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

Abstract

PURPOSE. Neer type II fractures of the external third of the clavicle are fractures with a high rate of nonunion or malunion (up to 30%). Multiple surgical techniques have been describe their treatment. Also, several arthroscopic techniques. METHODS. We have retrospectively reviewed 29 cases with Neer type II distal third clavicle fractures treated with coracoclavicular fixation with a suspension system. RESULTS. All fractures except 1 have undergone complete consolidation in 3 months,without the disadvantages of other systems such as KW,screws or plates. The rate of consolidation has been 96.5% (all but 1 patient).The mobility obtained was very satisfactory: flexion of 176º, abduction of 145º, an external rotation of 80º, an internal rotation with the hand until T11 and horizontal adduction of 132º. The functional results obtained have been excellent in most patients: obtaining 96 points on the Constant scale and excellent UCLA in 26 cases. This is one of the studies with more patients treated with this type of technique. All patients have been followed until the clinical and radiographic consolidation of the fractures.We also contribute some technical modifications to the initial technique that we have been obtaining with the experience to improve the clinical and radiological result of the patients. CONCLUSION.The arthroscopic assisted treatment of Neer type II distal third clavicle fractures with a Ziptight system is a reproducible technique that allows us to reduce and stabilize the fracture and also to diagnose and treat possible glenohumeral o rotator cuff injuries, obtaining excellent clinical and radiological results.