Detaillierte Beitrags-Information
| Beitragstitel | The Impact of Clavicular Length Restoration in the Treatment of Non-unions of Clavicular Midshaft |
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| Beitragscode | P014 |
| Autoren | |
| Präsentationsform | Poster |
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| Abstract |
Objectives: Multiple techniques and plate positioning options are available for the treatment of clavicular non-unions. In cases of segmental bone loss and clavicular shortening of more than 20 mm, there is an ongoing debate whether autologous cortical bone grafts should be applied for restoration of clavicular length in order to improve shoulder function and outcomes. Our aim was to evaluate the impact of plating and cortical bone grafting in clavicular non-unions on length restoration and its functional outcome Methods: In a ambidirectional, bicenter study all patients treated with plate osteosynthesis and iliac bone grafting after non-unions of the clavicle were identified in the hospital information system. Patients with a minimal follow-up of 2 years were invited for a clinical examination and functional outcome scores (Constant Score [CS], Simple Shoulder Test [SST] and Subjective Shoulder Value [SSV]). Clavicle length restoration was determined by both navigation ultrasound and radiographic measurements compared to the healthy contralateral side. Results: Since 2005, a total of 46 patients met the inclusion criteria in both clinics. Twenty-five patients (54%) (mean age 57.8 years, 52% female) were available for a median follow-up of 6 years (2 to 13 years). Median functional outcomes were high with CS=82 (range 38-95), SST=12 (range 3-12), SSV=95 (range 60-100), and also the patient satisfaction (88% had >=8 on a NRS 0-10). Four patients suffered from a refracture after removal of osteosynthesis material. One case was not revised resulting in a clavicle shortening of 32mm. No other patient revealed a shortening of > 20mm. Radiographic and ultrasound measurements showed a moderate correlation (Intraclass Correlation Coefficient = 0.602) Conclusions: Treatment of clavicle non-unions with plate osteosynthesis and iliac bone grafting offers safe stabilization and adequate length restoration with good functional outcome and a high degree of patient satisfaction. key words: clavicle non-union, iliac bone crest, plate ostesynthesis, navigation ultrasound |