This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowReprints and Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by McKee, M. D.
Right arrow Articles by Schemitsch, E. H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by McKee, M. D.
Right arrow Articles by Schemitsch, E. H.
Related Collections
Right arrow Surgical Techniques
Right arrow Shoulder
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Technorati  
What's this?
The Journal of Bone and Joint Surgery (American) 86:37-43 (2004)
© 2004 The Journal of Bone and Joint Surgery, Inc.

Midshaft Malunions of the Clavicle

Surgical Technique

Michael D. McKee, MD, FRCS(C)1, Lisa M. Wild, BScN1 and Emil H. Schemitsch, MD, FRCS(C)1

1 Upper Extremity Reconstructive Service, Division of Orthopaedics, Department of Surgery, St. Michael's Hospital and the University of Toronto, 55 Queen Street East, Suite 800, Toronto, ON M5C 1R6, Canada. E-mail address for M.D. McKee: mckeem{at}smh.toronto.on.ca

Investigation performed at the Upper Extremity Reconstructive Service, Division of Orthopaedics, Department of Surgery, St. Michael's Hospital and the University of Toronto, Toronto, Ontario, Canada

The original scientific article in which the surgical technique was presented was published in JBJS Vol. 85-A, pp. 790-7, May 2003

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

BACKGROUND:

The purpose of this study was to analyze the functional results of corrective osteotomy of a malunited clavicular fracture in patients with chronic pain, weak ness, neurologic symptoms, and dissatisfaction with the appearance of the shoulder.

METHODS:

We identified fifteen patients (nine men and six women with a mean age of thirty-seven years) who had a malunion following nonoperative treatment of a displaced midshaft fracture of the clavicle. The mean time from the injury to presentation was three years (range, one to fifteen years). Outcome scores revealed major residual deficits. The mean amount of clavicular shortening was 2.9 cm (range, 1.6 to 4.0 cm). All patients underwent corrective osteotomy of the malunion through the original fracture line and internal fixation.

RESULTS:

At the time of follow-up, at a mean of twenty months (range, twelve to forty-two months) post-operatively, the osteotomy site had united in fourteen of the fifteen patients. All fourteen patients expressed satisfaction with the result. The mean DASH (Disabilities of the Arm, Shoulder and Hand) score for all fifteen patients improved from 32 points preoperatively to 12 points at the time of follow-up (p = 0.001). The mean shortening of the clavicle improved from 2.9 to 0.4 cm (p = 0.01). There was one nonunion, and two patients had elective removal of the plate.

CONCLUSIONS:

Malunion following clavicular fracture may be associated with orthopaedic, neurologic, and cosmetic complications. In selected cases, corrective osteotomy results in a high degree of patient satisfaction and improves patient-based upper-extremity scores.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Technorati Technorati    What's this?


This article has been cited by other articles:


Home page
 JBJSHome page
Canadian Orthopaedic Trauma Society
Nonoperative Treatment Compared with Plate Fixation of Displaced Midshaft Clavicular Fractures. A Multicenter, Randomized Clinical Trial
J. Bone Joint Surg. Am., January 1, 2007; 89(1): 1 - 10.
[Abstract] [Full Text] [PDF]