Importance of suture Endobutton augmentation in type 2B clavicle fracture fixation using a locking plate.

Abstract

Background: Instability in distal clavicle fractures with impaired integrity of the coracoclavicular (CC) ligament poses a serious risk of nonunion, necessitating surgical intervention. Despite a consensus on the need for surgery in cases of unstable distal clavicle fractures, various surgical techniques are available. The aim of this study is to evaluate the radiological and functional outcomes of CC augmentation using the suture Endobutton technique for Neer type 2b clavicle fractures were evaluated.

Methods: In this retrospective study, 42 patients who met the criteria were divided into two groups: group 1 (locking plate with CC augmentation) and group 2 (locking plate without CC augmentation). Demographic data, Constant-Murley score (CMS), union time, range of motion, complications, and implant failures during the follow-up period were recorded.

Results: Among study patients, 13 (31.0%) were female and 29 (69.0%) were male. The mean age was 40.5±11.5 years. Significant differences were found in union time (week) (t(40)=-2.11, P=0.04) and the 6-month CMS (t(40)=4.19, P=0.01). Significant difference was not observed in postoperative complications between the groups (P>0.05).

Conclusions: CC augmentation with a suture Endobutton in type 2b distal clavicle fractures resulted in more favorable short-term functional and radiological outcomes. Level of evidence: III.