ABSTRACT
Patellar tendon ruptures are rare injuries in young athletes, resulting in disruption of the extensor mechanism, and require surgery for functional recovery. Several techniques have been reported, including end-to-end repair and single-row suture anchor constructs. The strength of these repairs has been questioned, and they are commonly augmented. We endorse a double-row repair technique that provides an anatomic restoration of the footprint, has high fixation strength, eliminates the need for graft augmentation, and allows early motion.
ABSTRACT
BACKGROUND: Distal third clavicle fractures are associated with high rates of nonunion. Acceptable healing rates have been reported; however, complications and the need for additional procedures are a concern. The purpose of this study was to evaluate the functional outcomes and healing rates of an arthroscopy-assisted technique for fixation of unstable distal third clavicle fractures. METHODS: Seven patients presenting to a single surgeon with displaced distal clavicle fractures were included. A curved suspensory button and suture tape construct with a single coracoclavicular tunnel was used. Visual Analog Scale, American Shoulder and Elbow Surgeons scores, Simple Shoulder Test, and Subjective Shoulder Value scores were analyzed preoperatively and at final follow-up. Radiographic evidence of union, maintenance of reduction and complications were recorded. All patients were available for 1-year follow-up. RESULTS: Mean Visual Analog Scale pain score improved from 6.1±1.1 to 1.1±1.0 (P=0.022). American Shoulder and Elbow Surgeons scores increased from 40.3±17.2 to 86.7±13.7 (P≤0.001). The mean Simple Shoulder Test score increased from 2.7±1.1 to 11.0±1.8 (P≤0.001). The Subjective Shoulder Value improved from 41.6±19.1 to 91.4±7.6 (P=0.210). Fracture united in 6 of 7 patients and reduction was maintained in all patients. Six patients were satisfied and returned to previous activity level. CONCLUSIONS: Arthroscopy-assisted fixation of unstable displaced distal clavicle fractures demonstrates improved functional outcomes and high patient satisfaction. This construct avoids many of the previously reported complications associated with other methods of fixation, while minimizing the amount of soft tissue dissection.
