Treatment of Neer IIb Distal Clavicle Fractures Using Anatomical Locked Plate Fixation With Coracoclavicular Ligament Augmentation.

PURPOSE: The purpose of this study was to evaluate the clinical and radiographic outcomes of Neer type IIb distal clavicle fractures treated with anatomical locking plate fixation combined with coracoclavicular ligament augmentation.

METHODS: Twelve patients with Neer Type IIb distal clavicle fractures treated with anatomical locking plate fixation combined with suture anchor augmentation of the coracoclavicular ligament, were retrospectively studied. Clinical outcomes were assessed using the Constant score and the Disabilities of the Arm, Shoulder, and Hand (DASH) score. Coracoclavicular distance was measured on plain radiographs.

RESULTS: All patients were reexamined at a mean follow-up of 26.3 months (range, 25-30 months). Bony union occurred in all cases within 12 weeks and no major complications were encountered. At the final follow-up, the mean Constant score was 94 (range, 87-100) and the DASH score was 10.4 (range, 2-20). The mean postoperative coracoclavicular distance on the injured side was decreased by 40% compared with the preoperative status.

CONCLUSIONS: Surgical fixation of Neer type IIb distal clavicle fractures using anatomical locking plate fixation combined with suture anchor augmentation of the coracoclavicular ligament was associated with a satisfactory functional outcome and low complication rate.

TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.