Table 1.
Characteristics of the Included Studiesa
| Lead Author (Year) | No. of AA-DCF | Age, y, mean ± SD | Male, % | Neer Type | Surgical Construct | Union Rate, % | Complications | Reoperations |
|---|---|---|---|---|---|---|---|---|
| Blake (2017)4 | 17 | 41.0 ± 19.0 | 35 | II | Arthrex TightRope CC fixation with modified fracture site cerclage | 82 | 3 nonunions, 1 deep infection, 1 adhesive capsulitis, 1 symptomatic cerclage suture | 1 I&D, 1 suture debridement/ROH |
| Checchia (2008)7 | 7 | 46.3 ± 10.8 | 57 | II (n = 3), V (n = 4) | Double Arthrex No. 5 FiberWire clavicular subcoracoid cerclage | 100 | 1 superficial infection, 1 adhesive capsulitis | |
| Flinkkilä (2015)9 | 21 | 39.0 ± 14.0 | 95 | II | Arthrex TightRope CC fixation vs hooked plate | 95 | 1 nonunion, 1 hardware failure, 1 infection, 1 sinus formation | 1 revision fixation, 1 I&D, 1 excision of sinus tract |
| Kraus (2015)12 | 20 | 38.3 ± 7.3 | 65 | II | Arthrex TightRope CC fixation with fracture site cerclage | 95 | 1 nonunion, 1 hardware failure, 1 symptomatic implant, 6 CC ossifications | 1 revision fixation, 1 ROH |
| Kuner (2019)13 | 20 | 45.0 ± 12.0 | 70 | II | Arthrex TightRope or DogBone CC fixation | 70 | 6 nonunions, 1 wound complication, 2 adhesive capsulitis, 2 symptomatic implants | 2 nonunion revisions, 1 scar revision, 2 ROH |
| Lim (2019)14 | 5 | 51.6 ± 19.8 | 20 | IIb | Arthrex DogBone CC fixation | NR | 5 CCBRCCT, 1 superficial infection, 2 hardware failures, 1 button migration, 1 CC ossification | 2 revision fixations, 1 I&D |
| Loriaut (2015)15 | 21 | 33.0 ± 12.3 | 67 | IIb | Arthrex TightRope CC fixation | 95 | 1 hardware failure with nonunion, 1 symptomatic implant, 1 adhesive capsulitis, 2 CC ossifications | None |
| Lu (2010)16 | 7 | 51.0 ± 17.0 | 57 | IIb | Arthrex TightRope CC fixation with modified fracture site cerclage fixation | 100 | None | None |
| Mochizuki (2019)17 | 23 | 34.3 ± 9.5 | NR | IIb | Zimmer ZipTight + K-wire | 100 | NR | None |
| Motta (2014)19 | 14 | 32.0 ± 5.8 | 100 | IIa (n = 2), IIb (n = 10), V (n = 2) | Arthrex TightRope CC fixation | 100 | 1 superficial infection, 3 SCCB, 2 button migrations, 2 CC ossifications | None |
| Pujol (2008)24 | 4 | 35.0 ± 5.0 | 75 | NR | Arthrex TightRope CC fixation | 100 | None | None |
| Sautet (2018)27 | 14 | 34.6 ± 6.8 | 71 | IIb | Subcoracoid suture, Arthrex DogBone clavicular cortical button | 100 | 4 symptomatic implants | 2 ROH |
| Takase (2012)31 | 7 | 41.9 ± 0.50 | 100 | II | Smith & Nephew Endobutton (coracoid side) with spike washer and screw (clavicle side) fixation with Dacron (Smith & Nephew) artificial ligament | 100 | None | None |
| Takase (2019)32 | 18 | 43.5 ± 6.8 | 90 | II | Smith & Nephew Endobutton (coracoid side) with spike washer and screw (clavicle side) fixation with Dacron artificial ligament | 100 | None | None |
| Xiong (2018)34 | 28 | 41.9 ± 13.5 | 59 | IIa (n = 12), IIb (n = 16) | Arthroscopic Smith & Nephew double Endobutton vs hook plate vs LCP | 96 | 1 nonunion | 1 nonunion revision |
aAA-DCF, arthroscopically assisted distal clavicle fractures; CC, coracoclavicular; CCBRCCT, cortical coracoid breach requiring conversion of construct or technique; I&D, irrigation and debridement; K-wire, Kirschner wire; LCP, locking compression plate; NR, not reported; ROH, removal of hardware; SCCB, salvageable cortical coracoid breach.