Operative treatment of clavicular nonunion.

Twelve patients treated for clavicular nonunion mainly with plate fixation and bone grafting were reviewed in order to evaluate the treatment. Follow-up was a median of 41 months (20-117). Nine out of 12 patients achieved a good end result, but the primary treatment failed in half of the cases, probably because of short (4-hole) semitubular plates and insufficient postoperative immobilization. We conclude that 4-hole semitubular plates cannot be recommended for treating clavicular nonunion because of a high risk of failure. Sufficient postoperative immobilization should follow plate fixation. If this is respected, plate fixation with bone grafting appears as a good method for treating clavicular nonunion.