured by ultrasound as compared to the healthy side.
resultsClavicle consolidation was achieved in 54 out of 58 patients (93.1%) after revision surgeries. The radiographic score and bone consolidation rates were significantly higher in group 2 (93.3%) as compared with 72% in group 1 (p = 0.02), resulting in a significantly shorter time to bone consolidation in group 2. Similarly, the relative risk for additional surgery after the first revision surgery was 4.7-fold higher in group 1 (p = 0.02). The long-term results showed overall very good results in DASH score (14.9 ± 16.5) and good results in Constant scores (77.9 ± 19.9). The group analyses found significantly better Constant scores and better visual analogue pain scale (VAS) numbers in group 2. Clavicle shortening appeared to affect the clinical results, and a mild correlation between shortening and Constant scores (R = -0.31) was found.
conclusionsThis study shows high rates of bone healing and good functional outcomes after surgical revision of clavicle non-unions and further demonstrates that additional bone graft could significantly accelerate bone healing. This indicates that revision surgery of clavicle non-unions might preferably be done with additional bone graft, even if the surgeon considers that bone healing might be achieved without bone grafting.
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