Clinical and Radiological Evaluation of Double Endobutton Fixation in Acute Acromioclavicular Joint Injuries and Unstable Lateral Clavicle Fractures: A Prospective Observational Study

Background: Acromioclavicular (AC) joint injuries and unstable lateral clavicle fractures are common shoulder girdle injuries that frequently affect young and active individuals. High-grade AC joint dislocations and unstable distal clavicle fractures often require surgical stabilization because of persistent instability, functional impairment, and a high risk of nonunion. Double Endobutton fixation has proven to be a biomechanically advantageous procedure that restores coracoclavicular stability but allows for natural shoulder function. The objective is to evaluate the functional and radiological outcomes of double Endobutton fixation with Fiber Wire in patients with acute acromioclavicular joint injuries and unstable lateral clavicle fractures. Material and Methods: It was a prospective observational study done in the Department of Orthopaedics in tertiary care teaching hospital. Thirty patients with acute injuries to the AC joint and/or lateral clavicle fractures that were unstable were treated with double Endobutton fixation.Double Endobutton fixation was performed on 30 patients with acute AC joint injuries and/or unstable lateral clavicle fractures. The patients were clinically and radiologically followed for 6 months. Functional outcome was evaluated by the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score, and radiological evaluation was carried out on maintenance of reduction, coracoclavicular distance and fracture union. Postoperative complications also were noted. Results: 30 patients (80.0% male) aged 36.00 ± 8.20 years were included in the study. 63.3 % of falls were the most common mechanism of injury. At six months, radiological reduction was maintained in 83.3% of patients, while mild and significant loss of reduction occurred in 13.3% and 3.3% of cases, respectively. The mean fracture union time for patients sustaining lateral clavicle fractures was 12.31 ± 1.32 weeks and all fractures united within 14 weeks. Our complications were rare, with only 6.7% of patients having a superficial infection. At six months, there was no significant relationship between the radiological reduction status and the QuickDASH score (p = 0.623 and p = 0.191). Conclusion: Double Endobutton fixation is effective in providing stabilization of acute acromioclavicular joint injuries and unstable lateral clavicle fractures. The technique is linked with good functional outcome, adequate radiological results, easy to keep reduction and low complication rates. It is a good surgical choice in appropriately selected patients to restore shoulder function and stability.

Keywords: Acromioclavicular joint injury, Double Endobutton, Lateral clavicle fracture, Coracoclevicular fixation and QuickDASH are keywords.