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VOLUME 2 , ISSUE 2-3 ( December, 2007 ) > List of Articles

Original Article

Corrective osteotomy after malunion of mid shaft fractures of the clavicle

R. J. Hillen, D. Eygendaal

Keywords : Clavicle/injuries, Fractures, Malunited/complications, Osteotomy/methods

Citation Information : Hillen RJ, Eygendaal D. Corrective osteotomy after malunion of mid shaft fractures of the clavicle. 2007; 2 (2-3):59-61.

DOI: 10.1007/s11751-007-0024-6

License: CC BY-NC-SA 4.0

Published Online: 01-12-2019

Copyright Statement:  Copyright © 2007; The Author(s).


Displaced mid shaft fractures of the clavicle result in some degree of shortening and rotation. These fractures often heal with some degree of malunion which can be symptomatic. The question arises as to whether surgical correction of the deformity will relieve the symptoms associated with the malunion. Ten patients with a symptomatic malunion of the clavicle were treated by means of a corrective osteotomy with plate and screw fixation. Outcome measurement was a pre and postoperative DASH score, range of motion and patient satisfaction. At follow up after a mean duration of 37 months there was a significant improvement of the DASH score, eight patients were satisfied, and range of motion did not differ significantly. Two patients had a complication resulting from the surgical procedure.

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  1. Allman FL Jr (1967) Fractures and ligamentous injuries of the clavicle and its articulation. J Bone Joint Surg Am 49:774-784
  2. Neer CS (1984) Fractures of the clavicle. In: Rockwood CA Jr, Green DP (eds) Fractures in adults, 2nd edn. Lipincott, Philadelphia, pp 707-713
  3. Edelson JG (2003) The bony anatomy of clavicular malunions. J Shoulder Elbow Surg 12:173-178
  4. Hill JM, Mc Guire MH, Crosby LA (1997) Closed treatment of displaced middle third fractures of the clavicle gives poor results. J Bone Joint Surg 79-B:537-539
  5. Nordqvist A, Redlund-Johnell I, von Scheele A, Petersson CJ (1997) Shortening of clavicle after fracture. Acta Orthop Scand 68:349-351
  6. Eskola A, Vainionpää S, Myllynen P, Pätiälä H, Rokkanen P (1986) Outcome of clavicular fractures in 89 patients. Arch Orth Trauma 105:337-338
  7. Rowe CR (1968) An atlas of anatomy and treatment of the midclavicular fractures. Clin Orthop 58:29-42
  8. Stanley D, Norris SH (1988) Recovery following fractures of the clavicle treated conservatively. Injury 19:162-164
  9. Ledger M, Leeks N, Ackland T, Wang A (2005) Short malunions of the clavicula: an anatomic and functional study. J Shoulder Elbow Surg 14:349-354
  10. McKee MD, Wild LM, Schemitsch EH (2003) Midshaft malunions of the clavicle. J Bone Joint Surg Am 85:790-797
  11. Nowak J, Holgersson M, Larsson S (2004) Can we predict longterm sequelae after fractures of the clavicle based on initial findings. J Shoulder Elbow Surg 13:479-486
  12. Nowak J, Holgersson M, Larsson S (2005) Sequelae from clavicular fractures are common: a prospective study of 222 patients. Acta Orthop 76:496-502
  13. McKee MD, Wild LM, Schemitsch EH (2004) Midshaft malunions of the clavicle. Surgical technique. J Bone Joint Surg Am 86:37-43
  14. Hudak PL, Amadio PC, Bombardier C (1996) Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med 30:372
  15. Bosch U, Skutek M, Peters G, Tscherne H (1998) Extension osteotomy in malunited clavicularfractures. J Shoulder Elbow Surg 7:402-405
  16. Shaun Simpson N, Jupiter JB (1996) Clavicular non union and malunion: Evaluation and surgical management. J Am Acad Orth Surg 4:1-8
  17. Canadian Orthopaedic Trauma Association (2001) None operative treatment comparedwith plate fixation of displaced midshaft clavicular fractures. J Bone Joint Surg Am 89:1-10
  18. McKee MD, Wild LM, Schemitsch EH (2004) Does delaymatter? The restoration of objectively measured shoulder strength and patient-orientedoutcome after immediate fixation versus delayed reconstruction of displaced midshaftfractures of the clavicle. J Shoulder Elbow Surg 16:514-518
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