Pseudarthrosis of the Clavicle

A Report of Twenty Cases

¹ Orthopaedic and Fracture Services of the Massachusetts General Hospital, Boston

Twenty ununited fractures of the clavicle have been reviewed. The factors predisposing to pseudarthrosis were severe trauma with persistent gross displacement of the fragments, primary open reduction with inadequate internal fixation, and insufficient external fixation. Fractures of the middle third of the clavicle may be more prone to non-union. If painful symptoms persist in the presence of non-union, intramedullary fixation and an onlay bone graft are indicated. An onlay iliac-bone graft fixed with screws combined with cancellous iliac bone packed between the ends would appear to give the best results. A spica or figure-of-eight plaster encasement should be used as external immobilization.

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