Clinical and Radiological Outcome Assessment following Coracoclavicular Reconstruction with Endobutton and Fibertape for Neer's Type II Lateral End Clavicle Fracture: A Prospective Study.

Introduction: To evaluate the clinical and radiological outcomes following coracoclavicular (CC) reconstruction with the endobutton for Neer type 2 lateral end clavicle fracture. Clavicular fracture is one of the commonest injuries encountered routinely in orthopedic practice, with an incidence ranging from 44 to 66% of all fractures. Based on the location of fractures they may be in the middle third, being most common or the lateral and medial thirds being least common. Fractures of the lateral end of the clavicle are troublesome to manage given their instability and ligamentous disruption and with a wide array of treatment options including fixation by means of plates, screws, K-wires, tapes and buttons making the decision often difficult for the surgeon based on the apprehended pros and cons of individual fixation methods. Materials and Methods: A prospective cohort study on 30 cases of adult Neer type 2 lateral end clavicle fractures was carried out, which were fixed with CC endobutton under fluoroscopic guidance. Postoperatively, patients were given an arm sling pouch for 2-weeks with graded physiotherapy and a range of exercises commencing after 2 weeks. Cases were followed up at 2-weeks, 6-weeks, 3-months, 6-months, and 1-year intervals each. Functional and radiological outcomes were observed and documented. Results: All 30 patients were assessed with a mean follow-up 12 months. The mean age group under the study was 34.70 years. Most of the patients had a constant shoulder score above 90 with excellent disabilities of the arm, shoulder, and hand scores. Mean fracture union time was 15 weeks without any major complication such as infection, revision surgeries, implant migration and stress fractures. Discussion and Conclusion: Endobutton technique for fixation of type 2 lateral end clavicle stands as a promising and effective option demonstrating significant improvements in terms of clinico-radiological perspective and patient satisfaction. The current method of treatment exhibits stronger biomechanics with good fixation with almost no implant-related complications. It also supports an early mobilization crucial for maintaining shoulder function and preventing stiffness.