Though the best and ideal method for internal fixation is a matter of non-yielding debate, but a few series of coracoclavicular
screws, tension band, K-wire hook plates, special anatomical locking and non-locking plates have been published with encouraging results in all the series.
Although bony union of the avulsion fractures was confirmed on the radiograms taken 1 year and 6 months after the injury, the coracoclavicular
interval and ACJ space remained wide (Figure 2(c)).
Neer type II patients were complicated with rupture of coracoclavicular
Open reduction and internal fixation with an anatomically-contoured, low-profile distal clavicle plate with coracoclavicular
cerclage is a reliable method for treatment of unstable Neer Type II distal clavicle fractures.
Vertical stability is provided by the two coracoclavicular
ligaments, the conoid and trapezoid ligaments (Figs.
3] The majority of these types of dislocations result from direct force trauma to the shoulder, causing rupture on the acromioclavicular and coracoclavicular
ligaments and tearing of the deltoid and trapezius muscles.
2) In Grade III dislocation, both acromioclavicular and coracoclavicular
ligaments are completely disrupted resulting in superior displacement of the distal clavicle.
Additionally, a thick periosteum forms a protective sleeve around the distal clavicle and the acromion and serves as a point of attachment for the coracoclavicular
1-4) These injuries have a wide range of severity, from sprains of the acromioclavicular and coracoclavicular
ligaments to complete dislocation of the AC joint.
The main purpose of all these methods is to replace the ruptured coracoclavicular
ligament in order to stabilize the clavicle.
Displaced acromioclavicular (AC) separations (type III or worse) involve disruption of the acromioclavicular ligaments and the coracoclavicular
(CC) ligament complex.
With higher energy injuries, there may also be damage to soft tissue surrounding structures such as the coracoclavicular
ligaments, acromioclavicular joint capsule, and underlying neurovascular structures.