Operative techniques for displaced distal clavicle fractures

Displaced distal clavicle fractures remain a treatment dilemma. Nonunion rates as high as 30% have been reported (Anderson K: in Miller MD (ed): Clinics in Sports Medicine. Philadelphia, PA, Saunders, 2003, pp 319–326). In a high-demand, young, active patient surgical treatment has been recommended to provide the most predictable result. When surgery is deemed appropriate, multiple techniques have been utilized. This paper reviews several accepted techniques and introduces a surgical technique utilizing a very strong nonabsorbable suture to permit repair. The author has utilized this technique in a small series of patients where there has been significant comminution or poor bone quality precluding metal fixation.