Treatment of distal clavicle fractures using an arthroscopic technique

Arthroscopic Stabilization for Displaced Lateral Clavicular Fractures: Can It Restore Anatomy?

“…Numerous complications in relation to arthroscopic fixation have been mentioned in the literature, including implant failure with nonunion, transient adhesive capsulitis, symptomatic AC joint arthritis, coracoid fracture, and clavicular erosion. 12,13,16,21) However, we did not encounter any of them except instability and over reduction. Even though Loriaut et al 13) and Motta et al 14) reported satisfactory radiologic outcomes after arthroscopic stabilization based on plane radiographs, malreduction/posterior angulation, an occult complication and its effect on clinical outcome has never been mentioned previously as it is not evident on routine Xrays.…”

“…19,20) Arthroscopic indirect reduction techniques may not result in adequate apposition in all fracture patterns, and there may exist residual instability between the fracture fragments, 12,15) which was evident in one of our patients. Numerous complications in relation to arthroscopic fixation have been mentioned in the literature, including implant failure with nonunion, transient adhesive capsulitis, symptomatic AC joint arthritis, coracoid fracture, and clavicular erosion.…”

“…Minimal invasive procedures are theoretically more advantageous over open technique in terms of fracture healing as well as ligament healing as a consequence of less soft tissue stripping and devascularization around the fracture site. 12,16) Arthroscopy allows for diagnosis and treatment of any intra-articular pathology. Arthroscopic preparation of the coracoid base also provides a better view of the bone tunnel than an open surgical technique.…”

“…Pujol et al 16) treated 4 patients with indirect reduction and double button device fixation through the arthroscopic rotator interval approach claiming union and a full recovery of the shoulder function in 6 months. Checchia et al, 12) using an arthroscopic rotator interval approach and figure of 8 circlage loop technique around coracoid, treated 7 patients with a mean age of 46 years. Mean union time was 7 weeks.…”

“…[7][8][9][10] Attention has recently shifted towards minimally invasive surgery and arthroscopic fixation of these unstable fractures. [11][12][13][14][15][16] Midterm results of arthroscopic flip button fixation showing favorable results in distal clavicle fractures have recently been published. 13,14) Arthroscopic fixation has many advantages; however, postoperative X-rays can be deceiving in that it cannot identify occult mal-reduction evident on 3-dimensional computed tomography (3D CT), which might affect the long term results of this novel technique.…”