Medium-term results after total clavicle resection in cases of osteitis: a consecutive case series of five patients

• Published in: International orthopaedics 2012-04, Vol.36 (4), p.775-781
• Main Authors: Oheim, Ralf, Schulz, Arndt Peter, Schoop, Rita, Grimme, Cornelius H., Gille, Justus, Gerlach, Ulf-Joachim
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Anti-Bacterial Agents - therapeutic use; Clavicle - diagnostic imaging; Clavicle - injuries; Clavicle - surgery; Female; Humans; Length of Stay; Medicine; Medicine & Public Health; Original Paper; Orthopedics; Osteitis - drug therapy; Osteitis - pathology; Osteitis - surgery; Pain, Postoperative; Prospective Studies; Radiography; Reoperation; Treatment Outcome; Wound Healing; Young Adult
• ISSN: 0341-2695; 1432-5195
• DOI: 10.1007/s00264-011-1342-3

Purpose Claviculectomy is a rare and poorly described event in the surgical therapy of diseases of the clavicle. We present a case series and functional results of patients who underwent total claviculectomy. Methods From 1995 to 2006 a total of 26 patients diagnosed with osteitis of the clavicle underwent surgery in our unit. Of these, five patients (all female) needed a total resection of the clavicle in order to ensure permanent healing from infection. The data collection was prospective. The data gathered preoperatively and at follow-up included clinical examinations, laboratory findings, radiographs and the Constant shoulder scores. The mean follow-up period was 7.5 months. Results The surgical concept described was able to eliminate infection in all cases studied within an average hospital stay of 13.4 days (8–18 days). Only one patient showed complications; suffering from chronic pain syndrome requiring surgical revision. After total resection of the clavicle four of five patients showed very good functional results. The average Constant score showed a significant increase from 82 before surgery to 95 at follow-up. Conclusions The surgical technique described for total claviculectomy, along with the insertion of local antibiotic beads, was able to eliminate infection in every case. Good functional results and a low complication rates were observed. For good functional results and the permanent elimination of infection, adjacent joints have to be addressed, the periosteal tube should be preserved and early functional treatment is essential.