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Mid-term outcome following revision surgery of clavicular non- and malunion using anatomic locking compression plate and iliac crest bone graft.
Beirer, Marc; Banke, Ingo J; Harrasser, Norbert; Crönlein, Moritz; Pförringer, Dominik; Huber-Wagner, Stefan; Biberthaler, Peter; Kirchhoff, Chlodwig.
Afiliação
  • Beirer M; Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstr. 22, Munich, 81675, Germany. marc.beirer@mri.tum.de.
  • Banke IJ; Clinic of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstr. 22, Munich, 81675, Germany.
  • Harrasser N; Clinic of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstr. 22, Munich, 81675, Germany.
  • Crönlein M; Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstr. 22, Munich, 81675, Germany.
  • Pförringer D; Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstr. 22, Munich, 81675, Germany.
  • Huber-Wagner S; Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstr. 22, Munich, 81675, Germany.
  • Biberthaler P; Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstr. 22, Munich, 81675, Germany.
  • Kirchhoff C; Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstr. 22, Munich, 81675, Germany.
BMC Musculoskelet Disord ; 18(1): 129, 2017 03 29.
Article em En | MEDLINE | ID: mdl-28356152
BACKGROUND: Treatment of clavicular non- and malunion is still challenging. Current surgical procedures often result in frustrating functional outcome along with high-grade subjective impairment and increased rates of revision surgery. However, the combination of biological augmentation with vital bone graft and a biomechanically sufficient fixation system seems to be a promising concept of treatment. METHODS: In this retrospective study, 14 patients with a mean age of 44 years (26-67 years) suffering from non-union (n = 11) and/or malunion (n = 3) of the clavicle were enrolled. All patients were surgically treated using an anatomical precontoured locking compression plate (LCP) and autologous iliac crest bone graft. Functional outcome was assessed using the age- and sex-specific relative Constant Score. RESULTS: Mean follow-up was 27 months (range 12-44 months). The relative Constant Score significantly improved from preoperative 61 ± 8 (43-72) to 82 ± 10 (65-100) points at the final follow-up examination (p < 0.05). All patients showed bony union radiographically. One patient presented with a re-fracture of the clavicle nearly 3 years after revision surgery and 5 weeks after implant removal. Secondary fractures at the donor site of the anterior superior iliac spine were recorded in two patients. CONCLUSIONS: Iliac crest bone graft and anatomic locking plate fixation allow for a safe and adequate stabilization and radiographical bony union in non- and malunions of the clavicle with a high degree of patient satisfaction. However, secondary fractures of the anterior superior iliac spine constitute relevant complications and the time of hardware removal should be considered carefully.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Reoperação / Placas Ósseas / Transplante Ósseo / Clavícula / Ílio Tipo de estudo: Observational_studies / Prognostic_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: BMC Musculoskelet Disord Assunto da revista: FISIOLOGIA / ORTOPEDIA Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Alemanha

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Reoperação / Placas Ósseas / Transplante Ósseo / Clavícula / Ílio Tipo de estudo: Observational_studies / Prognostic_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: BMC Musculoskelet Disord Assunto da revista: FISIOLOGIA / ORTOPEDIA Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Alemanha