Abstract

Purpose: The purpose of this study was to evaluate the radiologic and clinical outcomes after operative treatment using endobuttons for unstable distal clavicle fractures. Materials and Methods: Between October 2007 and September 2009, 9 consecutive patients who were followed up for at least more than 12 months after operative treatment using a TightRope were studied. The radiologic results on the serial plain radiographs and the clinical results according to the American Shoulder Elbow Surgeons (ASES) score were analyzed. Result: Bony union was shown in 8 cases (88.9%) and the average time to union was 12.9 (range: 9~16) weeks. The average coracoclavicular distances at the postoperative and final follow-up were 5.6 mm and 6.2 mm, respectively, with no statistically significant difference (p>0.05). The average ASES score was 90.3 (range: 78~96) and the clinical outcomes were 6 excellent, 2 good and one fair. There were no complications such as implant failure or infection except for one case of nonunion due to loss of the initial reduction. Conclusion: A major advantage of TightRope fixation for unstable distal clavicle fractures is that no further surgery is needed to remove the implant. We suggest that this technique provides an alternative for fracture with a distal fragment, which is difficult to fix.

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