title: Treatment of distal-third clavicular fractures (Neer type ii-b) with a triple button device.
abstract: OBJECTIVE
  The purpose of this study is to describe the outcomes of using a triple button device for the treatment of displaced distal-third clavicle fractures (Neer, type ii-b).
  
  
  METHODS
  A retrospective review was conducted on a series of patients between November 2011 and December 2014. Fourteen patients initially met the inclusion criteria, but 2 were excluded, leaving 12 patients (83.3% male; mean age 32.2 years) for the final analysis at a mean follow-up of 26±11.24 months (range, 12-48). Post-operative follow-up was performed at 2 weeks (two first months), and monthly thereafter, until was achieving clinically and radiological healing. The functional outcome was evaluated using the Constant score, and DASH score in the last follow-up.
  
  
  RESULTS
  The mean Constant Score was 95.5±5.2 points (range, 85-100), with a mean DASH score of 3.3±4.4 points (range, 0-12.5). The mean time to clinical healing was10.3±3.1 weeks (range, 8-16), and the mean time to radiological healing was 13.6±2.6 weeks (range, 12-20). There were no major complications. There were 5 minor complications without clinical impact: 2 coracoclavicular calcifications, 1 hypertrophic scar, 1 patient with discomfort due to the device, and 1 superficial wound infection. All patients returned their previous activity.
  
  
  CONCLUSIONS
  Good clinical results can be achieved with the triple button device in unstable distal fractures of the clavicle, without the need to remove the hardware.
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital General Universitario Los Arcos del Mar Menor, Facultad de Medicina, Universidad de Murcia, Pozo Aledo, Murcia, España. Electronic address: dockano@hotmail.com.
authors.forename: J A
authors.initials: JA
authors.lastname: Cano-Martínez
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital General Universitario Los Arcos del Mar Menor, Facultad de Medicina, Universidad de Murcia, Pozo Aledo, Murcia, España.
authors.forename: G
authors.initials: G
authors.lastname: Nicolás-Serrano
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital General Universitario Los Arcos del Mar Menor, Facultad de Medicina, Universidad de Murcia, Pozo Aledo, Murcia, España.
authors.forename: J
authors.initials: J
authors.lastname: Andrés-Grau
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital General Universitario Los Arcos del Mar Menor, Facultad de Medicina, Universidad de Murcia, Pozo Aledo, Murcia, España.
authors.forename: J
authors.initials: J
authors.lastname: Bento-Gerard
mesh_terms: D000293:Adolescent; D000328:Adult; D002968:Clavicle / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Clavícula lateral inestable; Coracoclavicular stabilisation; Dispositivo de triple botón; Distal third clavicle fracture; Estabilización coracoclavicular; Fractura tercio distal clavícula; Triple button device; Unstable distal clavicle