背景：尽管文献中已经报道了各种手术方法，目前尚无无可争议的金标准技术治疗NeerII型锁骨外侧骨折。这种创伤被归类为骨折，但这主要是一个韧带问题，因为它产生的不稳定性。本研究分析了使用三重Endobutton（Smith＆Nephew）技术治疗NeerII型锁骨外侧骨折的临床和放射学结果，对20例患者进行了至少2年的随访。
方法：这项研究纳入了20例NeerII型锁骨远端骨折患者，他们使用3例Endobutors（1例闭合环，2例没有）和3例接受了三重Endobutors技术。52017年10月至2020年5月的埃塞俄比亚邦德缝线（EthiconInc.）。在术后3、6、12和24个月对患者进行临床和放射学随访。临床评估包括视觉模拟量表和Constant评分。放射学评估是通过测量喙锁距离来实现的。
结果：平均随访35±9个月（范围，24-55个月）。视觉模拟量表和常数评分显示，从6±1（范围，4-8）和42±4（范围，35-48）术前评分为1±1（范围，0-1）和94±2（范围，90-98）在最终评估中的分数，分别(P<.001)。伤侧喙锁骨距离平均为9±1mm(范围,7-12mm）在最后的随访X线片上，与对侧的X线片没有显着差异（P=.75）。
结论：在这项研究中，三重Endobutton技术是安全的，可靠,和新颖的手术技术，在治疗NeerII型锁骨远端骨折方面产生了良好的短期临床和放射学结果。
BACKGROUND: Although various kinds of operative procedures have been reported in the literature, there is still no undisputed gold standard technique for the treatment of Neer type II lateral clavicle fractures. This trauma is classified as a bone fracture, but it is primarily a ligamentous problem due to the instability it generates. This study analyzed the clinical and radiological results of treatment for Neer type II lateral clavicle fractures using the triple Endobutton (Smith & Nephew) technique in 20 patients with at least 2 years of follow-up.
METHODS: This study enrolled 20 patients with Neer type II distal clavicle fractures who underwent the triple Endobutton technique using 3 Endobuttons (1 with a closed loop and 2 without) and 3 No. 5 Ethibond sutures (Ethicon Inc.) from October 2017 to May 2020. Patients were assessed with clinical and radiological follow-up at 3, 6, 12, and 24 months postoperatively. Clinical assessments consisted of the visual analog scale and the Constant score. Radiological evaluation was achieved by measuring the coracoclavicular distance.
RESULTS: The mean follow-up was 35 ± 9 months (range, 24-55 months). The visual analog scale and Constant scores revealed significant improvements from 6 ± 1 (range, 4-8) and 42 ± 4 (range, 35-48) scores preoperatively to 1 ± 1 (range, 0-1) and 94 ± 2 (range, 90-98) scores at the final evaluation, respectively (P < .001). The coracoclavicular distance of the injured side was an average of 9 ± 1 mm (range, 7-12 mm) at the final follow-up radiograph which was not significantly different from that of the contralateral side (P = .75).
CONCLUSIONS: In this study, the triple Endobutton technique was a safe, reliable, and novel surgical technique that yielded good to excellent short-term clinical and radiological outcomes for the treatment of Neer type II distal clavicle fractures.
