Arthroscopy-assisted fixation of fracture of the distal part of the clavicle by subcoracoid suture and clavicle button

Orthop Traumatol Surg Res. 2018 Dec;104(8):1237-1240. doi: 10.1016/j.otsr.2018.07.025. Epub 2018 Nov 2.

Abstract

Introduction: Neer IIB displaced fracture of the distal part of the clavicle is often treated surgically. Arthroscopy-assisted surgery was recently developed. The aim of the present study was to present an original technique of subcoracoid suture under arthroscopy, with clinical and radiological results.

Hypothesis: Arthroscopy-assisted subcoracoid suture in Neer IIB clavicle fracture provides satisfactory results.

Material and methods: Fourteen patients, with a mean age of 34.6 years (range, 24-51 years) with Neer IIB displaced clavicle fracture treated by subcoracoid suture between January 2013 and January 2017 were included. Clinical assessment comprised demographic data, weighted Constant score and Subjective Shoulder Value (SSV). Radiologic assessment comprised AP shoulder view.

Results: Bone healing was systematic within 3 months, except in 1 case of delayed healing. Mean follow-up was 20 months (range, 6-55 months). At last follow-up, mean weighted Constant score was 91% (range, 85-95%) and mean SSV 95% (range, 85-100%). 4 patients reported clavicle button irritation, 2 of whom asked for hardware removal.

Discussion: Arthroscopy-assisted subcoracoid suture provided satisfactory clinical results. There were no cases of implant failure, probably because the technique caused no iatrogenic coracoid trauma. Clavicle button irritation sometimes required hardware removal.

Level of evidence: IV.

Keywords: Arthroscopy; Coracoid; Fracture of the distal part of the clavicle; Suture.

MeSH terms

  • Adult
  • Arthroscopy / methods*
  • Clavicle / injuries*
  • Device Removal
  • Female
  • Follow-Up Studies
  • Fracture Fixation, Internal / adverse effects
  • Fracture Fixation, Internal / instrumentation
  • Fracture Fixation, Internal / methods*
  • Fracture Healing
  • Fractures, Bone / diagnostic imaging
  • Fractures, Bone / physiopathology
  • Fractures, Bone / surgery*
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery
  • Radiography
  • Shoulder / physiopathology
  • Sutures
  • Treatment Outcome
  • Young Adult