Publication

Abstract :

Introduction: Neer type 2 distal clavicular fractures are inherently unstable injuries owing to disruption of ligamentous tether between clavicle and coracoid. Despite description of various surgical procedures for its fixation, prudent surgical procedure is yet to be ascertained. Recent literature points towards success of combined approach for fixation across fracture site and stabilization of coracoclavicular interval. Methods and Materials: 8 patients were operated using a technique to secure fracture fragment apposition using FibreWire®suture(Arthrex, Naples, FL, USA)spanned across coracoclavicular space and secured over bony points through endobuttons. Along with this, temporary acromioclavicular joint sparing K wire spanning fracture fragments is also used. A possible repair of coracoclavicular ligaments is also attempted which ensures robust healing by fibrosis in acute settings. Results: All the patients regained painless shoulder with bony union and return to pre-injury activity level after a mean of 4 months. Sequential postoperative radiographs demonstrated good hold of initial bony fixation. Constant Murley scores measured and compared was found to be approaching opposite shoulder level at the end of 6 months after surgery. Conclusion: The concept of this technique is novel and provides for a strong fixation across the fracture site in addition to other benefits outlined above