MID-TERM OUTCOMES OF MID-SHAFT CLAVICULAR NON-UNIONS TREATED BY PLATE FIXATION WITH AUTOLOGOUS BONE GRAFTING: DOES THE TYPE OF INITIAL TREATMENT HAVE AN INFLUENCE ON THE SURGICAL RESULTS? OTOLOG KEMİK GREFTİ İLE PLAK FİKSASYONU İLE TEDAVİ EDİLEN MİD-ŞAFT KLAVİKULA KAYNAMAMALARININ ORTA DÖNEM SONUÇLARI: BAŞLANGIÇ TEDAVİSİNİN TİPİNİN CERRAHİ SONUÇLARA ETKİSİ VAR MIDIR?


DEMİREL M., Kocazeybek E., Bayram S., Koyuncu D., Erşen A.

Istanbul Tip Fakultesi Dergisi, vol.83, no.3, pp.220-226, 2024 (ESCI) identifier identifier

  • Publication Type: Article / Article
  • Volume: 83 Issue: 3
  • Publication Date: 2024
  • Doi Number: 10.26650/iuitfd.1438826
  • Journal Name: Istanbul Tip Fakultesi Dergisi
  • Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.220-226
  • Keywords: autologous bone grafting, initial treatment, Mid-shaft clavicular non-union, plate fixation
  • Istanbul University Affiliated: Yes

Abstract

Objective: The recent literature is scarce regarding the outcomes of mid-shaft clavicular non-union treated by open reduction and internal fixation (ORIF) with autologous bone grafting, and the influence of the type of initial treatment has not yet been investigated. The study aims: (1) to present the mid-term surgical results of mid-shaft clavicular non-unions treated by plate fixation with autologous bone grafting and (2) to determine the effect the type of initial treatment has on the surgical results. Material and Method: The study reviews 14 patients (eight females) who’d undergone ORIF with autologous bone grafting due to atrophic mid-shaft clavicular nonunion where clinical and radiographical outcomes were recorded. The study divides the patients into two groups based on their initial treatment: Group A (eight with non-surgical treatment) and Group B (six with surgical treatment). Result: The mean QuickDASH score at final follow-up was 22. The Constant Score significantly improved from 40 to 87 postoperatively. The mean Preoperative Visual Analogous Scale (VAS) score went down from 7 to 2 (p<0.001). A solid union was achieved in all patients. In the preoperative between-group comparison, no significant differences were observed for any of the clinical outcome. At final follow-up, Group A exhibited significantly higher Constant Scores. Conclusion: Regardless of the type of initial treatment, plate fixation with autologous bone grafting is effective in obtaining solid fusion and improving the clinical status of patients with mid-shaft clavicular non-union. Additionally, this technique can provide shorter time to union and greater improvements in specific shoulder function in patients who’ve undergone non-surgical treatment.