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DOI :10.26650/IUITFD.1438826   IUP :10.26650/IUITFD.1438826    Full Text (PDF)

MID-TERM OUTCOMES OF MID-SHAFT CLAVICULAR NONUNIONS TREATED BY PLATE FIXATION WITH AUTOLOGOUS BONE GRAFTING: DOES THE TYPE OF INITIAL TREATMENT HAVE AN INFLUENCE ON THE SURGICAL RESULTS?

Mehmet Demirel, Emre Kocazeybek, Serkan Bayram, Dağhan Koyuncu, Ali Erşen

Objective: The recent literature is scarce regarding the outcomes of mid-shaft clavicular non-union treated by open reduction and internal fixation (ORIF) with autologous bone grafting, and the influence of the type of initial treatment has not yet been investigated. The study aims: (1) to present the mid-term surgical results of mid-shaft clavicular non-unions treated by plate fixation with autologous bone grafting and (2) to determine the effect the type of initial treatment has on the surgical results.

Material and Method: The study reviews 14 patients (eight females) who’d undergone ORIF with autologous bone grafting due to atrophic mid-shaft clavicular nonunion where clinical and radiographical outcomes were recorded. The study divides the patients into two groups based on their initial treatment: Group A (eight with non-surgical treatment) and Group B (six with surgical treatment).

Result: The mean QuickDASH score at final follow-up was 22. The Constant Score significantly improved from 40 to 87 postoperatively. The mean Preoperative Visual Analogous Scale (VAS) score went down from 7 to 2 (p<0.001). A solid union was achieved in all patients. In the preoperative between-group comparison, no significant differences were observed for any of the clinical outcome. At final follow-up, Group A exhibited significantly higher Constant Scores.

Conclusion: Regardless of the type of initial treatment, plate fixation with autologous bone grafting is effective in obtaining solid fusion and improving the clinical status of patients with mid-shaft clavicular non-union. Additionally, this technique can provide shorter time to union and greater improvements in specific shoulder function in patients who’ve undergone non-surgical treatment.

Keywords: Mid-shaft clavicular non-union, initial treatment, plate fixation, autologous bone grafting
DOI :10.26650/IUITFD.1438826   IUP :10.26650/IUITFD.1438826    Full Text (PDF)

OTOLOG KEMİK GREFTİ İLE PLAK FİKSASYONU İLE TEDAVİ EDİLEN MİD-ŞAFT KLAVİKULA KAYNAMAMALARININ ORTA DÖNEM SONUÇLARI: BAŞLANGIÇ TEDAVİSİNİN TİPİNİN CERRAHİ SONUÇLARA ETKİSİ VAR MIDIR?

Mehmet Demirel, Emre Kocazeybek, Serkan Bayram, Dağhan Koyuncu, Ali Erşen

Amaç: Otolog kemik grefti ile açık redüksiyon ve internal fiksasyon (ORIF) ile tedavi edilen mid-şaft klavikula kaynamamasının sonuçlarıyla ilgili güncel literatür azdır. Bu çalışmanın amaçları şunlardı: (1) otolog kemik grefti ile plak fiksasyonu ile tedavi edilen mid-şaft klaviküler kaynamamaların orta dönem cerrahi sonuçlarını ardışık bir vaka serisinde sunmak ve (2) başlangıç tedavi yönteminin klinik sonuçlara olan etkisini araştırmaktır.

Gereç ve Yöntem: Atrofik mid-şaft klavikula kaynamaması nedeniyle otolog kemik grefti ile ORIF uygulanan 14 hasta (sekiz kadın) retrospektif olarak incelendi. Genel çalışma popülasyonunda çeşitli klinik ve radyografik sonuçlar kaydedildi. Hastalar daha sonra başlangıç tedavisinin türüne göre iki gruba ayrıldı: Grup A (sekizi cerrahi olmayan tedavi) ve Grup B (altısı cerrahi tedavi).

Bulgular: Son değerlendirmede ortalama QuickDASH skoru 22 idi. Constant skoru ameliyat sonrası 40'tan 87'ye anlamlı olarak arttı. Ameliyat öncesi ortalama görsel analog skala (VAS) skoru son değerlendirmede 7'den 2'ye (p<0,001) geriledi. Tüm hastalarda kaynama görüldü. Ameliyat öncesi dönemde gruplar arası karşılaştırmada, klinik sonuçları arasında anlamlı bir fark gözlenmedi. Son değerlendirmede gruplar arası karşılaştırmada grup A anlamlı derecede daha yüksek Constant puanları sergiledi.

Sonuç: Başlangıç tedavisinin türü ne olursa olsun, otolog kemik grefti ile plak tespiti, mid-şaft klaviküler kaynamaması olan hastalarda füzyon elde etmede ve klinik durumu iyileştirmede etkilidir. Ek olarak, bu teknik, başlangıçta konservatif tedavi gören hastalarda kaynamanın daha kısa sürede gerçekleşmesini ve spesifik omuz fonksiyonlarında daha büyük iyileşmeler sağlayabilir. 

Keywords: Mid-şaft klavikula kaynamama, başlangıç tedavisi, plak ile osteosentez, otolog kemik greftleme

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References

  • 1. McKnight B, Heckmann N, Hill JR, Pannell WC, Mostofi A, Omid R, et al. Surgical management of midshaft clavicle nonunions is associated with a higher rate of short-term complications compared with acute fractures. J Shoulder Elbow Surg 2016;25(9):1412-7. [CrossRef] google scholar
  • 2. Martetschlâger F, Gaskill TR, Millett PJ. Management of clavicle nonunion and malunion. J Shoulder Elbow Surg 2013;22(6):862-8. [CrossRef] google scholar
  • 3. Simpson SN, Jupiter JB. Clavicular nonunion and malunion: evaluation and surgical management. J Am Acad Orthop Surg 1996;4(1):1-8. [CrossRef] google scholar
  • 4. Endrizzi DP, White RR, Babikian GM, Old AB. Nonunion of the clavicle treated with plate fixation: a review of forty-seven consecutive cases. J Shoulder Elbow Surg 2008;17(6):951-3. [CrossRef] google scholar
  • 5. Marti R, Nolte P, Kerkhoffs G, Besselaar P, Schaap G. Operative treatment of mid-shaft clavicular non-union. Int Orthop. 2003;27:131-5. [CrossRef] google scholar
  • 6. Der Tavitian J, Davison J, Dias J. Clavicular fracture non-union surgical outcome and complications. Injury 2002;33(2):135-43. [CrossRef] google scholar
  • 7. Kloen P, Sorkin A, Rubel I, Helfet D. Anteroinferior plating of midshaft clavicular nonunions. J Orthop Trauma 2002;16(6):425-30. [CrossRef] google scholar
  • 8. Huang TL, Lin FH, Hsu HC. Surgical treatment for non-union of the mid-shaft clavicle using a reconstruction plate: scapular malposition is related to poor results. Injury 2009;40(3):231-5. [CrossRef] google scholar
  • 9. Bradbury N, Hutchinson J, Hahn D, Colton CL. Clavicular nonunion: 31/32 healed after plate fixation and bone grafting. Acta Orthop Scand 1996;67(4):367-70. [CrossRef] google scholar
  • 10. Petrovic I, Davila S, Premuzic I, Zdunic N, Trotic R, Prutki M. Long-term outcomes of clavicular pseudoarthrosis therapy. J Surg Res 2004;121(2):222-7. [CrossRef] google scholar
  • 11. Laursen MB, D0ssing KV. Clavicular nonunions treated with compression plate fixation and cancellous bone grafting: the functional outcome. J Shoulder Elbow Surg 1999;8(5):410-3. [CrossRef] google scholar
  • 12. Beaton DE, Wright JG, Katz JN, Group UEC. Development of the QuickDASH: comparison of three item-reduction approaches. J Bone Joint Surg Am 2005;87(5):1038-46. [CrossRef] google scholar
  • 13. Constant CR, Gerber C, Emery RJ, S0jbjerg JO, Gohlke F, Boileau P. A review of the Constant score: modifications and guidelines for its use. J Shoulder Elbow Surg 2008;17(2):355-61. [CrossRef] google scholar
  • 14. Ayik O, Demirel M, Birisik F, Ersen A, Balci HI, Sahinkaya T et al. The Effects of Tourniquet Application in Total Knee Arthroplasty on the Recovery of Thigh Muscle Strength and Clinical Outcomes. J Knee Surg 2021;34(10):1057-63. [CrossRef] google scholar
  • 15. Baker JF, Mullett H. Clavicle non-union: autologous bone graft is not a necessary augment to internal fixation. Acta Orthop Belg 2010;76:725-9. google scholar
  • 16. Beirer M, Banke IJ, Harrasser N, Crönlein M, Pförringer D, Huber-Wagner S, et al. Mid-term outcome following revision surgery of clavicular non-and malunion using anatomic locking compres-sion plate and iliac crest bone graft. BMC Musculoskelet Disord 2018;18(1):1-8. [CrossRef] google scholar

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APA

Demirel, M., Kocazeybek, E., Bayram, S., Koyuncu, D., & Erşen, A. (2024). MID-TERM OUTCOMES OF MID-SHAFT CLAVICULAR NONUNIONS TREATED BY PLATE FIXATION WITH AUTOLOGOUS BONE GRAFTING: DOES THE TYPE OF INITIAL TREATMENT HAVE AN INFLUENCE ON THE SURGICAL RESULTS?. Journal of Istanbul Faculty of Medicine, 87(3), 220-226. https://doi.org/10.26650/IUITFD.1438826


AMA

Demirel M, Kocazeybek E, Bayram S, Koyuncu D, Erşen A. MID-TERM OUTCOMES OF MID-SHAFT CLAVICULAR NONUNIONS TREATED BY PLATE FIXATION WITH AUTOLOGOUS BONE GRAFTING: DOES THE TYPE OF INITIAL TREATMENT HAVE AN INFLUENCE ON THE SURGICAL RESULTS?. Journal of Istanbul Faculty of Medicine. 2024;87(3):220-226. https://doi.org/10.26650/IUITFD.1438826


ABNT

Demirel, M.; Kocazeybek, E.; Bayram, S.; Koyuncu, D.; Erşen, A. MID-TERM OUTCOMES OF MID-SHAFT CLAVICULAR NONUNIONS TREATED BY PLATE FIXATION WITH AUTOLOGOUS BONE GRAFTING: DOES THE TYPE OF INITIAL TREATMENT HAVE AN INFLUENCE ON THE SURGICAL RESULTS?. Journal of Istanbul Faculty of Medicine, [Publisher Location], v. 87, n. 3, p. 220-226, 2024.


Chicago: Author-Date Style

Demirel, Mehmet, and Emre Kocazeybek and Serkan Bayram and Dağhan Koyuncu and Ali Erşen. 2024. “MID-TERM OUTCOMES OF MID-SHAFT CLAVICULAR NONUNIONS TREATED BY PLATE FIXATION WITH AUTOLOGOUS BONE GRAFTING: DOES THE TYPE OF INITIAL TREATMENT HAVE AN INFLUENCE ON THE SURGICAL RESULTS?.” Journal of Istanbul Faculty of Medicine 87, no. 3: 220-226. https://doi.org/10.26650/IUITFD.1438826


Chicago: Humanities Style

Demirel, Mehmet, and Emre Kocazeybek and Serkan Bayram and Dağhan Koyuncu and Ali Erşen. “MID-TERM OUTCOMES OF MID-SHAFT CLAVICULAR NONUNIONS TREATED BY PLATE FIXATION WITH AUTOLOGOUS BONE GRAFTING: DOES THE TYPE OF INITIAL TREATMENT HAVE AN INFLUENCE ON THE SURGICAL RESULTS?.” Journal of Istanbul Faculty of Medicine 87, no. 3 (Nov. 2024): 220-226. https://doi.org/10.26650/IUITFD.1438826


Harvard: Australian Style

Demirel, M & Kocazeybek, E & Bayram, S & Koyuncu, D & Erşen, A 2024, 'MID-TERM OUTCOMES OF MID-SHAFT CLAVICULAR NONUNIONS TREATED BY PLATE FIXATION WITH AUTOLOGOUS BONE GRAFTING: DOES THE TYPE OF INITIAL TREATMENT HAVE AN INFLUENCE ON THE SURGICAL RESULTS?', Journal of Istanbul Faculty of Medicine, vol. 87, no. 3, pp. 220-226, viewed 15 Nov. 2024, https://doi.org/10.26650/IUITFD.1438826


Harvard: Author-Date Style

Demirel, M. and Kocazeybek, E. and Bayram, S. and Koyuncu, D. and Erşen, A. (2024) ‘MID-TERM OUTCOMES OF MID-SHAFT CLAVICULAR NONUNIONS TREATED BY PLATE FIXATION WITH AUTOLOGOUS BONE GRAFTING: DOES THE TYPE OF INITIAL TREATMENT HAVE AN INFLUENCE ON THE SURGICAL RESULTS?’, Journal of Istanbul Faculty of Medicine, 87(3), pp. 220-226. https://doi.org/10.26650/IUITFD.1438826 (15 Nov. 2024).


MLA

Demirel, Mehmet, and Emre Kocazeybek and Serkan Bayram and Dağhan Koyuncu and Ali Erşen. “MID-TERM OUTCOMES OF MID-SHAFT CLAVICULAR NONUNIONS TREATED BY PLATE FIXATION WITH AUTOLOGOUS BONE GRAFTING: DOES THE TYPE OF INITIAL TREATMENT HAVE AN INFLUENCE ON THE SURGICAL RESULTS?.” Journal of Istanbul Faculty of Medicine, vol. 87, no. 3, 2024, pp. 220-226. [Database Container], https://doi.org/10.26650/IUITFD.1438826


Vancouver

Demirel M, Kocazeybek E, Bayram S, Koyuncu D, Erşen A. MID-TERM OUTCOMES OF MID-SHAFT CLAVICULAR NONUNIONS TREATED BY PLATE FIXATION WITH AUTOLOGOUS BONE GRAFTING: DOES THE TYPE OF INITIAL TREATMENT HAVE AN INFLUENCE ON THE SURGICAL RESULTS?. Journal of Istanbul Faculty of Medicine [Internet]. 15 Nov. 2024 [cited 15 Nov. 2024];87(3):220-226. Available from: https://doi.org/10.26650/IUITFD.1438826 doi: 10.26650/IUITFD.1438826


ISNAD

Demirel, Mehmet - Kocazeybek, Emre - Bayram, Serkan - Koyuncu, Dağhan - Erşen, Ali. “MID-TERM OUTCOMES OF MID-SHAFT CLAVICULAR NONUNIONS TREATED BY PLATE FIXATION WITH AUTOLOGOUS BONE GRAFTING: DOES THE TYPE OF INITIAL TREATMENT HAVE AN INFLUENCE ON THE SURGICAL RESULTS?”. Journal of Istanbul Faculty of Medicine 87/3 (Nov. 2024): 220-226. https://doi.org/10.26650/IUITFD.1438826



TIMELINE


Submitted17.02.2024
Accepted22.04.2024
Published Online28.05.2024

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