title: Modified tension band fixation for unstable distal clavicle fractures.
abstract: BACKGROUND
  Optimal surgical treatment of unstable distal clavicle fractures is controversial, and various fixation options are available. The objective of this study was to evaluate a new modified tension band fixation technique for unstable distal clavicle fractures.
  
  
  METHODS
  Forty-two patients with acute unstable distal clavicle fractures were managed with open reduction and internal fixation using modified tension band fixation. All patients had radiographic and clinical follow-ups at a minimum of 12 months (range, 12-39 months). Bony union and coracoclavicular interval distance were evaluated radiographically. Clinical outcomes were measured with the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form.
  
  
  RESULTS
  All fractures united solidly within 3 months. All patients had a good functional result, with a mean American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form score of 92 points and a coracoclavicular interval distance of 8.7 mm (range, 5-14 mm; 1.24 times of normal shoulder) at the final follow-up.
  
  
  CONCLUSIONS
  Surgical treatment for unstable distal clavicle fractures using modified tension band fixation is effective. This technique allows simple, cost-effective, and minimally invasive fixation with universally available implants and good fracture healing.
authors: Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
authors: Jae-Myeung
authors: JM
authors: Chun
authors: Soung-Yon
authors: SY
authors: Kim