Channel bone grafting in treatment of postoperative atrophic nonunion of clavicular fracture
10.3760/cma.j.cn115530-20210916-00415
- VernacularTitle:通道成骨技术治疗锁骨萎缩性骨不连的初步疗效观察
- Author:
Congming ZHANG
1
;
Zhong LI
;
Qian WANG
;
Teng MA
;
Hanzhong XUE
;
Liang SUN
;
Lu LIU
;
Yibo XU
;
Chengcheng ZHANG
;
Kun ZHANG
;
Dezhi WANG
;
Ning DUAN
Author Information
1. 西安交通大学附属红会医院创伤骨科医院下肢病区，西安 710054
- Keywords:
Clavicle;
Bone transplantation;
Fractures, ununited;
Channel bone grafting;
Atrophic nonunion
- From:
Chinese Journal of Orthopaedic Trauma
2022;24(2):107-113
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinic efficacy of channel bone grafting [preservation of the sclerotic bone at the broken nonunion ends and fixation with limited contact dynamic compression plate (LC-DCP)] in the treatment of postoperative atrophic nonunion of middle clavicular fracture.Methods:The 41 patients were retrospectively analyzed who had been treated at Department of Orthopaedics and Traumatology, Xi'an Hong-Hui Hospital for atrophic nonunion after internal fixation of middle clavicular fracture from June 2015 to December 2019. They were 23 males and 18 females, with a mean age of 47.6 years (from 28 to 63 years). The left side was affected in 25 cases and the right side in 16 cases. The time interval between initial fracture surgery and nonunion surgery averaged 18.5 months (from 9 to 40 months). Thirty-six cases had undergone one operation and 5 cases 2 operations before admission. The length of bone defect was measured during operation. All nonunions were treated with construction of a graft channel, iliac bone graft and LC-DCP internal fixation above the clavicle. The upper limb function of the affected side was evaluated by the Disabilities of Arm, Shoulder and Hand (DASH) 12 months after operation.Results:The 41 patients were followed up for an average of 13.6 months (from 12 to 15 months). A bone defect ≤2.0 cm was found in 25 cases and that >2.0 cm in 16 ones. Nonunion healed in all patients after an average time of 14 weeks (from 12 to 16 weeks). One patient reported continuous pain in the donor area after operation and the other developed deep venous thrombosis at the right lower limb. The DASH upper limb scores at 12 months after operation averaged 14.7.Conclusion:Channel bone grafting is a feasible clinical treatment of postoperative atrophic nonunion of middle clavicular fracture, because it preserves the sclerotic bone at the broken nonunion ends, reduces the amount of iliac bone graft and leads to fine clinic efficacy.
