Acute lateral dislocated clavicular fractures: arthroscopic stabilization with TightRope

Abstract

Type IIA, IIB, and V lateral clavicular fractures (Craig modification of the Neer classification) are characterized by a constant displacement and are associated with a high rate of nonunion. The aim of this study is to verify whether the reduction and arthroscopic stabilization of these clavicular fractures with coracoclavicular cerclage provide stable fixation to allow for bone healing. To date, the treatment of these fractures is still controversial in young active patients in whom functional requirements are to be met. Fourteen male patients, with type IIA, IIB, and V lateral clavicular fractures (2 type IIA, 10 type IIB, and 2 type V) had been treated arthroscopically with a TightRope (Arthrex, Naples, FL, USA) and had a radiologic/clinical follow-up of at least 2 years. All fractures were confirmed to have healed without limitations in range of motion or loss of reduction. The acromioclavicular joint and the coracoclavicular interspace were restored to the level ofthe healthy site in all but 1 patient, in whom a reduction was observed because of hypercorrection of the fracture. The mean Constant score was 95, and all patients had a Simple Shoulder Test score of 12points. Healing was delayed up to 20 days in 1 patient because of a skin infection, and the coracoid bone tunnel was too marginal in another patient, in whom the coracoid button broke the lateral side of the tunnel during fixation. The arthroscopic procedure with the TightRope allows for fracture healing with no loss of reduction in the acromioclavicular joint and full return to everyday activities.