We reviewed the cases of thirty-three patients with non-union of a
clavicular fracture. The patients who seemed to have a predilection to
non-union were seven who had sustained a refracture and twenty-one who had
had severe trauma. Eleven patients had an atrophic non-union, and these
lesions were less symptomatic than the hypertrophic non-unions in the
series. Only three of the eleven patients with an atrophic non-union had an
operation, compared with sixteen of the twenty-two patients with a
hypertrophic non-union. The results in the nineteen patients who underwent
the various surgical procedures (twenty-five operations) showed that the
most successful procedure was internal fixation and bone-grafting. Even
though union was achieved in twelve patients who were surgically treated,
mild to moderate symptoms persisted in some.