Outcomes of arthroscopic assisted fixation of distal clavicle fractures using an adjustable button

Distal clavicle fractures, particularly unstable Neer type II fractures, pose a challenge due to high nonunion rates. Arthroscopic-assisted techniques for coracoclavicular (CC) stabilization, such as the adjustable button fixation, have been used for their minimal invasiveness and effectiveness.

This retrospective study analyzed 24 patients with Neer type II distal clavicle fractures treated with arthroscopically assisted adjustable button fixation. Patients were evaluated using the Constant-Murley and the American Shoulder and Elbow Surgeons scoring systems, with a minimum follow-up of 18 months. Outcomes assessed included CC distance, return to sports, complications, and reoperations.

The majority of injuries were due to sports (58%), with a mean age of 25.7 years. The average operation time was 85.3 minutes, and the average follow-up was 38.7 months. The preoperative CC distance was reduced from 19.3 mm to 10.6 mm postoperatively. Complications were minimal, with 1 instance of superficial infection treated with antibiotics and 1 case of button displacement that was treated conservatively. The median American Shoulder and Elbow Surgeons score was 89.0, and the Constant-Murley score averaged 91.8. A total of 87.5% of patients returned to sports, with 66.7% returning to their previous level of activity. Age was negatively correlated with the return to sports and preinjury activity levels.

Arthroscopic-assisted fixation of distal clavicle fractures using the adjustable button technique demonstrated good functional and radiological outcomes, with a high rate of return to sports and minimal postoperative complications. This method may be considered an effective option for the treatment of Neer type II distal clavicle fractures.