Abstract
We analysed 20 cases of clavicular nonunions, treated by internal fixation with plate and bone
graft at the Pohang St. Marrys Hospital between 1993 and 1997. Among them, sixteen patients
had been treated with conservative method and four with surgery initially.
Radiologically, seventeen nonunions were atrophic and three hypertrophic. Interposition of
the injured soft tissue, inadequate reduction and insecure fixation were etiologic factors of
nonunion in this study. The complete unionswere achieved in eighteen by plating with iliac bone
graft and in two by intramedullary fixation with S-pin or Rush-pin each The average time for
union was 14.2 weeks. The average length of follow-up was 16.5 months. The complications
were limitation of motion in three patients and brachial plexus injury in one. Associated
symptoms of the nonunion including pain disappeared in all patients.
In this study, we discuss the cause and treatment of clavicular nonunion with specific attention
to the rigid internal fixation and the outcome of treatment. We concluded that symptomatic
nonunion of the clavicle could be treated by operation, and rigid internal fixation with plate and
bone grafts are thought to be a reliable treatment for the nonunion of the clavicle.