The use of Tightrope device as the sole method of fixation in treating lateral end clavicle fractures

Abstract

Background Lateral end clavicle fractures can be challenging due to the small and often comminuted lateral fragment, problems with union and stability and implant morbidity. We retrospectively reviewed outcomes of Tightrope device in isolation to treat lateral end clavicle fractures. Methods Subjective and objective measures were assessed for 29 patients. The subjective comprised of functional clinical scores: Oxford shoulder score and EuroQoL5D. The objective measures were maintenance of fracture reduction, bone healing and complications. Results Median age was 36 years and 72% of cases were male patients. Average clinical follow up time was 21 months. Evaluation of latest radiographs showed that all reductions were maintained post-operatively. Twenty-two fractures had united and one patient had established non-union. Functional outcomes showed predominantly good results with Oxford shoulder score average of 41, EuroQoL5D index score of 0.78 and EuroQol Visual Analogue Scale 76. The overall post-operative complication rate was 10%; only one case requiring a secondary procedure. Discussion In our series, using the Tightrope as the sole device to treat displaced lateral end of clavicle fractures resulted in good radiological and functional outcomes, with minimal complications requiring secondary procedures. We believe the Tightrope device is a good method of fixing these challenging fractures and advocate its use.

Open reduction and tunneled suspensory fixation for lateral end of clavicle fractures: surgical technique

“…Moreover, two patients had mild forward flexion limitation, and another two patients had mild discomfort when performing demanding activities. Al-Tawil et al 1 have reported at a mean follow-up of 21 months that standalone TightRope device fixation achieved high union rates (22 out of 23 patients). Three complications were encountered in this series consisting of shoulder stiffness, prominence of the TightRope implant, and coracoid button migration.…”

Stabilization of Neer IIB type distal clavicle fracture using the Tightrope system: Case report

“…Fractures of the distal end of the clavicle account for 10% -30% of all fractures of this bone, and are the second most common fractures, after diaphyseal fractures [1][2][3]. At the same time, they have the greatest frequency of non-unions and malunions -as many as 50% [1,4].…”

“…Fractures of the distal end of the clavicle account for 10% -30% of all fractures of this bone, and are the second most common fractures, after diaphyseal fractures [1][2][3]. At the same time, they have the greatest frequency of non-unions and malunions -as many as 50% [1,4]. Neer type IIB fractures are defined as fractures in the region of the coracoclavicular (CC) ligament wherein the conoid segment of the CC ligament is disrupted and there is a dislocation of the proximal fragment [1,5].…”

“…At the same time, they have the greatest frequency of non-unions and malunions -as many as 50% [1,4]. Neer type IIB fractures are defined as fractures in the region of the coracoclavicular (CC) ligament wherein the conoid segment of the CC ligament is disrupted and there is a dislocation of the proximal fragment [1,5].…”

“…The treatment of Neer type IIB fractures of the distal end of the clavicle is most commonly surgical, primarily due to the high incidence of non-union and malunion in patients treated non-surgically [1,5]. Currently, there is no gold standard regarding the surgical technique for this type of fracture, rather, surgical techniques are, according to the concept of fixation, divided into the following two groups: direct osteosynthesis of the clavicle (with the application of various plates, screws and intramedullary nails) and indirect stabilization of the fracture through fixation of the CC joint (with the use of various systems of rigid or flexible fixation) [1,6,7].…”