Indirect osteosynthesis for unstable distal end of clavicle fracture with endobutton and Fibertape: A Prospective study

Abstract

Introduction: Fracture clavicle is one of the most common fractures present to orthopedic emergency and near about 10 % of all fracture. Fracture lateral end of clavicle is relative less in comparison to shaft fracture. Due to fracture geometry and deforming forces Neer”s type 2 fracture is unstable one and required surgical intervention. We can divide surgical procedure into rigid & flexible one with or without involvement of acromioclavicular joint. Material Methods: we treated 38 Neer’s type 2 fracture with two loose endobutton with fiber tape in tight rope fashion from February 2018 to December 2021. Pre-operative assessment done with X-ray AP view, standing position. Post-operative pendulum exercise started on suture removal at 12th day. Passive, active assisted and active range of motion exercise added depending upon the patient’s recovery and tolerability at regular 2-3 weeks interval. X-Ray taken at subsequent interval of one month till fracture union. Results: All fracture united well, five cases had minimal loss of reduction radiological without affecting the shoulder function. Assessment of shoulder function done by UCLA Shoulder Score score at four-month post operatively. Conclusion: Treating lateral end of clavicle with indirect osteosynthesis without incorporation of acromioclavicular joint and acromion is very effective, minimal invasive and without complication of hardware, sub acromion impingement and AC joint arthrosis.