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    Journal Reading: Nonunion of Fracture Clavicle

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    Khafid Asy' Ari
    This document summarizes a study on the treatment of clavicle nonunion using compression plate fixation and bone grafting. 15 patients were treated for clavicle nonunion using an operative technique involving excision of the nonunion site, compression of the clavicle fragments together using a plate, and packing the area with cancellous bone graft. All patients achieved bone union by 10 weeks on average and returned to full function and activities with pain relief and no limitations. The technique provided stable fixation while allowing early mobilization and minimizing morbidity.

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    Journal Reading: Nonunion of Fracture Clavicle

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    Khafid Asy' Ari
    28 views14 pages
    This document summarizes a study on the treatment of clavicle nonunion using compression plate fixation and bone grafting. 15 patients were treated for clavicle nonunion using an operative technique involving excision of the nonunion site, compression of the clavicle fragments together using a plate, and packing the area with cancellous bone graft. All patients achieved bone union by 10 weeks on average and returned to full function and activities with pain relief and no limitations. The technique provided stable fixation while allowing early mobilization and minimizing morbidity.

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    This document summarizes a study on the treatment of clavicle nonunion using compression plate fixation and bone grafting. 15 patients were treated for clavicle nonunion using an operative technique involving excision of the nonunion site, compression of the clavicle fragments together using a plate, and packing the area with cancellous bone graft. All patients achieved bone union by 10 weeks on average and returned to full function and activities with pain relief and no limitations. The technique provided stable fixation while allowing early mobilization and minimizing morbidity.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    28 views14 pages

    Journal Reading: Nonunion of Fracture Clavicle

    Uploaded by

    Khafid Asy' Ari
    This document summarizes a study on the treatment of clavicle nonunion using compression plate fixation and bone grafting. 15 patients were treated for clavicle nonunion using an operative technique involving excision of the nonunion site, compression of the clavicle fragments together using a plate, and packing the area with cancellous bone graft. All patients achieved bone union by 10 weeks on average and returned to full function and activities with pain relief and no limitations. The technique provided stable fixation while allowing early mobilization and minimizing morbidity.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 14

    Nonunion of Fracture Clavicle;

    Treatment by Compression Plate


    and Bone Graft
    Shabir, M. Et Durrani, Z.
    Journal reading
    Introduction
    Fracture of Clavicle
    One of most common bony injury
    Rarely require open reduction
    Usually caused by fall on shoulder or
    outstretched hand
    Classified on basis of fracture location
    Can lead to complication, particularly
    nonunion
    Introduction
    Nonunion
    Normal process of fracture repair is
    thwarted and bone fails to unite
    Divided into 2 types:
    Hypertrophic nonunion
    Atrophic nonunion
    introduction
    Causes of Nonunion
    Distraction and separation of fragments
    Excessive movement at fracture line
    A severe injury that renders local tissues
    nonviable
    Poor local blood supply
    Infection
    Introduction
    Major contributing factors to nonunion
    Severe initial trauma
    Marked initial displacement
    Shortening
    Refracture
    Open fracture
    Polytrauma
    Inadequate initial immobilization
    Introduction
    Option of management of symptomatic
    nonunion of clavicle
    Excision of the site
    Interosseous wiring with a bone graft
    Intramedullary fixation
    Interfragmentary screw fixation and
    dynamic compression platting with
    combination of cortical or cancellous auto
    graft
    Material and Methods
    They studied 15 patients treated for
    nonunion of clavicle since desember 2001
    to desember 2003
    All of patients were interviewed, examined
    in detail (ROM, grip and pinch strength,
    and width of shoulder girdle)
    They used DASH questionnaire to allow to
    record upper-limb fuction
    Operative Technique
    Incision made parallel with and just distal
    to clavicle
    Periosteum incised and elevated with
    periosteum elevator
    The site of nonunion was completely
    excised down to the bleeding bone
    The cut ends of the clavicle are
    compressed together
    Operative Technique (cont)
    Four to six hole dynamic compression
    plate is then contoured to fit the upper
    surface of clavicle
    Area around the nonunion is packed with
    cancellous bone graft from illiac crest
    The wound is closed over the drain
    Result
    The average time to union was ten weeks,
    and all patiens returned to full function and
    employment
    All had full pain relief and none had
    limitation of activities
    No patients was disstatisfied with his/her
    appearance
    None of patient had narrowing of shoulder
    girdle
    Result (cont)
    The range of shoulder movement was
    equal on both side
    Pinch-grip strengths were only slightly
    reduce on the operated side
    The DASH questionnaire confirm that no
    patient had any difficulties with shoulder-
    related activities
    Discussion
    Most closed fracture of clavicle are
    managed conservatively and often unite
    with some shortening
    Painless nonunion rarely requires
    treatment, unless neurovascular
    symptoms are present
    Partial removal of clavicle has been
    described for nonunion associated with a
    thoracic outlet syndrom and local pain
    Discussion (cont)
    Intramedullary pinning may be combined
    with cancellous bone or onlay illiac crest
    grafting, but this is difficult
    Intraosseous wiring with illiac crest bone
    graft not gives full stability

    Conclusion
    The technique of this research respect AO
    principles for the treatment of nonunion,
    allows early postoperative mobilization of
    adjecent joints, and minimize morbidity
    The lack restoration of the shoulder width
    has proved to be cosmetically acceptable
    and gives excellent function

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