Vascularized fibular grafts for salvage reconstruction of clavicle nonunion

Three cases of persistent nonunion of the clavicle with segmental bone loss were treated with autogenous, vascularized fibular grafts. In each case, t he patient presented with pain and shoulder dysfunction after an average of 3.7 procedures. Each case was characterized by segmental bone loss that fa iled to unite after treatment of clavicle nonunion by traditional means. Un ion was achieved in all 3 cases. Average follow-vp was 2.8 years. Both pain and shoulder function were improved with the procedure. To date, the use o f vascularized fibular grafts has not been described in clavicle reconstruc tion. We believe that vascularized fibular grafting may be used successfull y as a salvage procedure when traditional means of achieving union have fai led.