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  • Title: Healing and graft-site morbidity rates for midshaft clavicle nonunions treated with open reduction and internal fixation augmented with iliac crest aspiration.
    Author: Tashjian RZ, Horwitz DS.
    Journal: Am J Orthop (Belle Mead NJ); 2009 Mar; 38(3):133-6. PubMed ID: 19377646.
    Abstract:
    We conducted a study of the healing and graft-site morbidity rates for midshaft clavicle nonunions treated with open reduction and internal fixation (ORIF) augmented with iliac crest aspiration. Thirteen patients who had undergone ORIF augmented with iliac crest aspiration and tricalcium phosphate for symptomatic midshaft clavicle nonunions (5 hypertrophic, 8 atrophic) were retrospectively evaluated for nonunion healing, complications, and graft-site morbidity. No patient required intercalary allograft for severe bone loss. Ten nonunions had complete follow-up; 3 did not. Nine (90%) of the 10 with complete follow-up healed; the patient whose nonunion did not heal developed a postoperative infection. Five patients required hardware removal. No graft-site morbidity was documented. Clavicle nonunions treated with iliac crest aspirate augmentation have healing rates comparable to those of nonunions treated with autograft, as reported in the literature, and there is no graft-harvest-site morbidity.
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