title: Modified tension band fixation and coracoclavicular stabilisation for unstable distal clavicle fracture.
abstract: BACKGROUND
  The purpose of this study was to report a new surgical technique for the treatment of unstable distal clavicle fracture with modified tension band fixation (MTBF) and coracoclavicular (CC) stabilisation, and evaluate the radiologic and clinical outcome of these patients.
  
  
  METHODS
  Thirteen patients who had a fracture of the distal clavicle (Neer classification type IIb) were treated with MTBF and CC stabilisation. After the CC stabilisation was performed with a suture anchor or flip button, internal fixation using MTBF was carried out. Each patient was followed up for a minimum of 12 months and their clinical and radiological results were analysed.
  
  
  RESULTS
  The mean period required for fracture union was 12.6 (range, 8-24) weeks and union was successfully completed in all cases. The mean Constant score at the final follow-up was 94.7 (88-100); the modified University of California, Los Angeles (UCLA) shoulder rating scale was 31.3 points (range, 22-35). All patients returned to normal daily activities at an average of 3.7 months postoperatively (range, 3-5 months). One patient had a new fracture around drilled holes for CC stabilisation by inappropriate tunnelling.
  
  
  CONCLUSIONS
  MTBF and CC stabilisation is a useful technique for treating an unstable distal clavicle fracture. This procedure provides minimal incision and stable fixation without causing any further acromioclavicular joint injury to those with distal clavicle fractures.
authors.affiliation: Department of Orthopedic Surgery, Jeju National University School of Medicine, Jeju, South Korea.
authors.forename: Sungwook
authors.initials: S
authors.lastname: Choi
authors.affiliation: Department of Orthopedic Surgery, Jeju National University School of Medicine, Jeju, South Korea.
authors.forename: Sang-Rim
authors.initials: SR
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Jeju National University School of Medicine, Jeju, South Korea. Electronic address: oskanghs@gmail.com.
authors.forename: Hyunseong
authors.initials: H
authors.lastname: Kang
authors.affiliation: Department of Orthopedic Surgery, Jeju National University School of Medicine, Jeju, South Korea.
authors.forename: Donghee
authors.initials: D
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Jeju National University School of Medicine, Jeju, South Korea. Electronic address: cellulosae@naver.com.
authors.forename: Yong-Geun
authors.initials: YG
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D001864:Bone Wires; D002968:Clavicle / Q000293:injuries* / Q000503:physiopathology; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing; D050723:Fractures, Bone / Q000601:surgery*; D005599:Fractures, Ununited / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007593:Joint Instability / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D020127:Recovery of Function; D013536:Suture Techniques; D016896:Treatment Outcome
keywords: Coracoclavicular stabilisation; Modified tension band fixation; Unstable distal clavicle