title: Anatomic locking plate and coracoclavicular stabilization with suture endo-button technique is superior in the treatment of Neer Type II distal clavicle fractures.
abstract: BACKGROUND
  The purpose of this retrospective study was to compare the clinical results of three different fixation techniques for the treatment of Neer Type IIb fractures. We hypothesized that anatomic locking plate and coracoclavicular stabilization with suture endo-button technique provides more stable and biomechanically superior fixation among others with low complication rates.
  
  
  METHODS
  Thirty six patients with Neer Type IIb fractures treated were evaluated. Patients were divided into three groups according to surgical choice that was performed: tension band and coracoclavicular suture stabilization with k-wires was defined as Group 1, anatomic locking plate and coracoclavicular stabilization with screw was defined as Group 2, and anatomic locking plate and coracoclavicular stabilization with suture endo-button (LPES) was defined as group 3. Mean age was 36.1 years, and mean follow-up period was 32.4 months. Radiological follow-ups and constant were recorded and compared at 3, 6, 12 and 24 months.
  
  
  RESULTS
  At 3rd and 12th month follow-up in the LPES group, mean constant scores were statistically higher than other two groups (p < 0.01). The difference between other two groups was insignificant (p > 0.05). At 6th month follow-up, mean constant scores in LPES group were higher than other groups; there was less statistical significance than other time zones (p < 0.05).
  
  
  CONCLUSIONS
  Anatomic locking plate combined with suture endo-button for CC ligament reinforcement is a reliable method to achieve osteosynthesis and stabilization for Neer Type IIb distal clavicle fractures without compromising physiology of shoulder.
authors.affiliation: Acibadem University Faculty of Medicine, Department of Orthopaedic Surgery, Acibadem Kadikoy Hospital, Tekin sok. No: 8, 34718, Istanbul, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Seyhan
authors.forename: Baris
authors.initials: B
authors.lastname: Kocaoglu
authors.forename: Gorkem
authors.initials: G
authors.lastname: Kiyak
authors.forename: Arel
authors.initials: A
authors.lastname: Gereli
authors.forename: Metin
authors.initials: M
authors.lastname: Turkmen
mesh_terms: D000328:Adult; D001860:Bone Plates; D001863:Bone Screws; D002968:Clavicle / Q000293:injuries* / Q000601:surgery; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome; D055815:Young Adult