Tension band suturing for the treatment of displaced type 2 lateral end clavicle fractures.

INTRODUCTION: Non-operative treatment of Neer type 2 lateral end clavicle fractures presents a difficult problem due to the high incidence of non-union, delayed union and resulting shoulder girdle instability. Operative techniques described may require extensive soft tissue reconstruction, implant removal or lead to implant failure. MATERIALS AND METHODS: We report a modified tension band suturing technique for the treatment of these lateral end displaced clavicle fractures that avoids these problems of extensive soft tissue dissection, implant removal or implant failure. Ten patients were reviewed clinically, radiologically and with Constant assessment score outcomes using the tension band suture for the treatment of these fractures. RESULTS: All the fractures had healed at a mean follow-up of 9.2 weeks (range 6-16 weeks) with a mean Constant score of 91 and the power was comparable to the normal shoulder using the Nottingham Myometer. CONCLUSION: The results of this pilot study for treatment of Neer's type 2 lateral end clavicle fractures are very encouraging. We do recommend the need for a prospective larger study of this technique for the treatment of Neer type 2 lateral end clavicle fracture to evaluate this technique further.

An unusual rugby injury.

We describe an unusual sports injury in a young man, a combination of obturator hip dislocation with an ipsilateral anterior cruciate ligament injury. Traumatic non-prosthetic hip dislocations, particularly obturator hip dislocations, are extremely rare sports injuries and have not previously been reported in conjunction with a knee ligament injury. The severe pain and obvious deformity from the hip injury can distract from other injuries, particularly to the ipsilateral knee. This case reinforces the need for a thorough assessment of the knee joint, before hip reduction if possible and certainly after reduction of the dislocation.