Treatment of distal-third clavicular fractures (Neer type II-b) with a triple button device

Abstract

ObjectiveThe purpose of this study is to describe the outcomes of using a triple button device for the treatment of displaced distal-third clavicle fractures (Neer type II-b). Material and methodA retrospective review was conducted on a series of patients between November 2011 and December 2014. Fourteen patients initially met the inclusion criteria, but 2 were excluded, leaving 12 patients (83.3% male; mean age 32.2 years) for the final analysis at a mean follow-up of 26±11.24 months (range, 12–48). Post-operative follow-up was performed at 2 weeks (two first months), and monthly thereafter, until was achieving clinically and radiological healing. The functional outcome was evaluated using the Constant score, and DASH score in the last follow-up. ResultsThe mean Constant Score was 95.5±5.2 points (range, 85–100), with a mean DASH score of 3.3±4.4 points (range, 0–12.5). The mean time to clinical healing was 10.3±3.1 weeks (range, 8–16), and the mean time to radiological healing was 13.6±2.6 weeks (range, 12–20). There were no major complications. There were 5 minor complications without clinical impact: 2 coracoclavicular calcifications, 1 hypertrophic scar, 1 patient with discomfort due to the device, and 1 superficial wound infection. All patients returned their previous activity. ConclusionGood clinical results can be achieved with the triple button device in unstable distal fractures of the clavicle, without the need to remove the hardware.