Intramedullary fixation of Neer type 2 fractures of the distal clavicle with an AO/ASIF screw.
BACKGROUND
Neer 2 fractures of the distal clavicle are notorious for their high rates of non-union and numerous methods of fixation are recommended. We review a simple method of fixation of these fractures with an intramedullary AO/ASIF malleolar screw.


METHODS
Ten patients with Neer type 2 fractures of the distal clavicle were treated between 1996 and 2002. All had open reduction and internal fixation with an intramedullary 4.5 mm AO/ASIF malleolar screw. In all cases the coraco-clavicular ligaments were not repaired, and the screws were removed once the fractures had united.


RESULTS
All fractures united at between 6 and 12 weeks. All patients had a good functional result, with an excellent to good Oxford Shoulder score.


CONCLUSIONS
This is a simple technique with a universally available implant and good fracture healing. We report no cases of screw breakage or migration and we question the necessity to repair the coraco-clavicular ligaments.
Scadden
J E
JE
17 St Johns Street, Winchester, Hampshire S023 0HF, UK. sianscadden@bigpond.com
Richards
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D001863:Bone Screws; D002968:Clavicle / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography