Osteosynthesis using a scorpion plate and a shaped bone graft for distal clavicle nonunion with bone defect: a case report

Unstable distal clavicle fractures often develop symptomatic nonunion following conservative treatment; however, cases in which bone defect occurs at the site of nonunion are rare. We report a case of distal clavicle nonunion with a bone defect that was treated with osteosynthesis using a scorpion plate and a shaped bone graft. A 66-year-old man presented with symptomatic distal clavicle nonunion sustained 5 months earlier. We reduced the fracture fragments, revealing a bone defect at the nonunion site. We harvested a bicortical iliac bone graft with a triangular column shape to match the shape of the bone defect and used a scorpion plate for fixation. Postoperatively, bone union and the satisfactory functional outcomes were achieved. Thus, our technique is advantageous in cases of distal clavicle nonunion with bone defect. Using the scorpion plate enabled fixation of the bone graft without further fragmentation, while shape-matched bone grafting to the defect restored clavicle length.