Long-term functional outcome assessment of plate fixation and autogenous bone grafting for clavicular non-union.
The aim of our study was to assess the long-term functional and radiological outcome of clavicular non-union in patients treated with open reduction and bone grafting. A total of 24 non-unions treated between 1994 and 2001 were analysed using chart and radiological review and assessed with the American Academy of Orthopaedic Surgeons (AAOS) DASH questionnaire. There were 13 males and 10 females with a mean age of 37.95 (range 21-65) years. One patient had bilateral injuries. The average time from injury to operation was 10.3 (range 4-29) months and the average follow-up post-operatively was 42.1 (range 6-75) months. All patients were treated using a dynamic compression or reconstruction plate with autogenous bone grafting. Twenty-two of the 24 non-unions eventually healed. DASH assessment indicated a higher level of disability in the treated group than found in the normal population. This only proved significant in the sub-population of patients with associated co-morbidities. We conclude that the long-term outcome results of this procedure indicate it to be a well-tolerated and successful operation in treating the disability and pain associated with clavicular non-union. Most patients return to a daily level of function close to the general population. Patients with associated co-morbidities should have these treated pre-operatively for best results.