Triple Endobutton technique for the treatment of Neer type II lateral clavicle fractures: 2-year findings.

Abstract

Although various kinds of operative procedures have been reported in the literature, there is still no undisputed gold standard technique for the treatment of Neer type II lateral clavicle fractures. This trauma is classified as a bone fracture, but it is primarily a ligamentous problem due to the instability it generates. This study analyzed the clinical and radiological results of treatment for Neer type II lateral clavicle fractures using the triple Endobutton (Smith & Nephew) technique in 20 patients with at least 2 years of follow-up. This study enrolled 20 patients with Neer type II distal clavicle fractures who underwent the triple Endobutton technique using 3 Endobuttons (1 with a closed loop and 2 without) and 3 No. 5 Ethibond sutures (Ethicon Inc.) from October 2017 to May 2020. Patients were assessed with clinical and radiological follow-up at 3, 6, 12, and 24 months postoperatively. Clinical assessments consisted of the visual analog scale and the Constant score. Radiological evaluation was achieved by measuring the coracoclavicular distance. The mean follow-up was 35 ± 9 months (range, 24-55 months). The visual analog scale and Constant scores revealed significant improvements from 6 ± 1 (range, 4-8) and 42 ± 4 (range, 35-48) scores preoperatively to 1 ± 1 (range, 0-1) and 94 ± 2 (range, 90-98) scores at the final evaluation, respectively (P < .001). The coracoclavicular distance of the injured side was an average of 9 ± 1 mm (range, 7-12 mm) at the final follow-up radiograph which was not significantly different from that of the contralateral side (P = .75). In this study, the triple Endobutton technique was a safe, reliable, and novel surgical technique that yielded good to excellent short-term clinical and radiological outcomes for the treatment of Neer type II distal clavicle fractures.