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This procedure provides consistent and reproducible results in carefully selected patients and allows them an early return to sporting activities with minimal residual morbidity.

Entrapment of posterior interosseous nerve (PIN) can be due to fracture dislocation of elbow, fibrous arcade of Frohse, neoplasms (lipoma, schwannoma), ganglion cysts and rheumatoid synovitis. Parosteal lipomas are extremely rare. These tumors grow slowly and as they grow, they can compress a nearby nerve producing sensory and motor disturbances. Till date less than 50 cases of PIN entrapment due to parosteal lipoma have been reported in literature. However, to the best of our knowledge, none was bilobed. A 54-year-old female patient presented with progressive weakness of the right-hand extensors including thumb for the last 5 months with no sensory loss. Clinico-radiological findings and electophysiological studies revealed parosteal lipoma causing entrapment of PIN. Surgical excision of the lesion was done through posterior approach. The excised mass was sent for histopathological examination which confirmed the diagnosis of lipoma. Appreciable recovery was first noticed at 3 months and complete recovery was seen at 7 months. No recurrence was seen until 2 years of follow up. Urgent surgical excision is necessary to prevent entrapment of this nerve and facilitate early functional and neurological recovery.

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Introduction Many surgical techniques have been described for the treatment of Neer type II lateral end clavicle fractures like open reduction and internal fixation with hook plate, tension band wiring, coracoclavicular screw fixation, and distal clavicle locking plate. However, most of these operative procedures are associated with high perioperative complications ranging from hardware prominence, hardware failure, screw and plate pull-out, and infection. As the lateral end clavicle fractures has both vertical and horizontal stress forces, any technique counteracting both the forces should result in a better clinical outcome. Therefore, this study was conducted to assess the functional and radiological outcome of type II lateral end clavicle fracture treated using pre-contoured locking plate along with coracoclavicular reconstruction with endobutton and fiberwire. Methods Thirty-two consecutive patients with Neer type II fractures of the lateral end of clavicle were treated surgically using pre-contoured locking plate and coracoclavicular reconstruction with endobutton and fiberwire between May 2014 and December 2016. Clinical outcome was assessed using the University of California Los Angeles (UCLA) shoulder score and Constant Murley score. The coracoclavicular distance was also recorded. These were compared to the unaffected side at one-year follow-up. Results The bony union was achieved in all cases. There were no major complications in any of the patients. All the patients were able to return to their preinjury level of activity. The UCLA score, the Constant Murley score, and coracoclavicular distance did not vary significantly at a one-year interval when compared to the normal shoulder. Conclusion Open reduction and internal fixation of Neer type II lateral end clavicle fractures using pre-contoured locking distal clavicle plate along with coracoclavicular reconstruction with endobutton and No. 2 fiberwire provide an excellent functional and radiological outcome.

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