Outcomes of arthroscopic assisted fixation of distal clavicle fractures using an adjustable button
Background: Distal clavicle fractures, particularly unstable Neer type II fractures, pose a challenge due to high nonunion rates. Arthroscopic-assisted techniques for coracoclavicular (CC) stabilization, such as the adjustable button fixation, have been used for their minimal invasiveness and effect...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-08-01
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| Series: | JSES Reviews, Reports, and Techniques |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666639125000483 |
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| Summary: | Background: Distal clavicle fractures, particularly unstable Neer type II fractures, pose a challenge due to high nonunion rates. Arthroscopic-assisted techniques for coracoclavicular (CC) stabilization, such as the adjustable button fixation, have been used for their minimal invasiveness and effectiveness. Methods: This retrospective study analyzed 24 patients with Neer type II distal clavicle fractures treated with arthroscopically assisted adjustable button fixation. Patients were evaluated using the Constant-Murley and the American Shoulder and Elbow Surgeons scoring systems, with a minimum follow-up of 18 months. Outcomes assessed included CC distance, return to sports, complications, and reoperations. Results: The majority of injuries were due to sports (58%), with a mean age of 25.7 years. The average operation time was 85.3 minutes, and the average follow-up was 38.7 months. The preoperative CC distance was reduced from 19.3 mm to 10.6 mm postoperatively. Complications were minimal, with 1 instance of superficial infection treated with antibiotics and 1 case of button displacement that was treated conservatively. The median American Shoulder and Elbow Surgeons score was 89.0, and the Constant-Murley score averaged 91.8. A total of 87.5% of patients returned to sports, with 66.7% returning to their previous level of activity. Age was negatively correlated with the return to sports and preinjury activity levels. Conclusion: Arthroscopic-assisted fixation of distal clavicle fractures using the adjustable button technique demonstrated good functional and radiological outcomes, with a high rate of return to sports and minimal postoperative complications. This method may be considered an effective option for the treatment of Neer type II distal clavicle fractures. |
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| ISSN: | 2666-6391 |