Although the clavicle is one of the most commonly fractured bone, nonunion is rare. The authors experienced 15 cases of clavicle nonunion in adult who were admitted and treated at the Department of Orthopedic Surgery of Severance Hospital during period from January 1983 to December 1990 (eight years). This study focused on the predisposing factors in relation to nonunion of clavicle and the analysis of the results after operative treatment The results of analysis wire as follows ; 1. Predisposing factors of nonunion were primary operative treatment with inadequate fixation, middle 1/3 of clavicle, severe associated injury and initial gross displacement of fracture fragment. 2. Among the 15 patients, 14 patients were treated with plate and screw fixation and autogenous iliac bone graft. One patient was treated by metal removal due to infected nonunion. 3. Using a rating scale of excellent(no apparent fractors), good(one factor), fair(two factors), poor(more than three factors), the result showed, 12 excellent, 1 good, and 2 poor 4. Amonf the is opeTative treatment, there was only one case of complication which was metal failure. It was concluded that symptomatic nonunion of the clavicle could be treated by operation. and the procedure of choice seemed to be rigid internal fixation with plate and bone graft.
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Comparison of Results in Two Operative Treatments for Clavicle Shaft Fractures in Adult: Comparison of Results between Open Reduction and Internal Fixation with the Plate and Percutaneous Reduction by Towel Clip and Intramedullary Fixation with Steinmann Sung-Sik Ha, Jae-Chun Sim, Ki-Do Hong, Jae-Young Kim, Jung-Ho Kang, Kwang-Hee Park Journal of the Korean Fracture Society.2007; 20(3): 233. CrossRef
There is no consensus on the best way to treat complicated fractures of the proximal humerus. We treated two-part surgical neck fractures which were not suitable for conservative method by semi-open reduction and Ender nailing with addition of cancellous bone graft. This method provided good three-point fixation and then early ROM exercise was possible even in case of osteoporotic or severely comminuted surgical neck fractures. Between June 1989 and February 1992, Ender nailinss were performed for two-part surgical neck fractures, and among those cases 16 were followed for more than 1 year. The results of study were as follows ; 1. All cases were treated by seml-open reduction and Ender nailing with additional cancelous bone graft. 2. Ender nails were inserted through retrograde entry in all cases. 3. Complications developed in 3 cases ; one case of proximal migration of Ender nail and two of shooter joint partlal stiffness. 4. The mean duration of radiologic bone union was postoperative 9 weeks. 5. According to Neer criteria 11 cases were good, 3 fair and 2 poor results.