Treatment of midclavicular nonunion: Comparison of dynamic compression plating and low-contact dynamic compression plating techniques

In this study a comparison of patients with midclovicular nonunion, treated by a combination of internal fixation with dynamic compression plate (DCP) or lowcontact DCP (LC-DCP) and application of autogenous corticocancellous chips or sculptured graft on nonunion areas, was performed. Time to union in the patients treated with LC-DCP fixation was shorter than in those treated with DCP fixation (P < .001). Union was obtained in oil patients treated with LC-DCP fixation and in 87.5% of those treated with DCP fixation. All of those treated with LC-DCP fixation returned to their original jobs, whereas two patients treated with DCP fixation had to change jobs. According to the Disabilities of the Arm, Shoulder, and Hand functional score, at the lost follow-up visit, functional outcomes of the patients treated with LC-DCP fixation were more satisfactory (P < .001). The addition of internal fixation of the clavicle with DCP or LC-DCP to application of autogenous corticocancellous chips, or sculptured graft on nonunion areas in patients with miciclavicular nonunion, shortens the time to union, increases union rates, and provides satisfactory functional outcomes.