Open Reduction Internal Fixation of Distal Clavicle Fracture With Supplementary Button Coracoclavicular Fixation

Abstract

Distal clavicle fractures are common, and no standard treatment exists. Many different surgical modalities exist. This report describes an open reduction internal fixation technique that achieves both plate and coracoclavicular stabilization using a button device. A precontoured superior-lateral plate is secured to the clavicle. A 3.2-mm spade-tipped drill bit is drilled across the clavicle and coracoid, passing through 4 cortices. The button is loaded onto an insertion device, passed across the 4 cortices, and captured on the undersurface of the coracoid under fluoroscopic guidance. This construct is linked to the distal clavicle plate by heavy sutures using a second button that sits in the plate. The lateral locking holes are then filled to finalize fixation. This technique provides for a simplified way to achieve coracoclavicular stabilization when using a plate for fixation of distal clavicle fractures.

Good to Excellent Functional Outcome and High Return to Sports Rate after Operative Treatment of Unstable Lateral Clavicle Fractures: Comparison of Two Coracoclavicular Button Fixation Techniques

“…Unstable or severely displaced lateral clavicle fractures need to be treated operatively. Numerous surgical techniques have been described in the literature [17][18][19][20]. In this context, hook plating was routinely used for this entity, leading to controverse results with respect to irritation of the skin in contrast to good to excellent functional outcome [9,20].…”

Tratamiento artroscópico de las fracturas de tercio distal de clavícula tipo 2 de Neer con sistema ZipTight.

“…El uso de la artroscopia, además de ser una técnica mínimamente invasiva que respeta los tejidos y nos posibilita acceder a la base de la coracoides con una mínima disección, nos permite además realizar un diagnóstico y tratamiento de la patología articular glenohumeral o del manguito de los rotadores en caso de que existiera. (Burkhart habla de hasta el 40% de los casos en luxaciones acromioclaviculares) [16][17][18][19][20][21][22] .…”

Arthroscopic-Assisted Management of Unstable Distal-Third Clavicle Fractures: Conoid Ligament Reconstruction and Fracture Cerclage With Sutures

“…1 Few authors have combined the biomechanical advantages of fracture-site fixation plus CC fixation, and they have reported good clinical and radiologic outcomes. 16,17 Shin et al 4 have reported successful union rates after performing interfragmentary fixation using 2 nonabsorbable suture tension bands in a figureof-8 configuration plus CC fixation using 2 suture anchors. They argued that the posteromedial suture anchor in position of the torn conoid ligament plays an important role by restraining the medial clavicle from vertical displacement.…”