Novel Lag Screw Application In The Reduction Of Neer Type V Distal Clavicle Fracture: A Case Report And Technical Note.

INTRODUCTION

Neer Type V distal clavicle fractures are an unstable fracture configuration that is often treated with surgery. Type V fractures are challenging as the integrity of the coracoclavicular ligament needs to be restored by reducing the inferior fragment - a technically challenging endeavor. Multiple heterogeneous surgical techniques have been proposed in the literature to treat unstable distal clavicle fractures without any consensus on best practice. To date, there remains a lack of described effective techniques to aid in reducing the inferior fracture fragment in Neer Type V distal clavicle fractures.

CASE REPORT: We employ a novel method of applying a lag screw technique to aid in the reduction of the inferior fragment to solve this notoriously challenging fracture pattern.

CONCLUSION

This novel technique builds on fundamental trauma concepts. The extended use of a lag screw as a reduction technique in distal clavicle fractures has not been described in the literature before. This reduction technique reduces the need for extensive soft-tissue dissection for coracoid exposure, as described in other techniques (e.g., suture anchor or button fixations), while enabling direct incorporation of the inferior fragment, bone-to-bone healing, and benefits from the stability of a plate-screw construct.