Results of fixation of comminuted Neer type-V distal clavicle fractures by locked plates and coracoclavicular osseo-ligamentous loop sutures

Background
Distal clavicle fractures are less common than mid-shaft fractures with a higher rate of nonunion if displaced. Different methods for fixation exist and each has its advantages and disadvantages. Fixation with anatomically precontoured locked plate with lateral extension proved satisfactory results with minimal complications.
Settings and design
This prospective study was conducted in Banha University Hospital.
Patients and methods
Twenty-three patients with Neer type-V distal clavicular fractures were fixed by distal clavicular locked plate with lateral extension and loop suturing of the coracoclavicular (CC) osseo-ligamentous fragment that is small to be fixed with a screw. The outcome was evaluated clinically by the Oxford shoulder score and radiologically for union, residual deformity, and nonunion through a 12–18-month follow-up period.
Results
The functional outcome was excellent in 19 cases, good in three, and fair in one. Minor complications were reported in six cases including periclavicular hypoesthesia, superficial wound infection, and post-traumatic rotator cuff tendinitis.
Conclusion
The distal clavicle anatomically precontoured the locked plate with lateral extension combined with loop suturing of the small CC osseo-ligamentous fragment that is not amenable for fixation with a screw is an excellent option for fixation of Neer type-V distal clavicle fracture with no need for additional implant to reattach the CC ligaments.