treatment of distal end clavicle fractures: suture fixation versus tension band wiring

Background: several methods like kirschner wire, suture fixation, plaque, and so on are used for surgical treatment of neer type-ii fracture of the distal end of the clavicle. objectives: because of no gold standard in treating fractures of the distal end of the clavicle, this study was conducted to compare therapeutic outcomes of tension band wire (tbw) and suture fixation (sf) in treating this type of fracture. methods: this retrospective, analytical cross-sectional study was performed on patients with confirmed unilateral unstable neer type-ii fracture of the distal end of the clavicle. based on the surgeon’s preferred protocol for fixation of fractures, pin and wire were used for the patients operated from september 21, 2010, to march 20, 2013 (tbw group), and suture fixation for patients operated from march 21, 2013, to september 23, 2015, (sf group). demographic information was recorded separately for both groups. all patients were evaluated and scored based on constant score, visual analog scale (vas), symptomatic hardware, and loss of reduction in 3 and 6 months, and final visit after surgery. results: among 85 patients, 41 and 44 were allocated in tbw and sf groups, respectively. the mean follow-up time was 36.7 months. our findings showed that both groups in three follow-up periods were similar in shoulder function based on constant score, vas score, loss of reduction, and nonunion. but the sf group had lesser symptomatic hardware rather than the tbw group (p=0.001). conclusion: although the measures of pain intensity and function were similar in the two groups, symptomatic hardware and the need for hardware removal in the tbw method are weak points that should be considered.