Decortication and plate osteosynthesis for nonunion of the clavicle

Between 1968 and 1995, 37 patients with ununited fractures of the clavicle were treated by decortication and plate osteosynthesis. Thirty-two (86%) we re Failures of union of fractures of the middle third. Thirty-four (92%) pa tients had post-traumatic nonunion or delayed union. Sixteen (43%) patients had undergone primary operative treatment. Autogenous cancellous bone graf t was used in 24 (65%) patients with atrophic nonunion. Nine tricortical, i liac crest, intercalary grafts were used For segmental bone loss equal to o r greater than 15 mm. At the end of treatment, union had been achieved in 3 5 (95%) cases. At a mean Follow-up of 8.6 years (range 13 months to 17 year s), 32 (86%) patients had no symptoms and had a full range of motion of the shoulder Decortication with plate osteosynthesis is a reliable, durable te chnique For the management of symptomatic, ununited fractures of the clavic le.