Using a right-angle forceps clamp to pass a suture under the coracoid base in coracoclavicular stabilization: a technical note.

A distal clavicle fracture is a common injury of the shoulder joint. Coracoclavicular (CC) stabilization is one of the recommended procedures for treating the distal clavicle fracture. However, it is difficult to pass the suture under the coracoid process with instruments normally available in the operating room (OR). Herein, the authors describe a simple technique to accomplish this suture passing quickly and easily using tools available in the OR. Case presentation: A 59-year-old Thai female presented with right shoulder pain after a fall. The physical examination showed a prominent bulge and tenderness at the right distal clavicle. A radiograph of both clavicles showed a right displaced distal clavicle fracture. After discussing the possible treatments with her, she decided to have CC stabilization as we recommended. Clinical discussion: In CC stabilization, the most important but difficult step is passing a suture under the coracoid base. There are some specialized commercial instruments which are matched to the shape of the coracoid process to make it easy to perform this step, but all are highly expensive (~$1400-1500 per piece) and thus often not available in ORs in resource-limited settings. Conclusion: The authors devised a technique using standard surgical instruments and materials available in all ORs to enable them to pass a suture easily and quickly under the coracoid base.