Evaluation of Modified CC Stabilization using LARS Artificial Ligament in Unstable Distal Clavicle Fracture

Unstable distal clavicle fractures are clinically common, and there is no consensus regarding gold-standard treatment. The purpose of this study was to report on a new surgical technique for the treatment of unstable distal clavicle fracture with modified coracoclavicular (CC) stabilization using a ligament augmentation and reconstruction system (LARS) of an artificial ligament, and to compare the clinical and radiographic outcomes with hook-plate fixation.Thirty patients with unstable distal clavicle fractures were treated with modified coracoclavicular (CC) stabilization using either a ligament augmentation and reconstruction system (LARS) or open reduction internal fixation with a hook plate. Indexes for evaluation included fracture healing, quality of reduction, and presence of complications. Shoulder function was evaluated using the Constant-Murley score.Patients were assessed at a mean time of 31.2 ± 10.1 months follow-up. All patients experienced radiographic union. The result at the last follow-up showed that patients treated surgically with ligament augmentation and reconstruction system had better Constant-Murley scores for shoulder function and lower complication rates than those treated with a hook plate.Treatment using LARS for unstable distal clavicle fractures resulted in excellent union rates and functional outcomes. This simple surgical technique is considered to be an efficient method for treating fractures that naturally restores stability of the distal clavicle fracture.