Treatment of unstable distal clavicular fractures with and without lesions of the acromioclavicular joint.

A series of 39 unstable fractures of the distal one-third of the clavicle is presented. As results after non-operative treatment of these fractures are poor, surgical therapy is indicated. In fractures with a small peripheral fragment or with an associated separation of the acromioclavicular joint, PDS-banding is a valuable technique for stabilization. According to the classification of Neer and Jäger/Breitner, a clear therapeutic strategy for lateral clavicular fractures can be defined. Unstable clavicular fractures with associated acromioclavicular ligament disruption should however be considered as a separate subtype in the existing classifications.