{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:36:22Z","timestamp":1787754982144,"version":"build-2784847793"},"reference-count":64,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Surgical repair of clavicle fractures is being employed more frequently, although most fractures are still treated conservatively. Both can result in nonunion. Current treatments for clavicle nonunion include open reduction with internal fixation (ORIF) plating without bone graft, ORIF plating with bone graft, and intramedullary pin fixation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We performed a systematic review and meta-analysis of studies reporting outcome, complication, and reoperation rates following surgical treatment for clavicle nonunion. Subgroup analysis was undertaken for outcome and complication rates between single plating and intramedullary pin fixation, bone graft use, and nonunion time length definition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Fifty-three studies met inclusion criteria (1,258 clavicle nonunions). Mean clinical follow-up was 2.6 years. Seventy-two percent of nonunions were of the middle third, 1% were proximal third, 12% were distal third, and 15% were not reported. Forty-eight percent of nonunions were atrophic or oligotrophic and 17% were hypertrophic (35% not reported). Mean time to union was 13.6 weeks. Ninety-five percent of patients achieved union after the primary nonunion surgery. Overall complication rate was 17%. Single-plating fixation had significantly faster union time (15.2 vs. 19.8 weeks), lower reoperation rate (23% vs. 37%), and hardware removal rate (20% vs. 34%) than intramedullary pin fixation. Bone graft had significantly lower rates of delayed union (0.6% vs. 3.6%) but higher complication (15% vs. 8%) and reoperation rates (29% vs. 14%) than the other groups. Studies that defined nonunion after 3 months had significantly faster union times than the 6-month studies (13 vs. 16 weeks). The 3-month group had a significantly lower overall complication rate (12% vs. 25%) and hardware\/fixation failure rate (3% vs. 5.5%) than the 6-month group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This systematic review is the largest report of complications, reoperations, and patient outcomes of clavicle nonunions after surgical intervention in the current literature. Plating showed faster time to union and lower reoperation rates than intramedullary pin fixation. Bone graft use showed lower rates of delayed union but substantially higher rates of complications and reoperations. Reports with a definition of nonunion at 3 months showed faster union times and lower complication rates compared to reports with a definition of nonunion that was 6 months or greater. Surgery could be considered at 3 months post-injury in cases of symptomatic non-united clavicle fracture, and plating results in reliable outcomes. Adjuvant bone grafting requires further study to determine its value and risk\/benefit ratio.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      <jats:underline>Level IV<\/jats:underline>\n                      , Systematic Review. See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.rvw.22.00171","type":"journal-article","created":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T16:07:48Z","timestamp":1675267668000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":12,"title":["Complications and Outcomes After Surgical Intervention in Clavicular Nonunion"],"prefix":"10.2106","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5390-3447","authenticated-orcid":false,"given":"Thomas","family":"Yetter","sequence":"first","affiliation":[{"name":"John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2047-2462","authenticated-orcid":false,"given":"Jacob","family":"Harper","sequence":"additional","affiliation":[{"name":"John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9751-4662","authenticated-orcid":false,"given":"Paul J.","family":"Weatherby","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Rehabilitation, The University of Texas Medical Branch, Galveston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7272-5922","authenticated-orcid":false,"given":"Jeremy S.","family":"Somerson","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Rehabilitation, The University of Texas Medical Branch, Galveston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,1]]},"reference":[{"issue":"17","key":"r1-20240731","doi-asserted-by":"crossref","first-page":"1576","DOI":"10.2106\/JBJS.L.00307","article-title":"Open reduction and plate fixation versus nonoperative treatment for displaced midshaft clavicular fractures: a multicenter, randomized, controlled trial","volume":"95","author":"Robinson","year":"2013","journal-title":"J Bone Joint Surg Am"},{"issue":"3","key":"r2-20240731","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1007\/s00068-019-01122-4","article-title":"Clavicle fractures in adults; current concepts","volume":"46","author":"Frima","year":"2020","journal-title":"Eur J Trauma Emerg Surg"},{"issue":"7","key":"r3-20240731","doi-asserted-by":"crossref","first-page":"1359","DOI":"10.2106\/00004623-200407000-00002","article-title":"Estimating the risk of nonunion following nonoperative treatment of a clavicular fracture","volume":"86","author":"Robinson","year":"2004","journal-title":"J Bone Joint Surg Am"},{"issue":"7","key":"r4-20240731","doi-asserted-by":"crossref","first-page":"392","DOI":"10.5435\/00124635-201107000-00002","article-title":"Management of distal clavicle fractures","volume":"19","author":"Banerjee","year":"2011","journal-title":"J Am Acad Orthop Surg"},{"issue":"3","key":"r5-20240731","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1007\/s00402-018-3075-x","article-title":"Which lateral clavicle fractures can be treated by an arthroscopic-assisted endobutton procedure? An analysis of risk factors","volume":"139","author":"Kuner","year":"2019","journal-title":"Arch Orthop Trauma Surg"},{"issue":"4","key":"r6-20240731","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1007\/s007760050103","article-title":"Reconstruction plate fixation with bone graft for mid-shaft clavicular non-union in semi-professional athletes","volume":"4","author":"Wentz","year":"1999","journal-title":"J Orthop Sci"},{"issue":"4","key":"r7-20240731","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1016\/j.jse.2008.11.011","article-title":"Novel method to treat sterno-clavicular joint instability and medial clavicle fracture symptomatic nonunion","volume":"18","author":"Al-Yassari","year":"2009","journal-title":"J Shoulder Elbow Surg"},{"issue":"2","key":"r8-20240731","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/S0020-1383(01)00069-9","article-title":"Clavicular fracture non-union surgical outcome and complications","volume":"33","author":"Der Tavitian","year":"2002","journal-title":"Injury"},{"issue":"7","key":"r9-20240731","doi-asserted-by":"crossref","first-page":"e1000097","DOI":"10.1371\/journal.pmed.1000097","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"6","author":"Moher","year":"2009","journal-title":"PLoS Med"},{"issue":"12","key":"r10-20240731","doi-asserted-by":"crossref","first-page":"2632","DOI":"10.2106\/00004623-200512000-00006","article-title":"Level of evidence in orthopaedic journals","volume":"87","author":"Obremskey","year":"2005","journal-title":"J Bone Joint Surg Am"},{"issue":"20","key":"r11-20240731","doi-asserted-by":"crossref","first-page":"4749","DOI":"10.3390\/jcm10204749","article-title":"Addition of bone marrow aspirate concentrate resulted in high rate of healing and good functional outcomes in the treatment of clavicle fracture nonunion: a retrospective case series","volume":"10","author":"Benshabat","year":"2021","journal-title":"J Clin Med"},{"issue":"1","key":"r12-20240731","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1007\/s00590-021-02904-6","article-title":"Osteosynthesis with autologous dual bone graft for nonunion of midshaft clavicle fractures: clinical and radiological outcomes","volume":"32","author":"Lim","year":"2022","journal-title":"Eur J Orthop Surg Traumatol"},{"issue":"4","key":"r13-20240731","first-page":"243","article-title":"Clavicle nonunion repair: what can patients expect?","volume":"78","author":"Fisher","year":"2020","journal-title":"Bull Hosp Jt Dis (2013)"},{"issue":"2","key":"r14-20240731","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.jse.2019.06.022","article-title":"Plate fixation of clavicle fractures: comparison between early and delayed surgery","volume":"29","author":"Kluijfhout","year":"2020","journal-title":"J Shoulder Elbow Surg"},{"issue":"3","key":"r15-20240731","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1016\/j.jseint.2020.04.002","article-title":"Plating and cortical bone grafting of clavicular nonunions: clinical outcome and its relation to clavicular length restoration","volume":"4","author":"Hollo","year":"2020","journal-title":"JSES Int"},{"issue":"3","key":"r16-20240731","doi-asserted-by":"crossref","first-page":"459","DOI":"10.4103\/ortho.IJOrtho_702_17","article-title":"Hyaluronic acid-based mesh add-on iliac autograft improves bone healing and functional outcomes in atrophic nonunion of clavicular midshaft: a 2-year followup","volume":"53","author":"Kir","year":"2019","journal-title":"Indian J Orthop"},{"issue":"1","key":"r17-20240731","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1186\/s13018-018-1015-7","article-title":"Clavicular non-union treated with fixation using locking compression plate without bone graft","volume":"13","author":"Chen","year":"2018","journal-title":"J Orthop Surg Res"},{"issue":"6","key":"r18-20240731","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1007\/s00590-018-2174-2","article-title":"Complications associated with plate fixation of acute midshaft clavicle fractures versus non-unions","volume":"28","author":"Sawalha","year":"2018","journal-title":"Eur J Orthop Surg Traumatol"},{"issue":"1","key":"r19-20240731","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1186\/s12891-017-1488-2","article-title":"Mid-term outcome following revision surgery of clavicular non- and malunion using anatomic locking compression plate and iliac crest bone graft","volume":"18","author":"Beirer","year":"2017","journal-title":"BMC Musculoskelet Disord"},{"issue":"suppl 3","key":"r20-20240731","doi-asserted-by":"crossref","first-page":"S60","DOI":"10.1016\/S0020-1383(17)30660-5","article-title":"Clavicle aseptic nonunion: is there a place for cortical allogenic strut graft?","volume":"48","author":"Rollo","year":"2017","journal-title":"Injury"},{"issue":"6","key":"r21-20240731","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1016\/j.otsr.2017.03.021","article-title":"Functional recovery following early mobilization after middle third clavicle osteosynthesis for acute fractures or nonunion: a case-control study","volume":"103","author":"L\u00e4dermann","year":"2017","journal-title":"Orthop Traumatol Surg Res"},{"issue":"11","key":"r22-20240731","doi-asserted-by":"crossref","first-page":"2339","DOI":"10.1007\/s00264-016-3262-8","article-title":"Comparative study suggests that human bone morphogenetic proteins have no influence on the outcome of operative treatment of aseptic clavicle non-unions","volume":"40","author":"von R\u00fcden","year":"2016","journal-title":"Int Orthop"},{"key":"r23-20240731","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s13018-014-0143-y","article-title":"Additional bone graft accelerates healing of clavicle non-unions and improves long-term results after 8.9 years: a retrospective study","volume":"10","author":"Schnetzke","year":"2015","journal-title":"J Orthop Surg Res"},{"issue":"2","key":"r24-20240731","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.otsr.2013.09.011","article-title":"Outcomes from surgical treatment of middle-third clavicle fractures non-union in adults: a series of 21 cases","volume":"100","author":"Faraud","year":"2014","journal-title":"Orthop Traumatol Surg Res"},{"issue":"2","key":"r25-20240731","doi-asserted-by":"crossref","first-page":"E14","DOI":"10.1097\/TA.0b013e31822fb987","article-title":"Osteosynthesis of symptomatic nonunions of type ii fractures of the distal clavicle using modified locking t-plate and bone grafting","volume":"72","author":"Kang","year":"2012","journal-title":"J Trauma Acute Care Surg"},{"issue":"2","key":"r26-20240731","doi-asserted-by":"crossref","first-page":"e197","DOI":"10.3928\/01477447-20120123-16","article-title":"Role of autologous bone graft in the surgical treatment of atrophic nonunion of midshaft clavicular fractures","volume":"35","author":"Huang","year":"2012","journal-title":"Orthopedics"},{"issue":"5","key":"r27-20240731","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/j.jcma.2012.04.003","article-title":"The role of autologous bone graft in surgical treatment of hypertrophic nonunion of midshaft clavicle fractures","volume":"75","author":"Huang","year":"2012","journal-title":"J Chin Med Assoc"},{"issue":"3","key":"r28-20240731","doi-asserted-by":"crossref","first-page":"61","DOI":"10.4103\/0973-6042.86232","article-title":"Open reduction and internal fixation of clavicular nonunions with allograft bone substitute","volume":"5","author":"Riggenbach","year":"2011","journal-title":"Int J Shoulder Surg"},{"issue":"6","key":"r29-20240731","first-page":"725","article-title":"Clavicle non-union: autologous bone graft is not a necessary augment to internal fixation","volume":"76","author":"Baker","year":"2010","journal-title":"Acta Orthop Belg"},{"issue":"2","key":"r30-20240731","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1007\/s00402-009-0864-2","article-title":"Treatment of midshaft clavicular delayed and non-unions with anteroinferior locking compression plating","volume":"130","author":"Stufkens","year":"2010","journal-title":"Arch Orthop Trauma Surg"},{"issue":"2","key":"r31-20240731","first-page":"439","article-title":"Locking compression plate in long standing clavicular nonunions with poor bone stock","volume":"64","author":"Khan","year":"2008","journal-title":"J Trauma"},{"issue":"1","key":"r32-20240731","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1097\/BTE.0b013e31802d7567","article-title":"The treatment of midshaft clavicle nonunion with bone defect","volume":"8","author":"von Unger","year":"2007","journal-title":"Tech Shoulder Elbow Surg"},{"issue":"2","key":"r33-20240731","first-page":"170","article-title":"Plate fixation of clavicle fractures: a comparative study between reconstruction plate and dynamic compression plate","volume":"73","author":"Shahid","year":"2007","journal-title":"Acta Orthop Belg"},{"issue":"5","key":"r34-20240731","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1016\/j.jse.2006.12.002","article-title":"Functional outcome of surgical treatment of symptomatic nonunion and malunion of midshaft clavicle fractures","volume":"16","author":"Rosenberg","year":"2007","journal-title":"J Shoulder Elbow Surg"},{"issue":"10","key":"r35-20240731","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1097\/01.bot.0000249434.57571.29","article-title":"Anterior-inferior plate fixation of middle-third fractures and nonunions of the clavicle","volume":"20","author":"Collinge","year":"2006","journal-title":"J Orthop Trauma"},{"issue":"6","key":"r36-20240731","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/S0020-1383(03)00239-0","article-title":"Long-term functional outcome assessment of plate fixation and autogenous bone grafting for clavicular non-union","volume":"35","author":"O'Connor","year":"2004","journal-title":"Injury"},{"issue":"4","key":"r37-20240731","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1016\/j.jse.2004.01.033","article-title":"Treatment of midclavicular nonunion: comparison of dynamic compression plating and low-contact dynamic compression plating techniques","volume":"13","author":"Kabak","year":"2004","journal-title":"J Shoulder Elbow Surg"},{"key":"r38-20240731","first-page":"193","article-title":"Non-union of fractures of clavicle","volume":"25","author":"Tuncel","year":"2003","journal-title":"Erciyes Tip Dergisi"},{"issue":"6","key":"r39-20240731","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1097\/00005131-200207000-00011","article-title":"Anteroinferior plating of midshaft clavicular nonunions","volume":"16","author":"Kloen","year":"2002","journal-title":"J Orthop Trauma"},{"issue":"3","key":"r40-20240731","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1097\/00005373-199809000-00014","article-title":"Treatment of clavicular aseptic nonunion: comparison of plating and intramedullary nailing techniques","volume":"45","author":"Wu","year":"1998","journal-title":"J Trauma"},{"issue":"6","key":"r41-20240731","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1097\/00005373-199606000-00021","article-title":"Operative treatment for delayed union and nonunion of midshaft clavicular fractures: AO reconstruction plate fixation and early mobilization","volume":"40","author":"Davids","year":"1996","journal-title":"J Trauma"},{"issue":"5","key":"r42-20240731","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1016\/S1058-2746(95)80017-4","article-title":"Treatment of midshaft clavicular nonunion with plate fixation and autologous bone grafting","volume":"4","author":"Olsen","year":"1995","journal-title":"J Shoulder Elbow Surg"},{"key":"r43-20240731","doi-asserted-by":"crossref","first-page":"482","DOI":"10.2174\/1874325001206010482","article-title":"Intramedullary fixation of diaphyseal clavicle fractures using the Rockwood clavicle pin: review of 86 cases","volume":"6","author":"Marlow","year":"2012","journal-title":"Open Orthop J"},{"issue":"3","key":"r44-20240731","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1177\/230949901202000306","article-title":"Tension band wiring versus Knowles pinning for non-union of type-2 distal clavicle fractures","volume":"20","author":"Wu","year":"2012","journal-title":"J Orthop Surg (Hong Kong)"},{"issue":"5","key":"r45-20240731","doi-asserted-by":"crossref","first-page":"514","DOI":"10.3109\/17453679909000991","article-title":"Rushpin fixation for midshaft clavicular nonunions: good results in 13\/14 cases","volume":"70","author":"Enneking","year":"1999","journal-title":"Acta Orthop Scand"},{"issue":"2","key":"r46-20240731","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1097\/00005131-199404000-00002","article-title":"Midshaft clavicle nonunions treated with intramedullary Steinman pin fixation and onlay bone graft","volume":"8","author":"Capicotto","year":"1994","journal-title":"J Orthop Trauma"},{"issue":"8","key":"r47-20240731","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.2106\/00004623-199173080-00012","article-title":"Non-union of fractures of the mid-shaft of the clavicle. Treatment with a modified Hagie intramedullary pin and autogenous bone-grafting","volume":"73","author":"Boehme","year":"1991","journal-title":"J Bone Joint Surg Am"},{"issue":"1","key":"r48-20240731","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/s13018-020-02154-y","article-title":"The treatment of the atrophic clavicular nonunion by double-plate fixation with autogenous cancellous bone graft: a prospective study","volume":"16","author":"Zhang","year":"2021","journal-title":"J Orthop Surg Res"},{"issue":"8","key":"r49-20240731","first-page":"e5480","article-title":"Acute surgery vs. non-union surgery of displaced midshaft clavicle fractures: a case-control study","volume":"11","author":"Marsalli","year":"2019","journal-title":"Cureus"},{"issue":"11","key":"r50-20240731","doi-asserted-by":"crossref","first-page":"1521","DOI":"10.1007\/s00402-016-2489-6","article-title":"Plate fixation and bone grafting of distal clavicle nonunions: radiologic and functional outcomes","volume":"136","author":"Villa","year":"2016","journal-title":"Arch Orthop Trauma Surg"},{"issue":"6","key":"r51-20240731","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/S1479-666X(07)80085-0","article-title":"The treatment of non-union of the clavicle with the ao mini external fixator","volume":"5","author":"Lodhi","year":"2007","journal-title":"Surgeon"},{"issue":"3","key":"r52-20240731","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1080\/00016470308540853","article-title":"Intramedullary cancellous screw fixation for nonunion of midshaft clavicular fractures","volume":"74","author":"Hoe-Hansen","year":"2003","journal-title":"Acta Orthop Scand"},{"issue":"6","key":"r53-20240731","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1007\/s00402-006-0137-2","article-title":"Preliminary results of the use of Ilizarov fixation in clavicular non-union","volume":"126","author":"Demiralp","year":"2006","journal-title":"Arch Orthop Trauma Surg"},{"issue":"11","key":"r54-20240731","doi-asserted-by":"crossref","first-page":"2570","DOI":"10.1016\/j.jse.2021.03.151","article-title":"Functional outcomes and complications following combined locking plate and tunneled suspensory device fixation of lateral-end clavicle nonunions","volume":"30","author":"Robinson","year":"2021","journal-title":"J Shoulder Elbow Surg"},{"issue":"2","key":"r55-20240731","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1097\/01.bot.0000197548.84296.2f","article-title":"Modification of the Ilizarov external fixator for aseptic hypertrophic nonunion of the clavicle: an option for treatment","volume":"20","author":"Tomi\u0107","year":"2006","journal-title":"J Orthop Trauma"},{"issue":"3","key":"r56-20240731","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1016\/j.jse.2020.06.035","article-title":"Clavicle nonunion: plate and graft type do not affect healing rates-a single surgeon experience with 71 cases","volume":"30","author":"Wiss","year":"2021","journal-title":"J Shoulder Elbow Surg"},{"issue":"3","key":"r57-20240731","first-page":"303","article-title":"Operative treatment of clavicular nonunion","volume":"60","author":"Pedersen","year":"1994","journal-title":"Acta Orthop Belg"},{"issue":"4","key":"r58-20240731","doi-asserted-by":"crossref","first-page":"366","DOI":"10.3109\/17453678608994413","article-title":"Surgery for ununited clavicular fracture","volume":"57","author":"Eskola","year":"1986","journal-title":"Acta Orthop Scand"},{"issue":"3","key":"r59-20240731","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1007\/s00264-016-3120-8","article-title":"Risk profile of patients developing nonunion of the clavicle and outcome of treatment: analysis of fifty five nonunions in seven hundred and twenty nine consecutive fractures","volume":"40","author":"Ban","year":"2016","journal-title":"Int Orthop"},{"issue":"3","key":"r60-20240731","first-page":"133","article-title":"Healing and graft-site morbidity rates for midshaft clavicle nonunions treated with open reduction and internal fixation augmented with iliac crest aspiration","volume":"38","author":"Tashjian","year":"2009","journal-title":"Am J Orthop (Belle Mead NJ)"},{"issue":"2","key":"r61-20240731","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/j.jss.2004.04.007","article-title":"Long-term outcomes of clavicular pseudoarthrosis therapy","volume":"121","author":"Petrovic","year":"2004","journal-title":"J Surg Res"},{"issue":"1","key":"r62-20240731","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1177\/230949900401200113","article-title":"Midshaft clavicular non-unions treated with the herbert cannulated bone screw","volume":"12","author":"Proubasta","year":"2004","journal-title":"J Orthop Surg (Hong Kong)"},{"key":"r63-20240731","doi-asserted-by":"crossref","DOI":"10.1016\/j.injury.2022.09.055","article-title":"Intramedullary nailing versus plating fixation for the treatment of midshaft clavicular fractures: a meta-analysis of randomized controlled trials","author":"Zhao","year":"2022","journal-title":"Injury"},{"issue":"11","key":"r64-20240731","doi-asserted-by":"crossref","first-page":"3200","DOI":"10.1016\/j.injury.2021.09.008","article-title":"Definition of long-bone nonunion: a scoping review of prospective clinical trials to evaluate current practice","volume":"52","author":"Wittauer","year":"2021","journal-title":"Injury"}],"container-title":["JBJS Reviews"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.RVW.22.00171","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:35:48Z","timestamp":1787751348000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.RVW.22.00171"}},"subtitle":["A Systematic Review"],"short-title":[],"issued":{"date-parts":[[2023,1]]},"references-count":64,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.rvw.22.00171","relation":{},"ISSN":["2329-9185"],"issn-type":[{"value":"2329-9185","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1]]}}}