Department of Orthopaedic Surgery, Academic Medical Center, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.
Arch Orthop Trauma Surg. 2010 Feb;130(2):159-64. doi: 10.1007/s00402-009-0864-2. Epub 2009 Apr 2.
Pain and impaired shoulder function are the predominant symptoms of midshaft clavicle non-unions. Obtaining consolidation and improvement of shoulder function is often successfully achieved with osteosynthesis and bone grafting. Most data in the literature pertain to plate osteosynthesis, placing the plate on the subcutaneous superior aspect of the clavicle. Although union rates are generally high, most patients require hardware removal as the plate is prominent under the skin causing pain and cosmetic problems.
In the current retrospective study, we followed a cohort of 21 consecutive cases (20 patients) with a midshaft clavicular delayed or non-union, treated with anteroinferior plating using a 3.5 mm locking compression plate (LCP) for a mean of 30 months.
We operated on 10 males and 10 females with a mean age of 48.2 years (range 16-65). There was one early plate failure that needed revision. Two patients required hardware removal because of prominence of the plate. All but two patients were satisfied with the final cosmetic result. The average DASH score at follow up was 22.8.
Anteroinferior plating with a 3.5 mm LCP is a reliable and reproducible treatment of midshaft clavicular delayed and non-union regarding consolidation, function, cosmesis and reduction of second surgery.
疼痛和肩部功能障碍是锁骨中段骨不连的主要症状。通过内固定和植骨通常可以成功地实现骨愈合和肩部功能的改善。文献中的大多数数据都涉及钢板内固定，即将钢板置于锁骨的皮下上方。尽管愈合率通常较高，但大多数患者需要去除内固定物，因为钢板在皮肤下突出会导致疼痛和美容问题。
在目前的回顾性研究中，我们对 21 例（20 例患者）锁骨中段延迟或骨不连患者进行了随访，采用 3.5 毫米锁定加压钢板（LCP）进行前下侧钢板固定，平均随访时间为 30 个月。
我们共治疗了 10 例男性和 10 例女性患者，平均年龄为 48.2 岁（16-65 岁）。有 1 例早期钢板失败需要翻修。有 2 例患者因钢板突出需要取出内固定物。除 2 例患者外，所有患者均对最终美容效果满意。随访时平均 DASH 评分为 22.8。
对于锁骨中段延迟和不愈合，采用 3.5 毫米 LCP 进行前下侧钢板固定是一种可靠且可重复的治疗方法，可实现骨愈合、功能、美容和减少二次手术。
