title: The treatment of distal clavicle fractures with coracoclavicular ligament disruption: a report of 10 cases.
abstract: OBJECTIVE
  Fractures of the distal third of the clavicle with coracoclavicular ligament disruption have been associated with delayed union or nonunion. A combined surgical technique for the fracture fixation and ligament repair for acute fractures was developed. The technique includes K-wire fixation and suture anchor placement with Ethibond suture to the coracoid process. The results of this combined technique were evaluated.
  
  
  METHODS
  Prospective, consecutive case series.
  
  
  METHODS
  Surgical treatment was performed at the Department of Orthopedics and Traumatology.
  
  
  METHODS
  Ten patients with acute fractures of the distal third of the clavicle were enrolled with a mean follow-up period of 24.1 (range, 12-36) months.
  
  
  METHODS
  A single suture anchor was placed on the coracoid process in a vertical position. The Ethibond suture attached to the anchor was used to depress the elevated proximal part of the clavicle by pulling it down to the coracoid process where the anchor was placed. The suture was pulled over the proximal clavicle and tied. The distal fragment was fixed to the proximal clavicle by an intramedullary K-wire. The torn coracoclavicular ligaments were approximated using absorbable suture.
  
  
  METHODS
  The patients were evaluated by the Constant scores and Modified Shoulder Rating Scale.
  
  
  RESULTS
  The mean Constant score was 96.6 points in the last follow-up. Nine patients had excellent results, and 1 patient had a good result, using the Modified Shoulder Rating Scale.
  
  
  CONCLUSIONS
  This is a reliable technique with encouraging results for treating displaced distal third clavicle fractures with coracoclavicular ligament disruption.
authors.affiliation: Department of Orthopedics and Traumatology, Marmara University School of Medicine, Istanbul, Turkey. bezer@superonline.com
authors.forename: Murat
authors.initials: M
authors.lastname: Bezer
authors.forename: Nuri
authors.initials: N
authors.lastname: Aydin
authors.forename: Osman
authors.initials: O
authors.lastname: Guven
mesh_terms: D000328:Adult; D002968:Clavicle / Q000293:injuries*; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000379:methods*; D006801:Humans; D008022:Ligaments / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D012784:Shoulder Fractures / Q000000981:diagnostic imaging / Q000601:surgery*