Evaluation of Modified CC Stabilization using LARS Artificial Ligament in Unstable Distal Clavicle Fracture

Abstract

Purpose

Unstable distal clavicle fractures are clinically common, and there is no consensus regarding gold-standard treatment. The purpose of this study was to report on a new surgical technique for the treatment of unstable distal clavicle fracture with modified coracoclavicular (CC) stabilization using a ligament augmentation and reconstruction system (LARS) of an artificial ligament, and to compare the clinical and radiographic outcomes with hook-plate fixation.

Methods

Thirty patients with unstable distal clavicle fractures were treated with modified coracoclavicular (CC) stabilization using either a ligament augmentation and reconstruction system (LARS) or open reduction internal fixation with a hook plate. Indexes for evaluation included fracture healing, quality of reduction, and presence of complications. Shoulder function was evaluated using the Constant-Murley score.

Results

Patients were assessed at a mean time of 31.2 ± 10.1 months follow-up. All patients experienced radiographic union. The result at the last follow-up showed that patients treated surgically with ligament augmentation and reconstruction system had better Constant-Murley scores for shoulder function and lower complication rates than those treated with a hook plate.

Conclusions

Treatment using LARS for unstable distal clavicle fractures resulted in excellent union rates and functional outcomes. This simple surgical technique is considered to be an efficient method for treating fractures that naturally restores stability of the distal clavicle fracture.

Zusammenfassung

Ziel

Unstabile Frakturen der distalen Klavikula sind klinisch häufig, und es besteht keine Einigkeit hinsichtlich der Goldstandardbehandlung. Das Ziel dieser Studie war es, über eine neue chirurgische Technik zur Behandlung von unstabilen Frakturen der distalen Klavikula mit modifizierter korakoklavikulärer (CC) Stabilisierung unter Verwendung eines künstlichen Ligaments in Form eines Ligamentenverstärkungs- und Rekonstruktionssystems (LARS) zu berichten und die klinischen und radiologischen Ergebnisse mit der Fixation mit einer Hakenplatte zu vergleichen.

Methoden

30 Patienten mit unstabilen Frakturen der distalen Klavikula wurden mit modifizierter korakoklavikulärer (CC) Stabilisierung unter Verwendung eines Ligamentenverstärkungs- und Rekonstruktionssystems oder einer offenen Reduktion und internen Fixation mit einer Hakenplatte behandelt. Die Bewertungsindizes umfassten die Frakturheilung, die Qualität der Reduktion und das Vorhandensein von Komplikationen. Die Schulterfunktion wurde mit dem Constant-Murley-Score bewertet.

Ergebnisse

Die Patienten wurden bei einer durchschnittlichen Nachbeobachtungszeit von 31,2 ± 10,1 Monaten bewertet. Alle Patienten zeigten radiologisch eine Knochenheilung. Das Ergebnis bei der letzten Nachuntersuchung zeigte, dass Patienten, die chirurgisch mit dem Ligamentenverstärkungs- und Rekonstruktionssystem (LARS) behandelt wurden, bessere Constant-Score-Ergebnisse für die Schulterfunktion und eine niedrigere Komplikationsrate hatten als jene, die mit einer Hakenplatte behandelt wurden.

Schlussfolgerungen

Die Behandlung von unstabilen Frakturen der distalen Klavikula mit LARS führte zu einer guten Versorgungsrate und einem guten funktionellen Ergebnis. Diese einfache chirurgische Technik wird als effiziente Methode zur Behandlung von Frakturen angesehen, die die Stabilität der distalen Klavikulafraktur natürlich wiederherstellen.

Keywords

unstable distal clavicle fracture - coracoclavicular stabilization - artificial ligament

Schlüsselwörter

instabile distale Schlüsselbeinfraktur - korakoklavikuläre Gelenkstabilität - künstliches Band

Publication History

Received: 25 December 2023

Accepted after revision: 08 July 2025

Article published online:
25 August 2025

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