Closed-Loop Double Endobutton Technique for Repair of Unstable Distal Clavicle Fractures

Area of Science:

• Orthopedic Surgery
• Traumatology

Background:

• Distal clavicle fractures are often unstable and prone to nonunion.
• Current surgical management for these fractures remains debated.

Purpose of the Study:

• To evaluate the efficacy of indirect osteosynthesis using a closed-loop double endobutton construct for unstable distal clavicle fractures.
• To determine if this method ensures reliable fracture union and eliminates the need for secondary interventions.

Main Methods:

• A case series of eight patients with acute, unstable Neer type IIB distal clavicle fractures.
• Treatment involved a closed-loop double endobutton implant.
• Six patients completed a mean follow-up of 3.4 years with functional and radiologic assessment.

Main Results:

• All patients achieved definitive fracture healing.
• No complications or additional surgeries were required.
• The mean Constant score at final follow-up was 97.

Conclusions:

• The closed-loop double endobutton technique effectively and reliably achieves union in Neer type IIB distal clavicle fractures.
• This method avoids late hardware removal and complications associated with other fixation techniques.