Functional and Radiological Outcome of Displaced Lateral End Clavicle Fractures Treated With Open Reduction and...

Displaced lateral end clavicle fractures are challenging injuries with a high risk of non-union and functional impairment when treated conservatively. Open reduction and endobutton fixation is a novel surgical technique that aims to provide stable fixation while preserving shoulder biomechanics, potentially improving functional and radiological outcomes compared to traditional methods.

This prospective study included 20 male patients (mean age: 35.2 years, range: 18-56) with displaced lateral clavicle fractures (Neer type IIB and type V). All patients underwent open reduction and fixation using a twin coracoclavicular endobutton construct. Functional outcomes were assessed using the Constant-Murley scores at 6 weeks, 3 months, 6 months, and 12 months. Radiological outcomes, including fracture union and residual displacement, were evaluated with serial radiographs. Complications, return to activity, and patient satisfaction were also analyzed.

The mean Constant-Murley score improved significantly from 60.3 ± 8.1 at 6 weeks to 87.4 ± 4.8 at 6 months (P < 0.01), stabilizing at 88.1 ± 5.2 by 12 months. Union was achieved in 95% of cases by 6 months, with a mean residual displacement of 1.1 mm. Complications were minimal (5% each for superficial infection and mild stiffness). All patients returned to sedentary work within 8 weeks and full manual labor or sports by 6 months. Patient satisfaction was high, with 90% reporting being "highly satisfied" at the end of 1 year.

Open reduction and endobutton fixation for displaced lateral clavicle fractures provide excellent functional recovery, high union rates, and minimal complications. This technique offers a reliable alternative to traditional fixation methods, particularly for young and active individuals. Further comparative studies and long-term follow-up are warranted to establish its role as the gold standard.