title: Results of minimal invasive coracoclavicular fixation by double button lift-up system in Neer type II distal clavicle fractures.
abstract: We aimed to evaluate clinical and functional outcomes of indirect fracture reduction performed by coracoclavicular fixation with minimal invasive double button lift-up system in Neer type IIa unstable fractures of distal clavicle.
  
  
  
  22 patients with Neer type 2 distal clavicle fracture were enrolled in that prospective study. All patients underwent indirect reduction and osteosynthesis performed by coracoclavicular fixation with minimal invasive double button lift-up system. Postoperative follow-up was carried out clinically and radiologically with plain X-rays and utilization of Constant and American Shoulder and Elbow Surgeons Standardized Shoulder Assessment (ASES) shoulder scores. Mean follow-up time was 15 months. A standard sling was applied for 2 weeks, postoperatively. Rehabilitation program was started on postoperative day 1.
  
  
  
  Mean age was 39 (range: 21-60), 18 of the patients were male. Right dominant extremity was affected in 14 patients. Mean duration of the surgical intervention was 40 min (range: 30-55 min). Mean union time was found to be 14 weeks (range: 7-21 weeks). Mean postoperative ASES and Constant scores were 79.9 (66.9-88.3) and 82.2 (71-100), respectively. The duration of return to normal daily activities were found to be 4.5 months. Any loss of reduction, AC joint arthrosis, and clavicular shortening were not detected in X-rays.
  
  
  
  This study has demonstrated that indirect osteosynthesis performed by coracoclavicular fixation with double button lift-up system in the treatment of unstable Neer type IIa fractures of the distal clavicle had successful clinical, radiological, and functional outcomes.
authors.affiliation: 1 Department of Orthopaedics and Traumatology, Okmeydanı Research and Training Hospital, İstanbul, Turkey.
authors.forename: Süleyman Semih
authors.initials: SS
authors.lastname: Dedeoğlu
authors.affiliation: 1 Department of Orthopaedics and Traumatology, Okmeydanı Research and Training Hospital, İstanbul, Turkey.
authors.forename: Yunus
authors.initials: Y
authors.lastname: İmren
authors.affiliation: 1 Department of Orthopaedics and Traumatology, Okmeydanı Research and Training Hospital, İstanbul, Turkey.
authors.forename: Haluk
authors.initials: H
authors.lastname: Çabuk
authors.affiliation: 1 Department of Orthopaedics and Traumatology, Okmeydanı Research and Training Hospital, İstanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Çakar
authors.affiliation: 1 Department of Orthopaedics and Traumatology, Okmeydanı Research and Training Hospital, İstanbul, Turkey.
authors.forename: Samet Murat
authors.initials: SM
authors.lastname: Arslan
authors.affiliation: 2 Department of Orthopaedics and Traumatology, Giresun University Hospital, İstanbul, Turkey.
authors.forename: Cem Zeki
authors.initials: CZ
authors.lastname: Esenyel
mesh_terms: D000328:Adult; D002968:Clavicle / Q000293:injuries* / Q000601:surgery*; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020127:Recovery of Function; D016896:Treatment Outcome; D055815:Young Adult
keywords: articular; clavicle/injuries*; fracture fixation; internal/methods*; minimally invasive; range of motion; surgical procedures