TO EVALUATE THE FUNCTIONAL OUTCOME OF ALL-SUTURE TECHNIQUES IN LATERAL END CLAVICLE FRACTURES

Background: Lateral end clavicle fractures, though less common than midshaft fractures, can be challenging to treat due to their proximity to the acromioclavicular (AC) joint and associated soft tissue damage, often requiring surgical intervention, particularly unstable Neer type II A, II B and V fractures. The absence of hardware in this method eliminates the risk of implant-related issues, such as rotator cuff tears, shoulder impingement syndrome, implant loosening, acromial erosion/osteolysis and infections. Adding to that no need for secondary surgery for implant removal—an advantage over traditional xation techniques. The all-suture technique has emerged as a minimally invasive alternative aiming to provide stable xation while preserving native anatomy. This prospectiv Methods: e observational study, conducted over 18 months (July 2023 to June 2025) at Index Medical College, Hospital and Research Centre (IMCHRC), Indore (M.P.), included 50 patients aged 18-65 years with Neer type 2A, 2B, and 5 lateral end clavicle fractures of less than 1 month duration treated with all suture open technique performed by specialized trauma surgeons with a minimum follow up of 3 months. Osteosuture repair using No. 5 Ethi-bond sutures was done consisting of coracoclavicular anchor cerclage and a gure of 8 cerclage of proximal and distal fragment, assessed using DASH, CMS, VAS and SANE score at 12th week. Radiological outcomes and treatment-related complications were also evaluated. The stu Results: dy found favorable clinical recovery and excellent functional outcome with mean scores of 20.44 ± 8.35 for DASH, 80.6 ± 10.19 for SANE, 22.1 ± 16.56 (mm) for VAS, and 87.98 ± 6.57 for CMS. The union rate was satisfactory. Complications were limited to surgical site infection (6%). This study's data, which is corroborated by the DASH, CMS, VAS, and SANE grading Conclusion: systems, demonstrated that lateral end clavicle fractures treated with all suture technique produce excellent functional outcomes demonstrating a high degree of union and a lower rate of post op complications up to the three-month follow-up. The majority of patients, particularly those in the 18–39 age group, demonstrated rapid functional improvement with good range of motion th th recovery by the 6 week, and full return to activity by the 12 week. The technique offers advantages like reduced exposure, avoidance of hardware-related issues, prevention of reoperation for hardware removal, and reduced expenses. However, it requires surgical skill and has limitations including the lack of a control group in this study and relatively short follow-up.