Novel Lag Screw Application In The Reduction Of Neer Type V Distal Clavicle Fracture: A Case Report And Technical Note

Introduction: Neer Type V distal clavicle fractures are an unstable fracture configuration that is often treated with surgery. Type V fractures are challenging as the integrity of the coracoclavicular ligament needs to be restored by reducing the inferior fragment – a technically challenging endeavor. Multiple heterogeneous surgical techniques have been proposed in the literature to treat unstable distal clavicle fractures without any consensus on best practice. To date, there remains a lack of described effective techniques to aid in reducing the inferior fracture fragment in Neer Type V distal clavicle fractures. Case Report: We employ a novel method of applying a lag screw technique to aid in the reduction of the inferior fragment to solve this notoriously challenging fracture pattern. Conclusion: This novel technique builds on fundamental trauma concepts. The extended use of a lag screw as a reduction technique in distal clavicle fractures has not been described in the literature before. This reduction technique reduces the need for extensive soft-tissue dissection for coracoid exposure, as described in other techniques (e.g., suture anchor or button fixations), while enabling direct incorporation of the inferior fragment, bone-to-bone healing, and benefits from the stability of a plate-screw construct. Keywords: Clavicle fracture, distal, type V, Neer, reduction, lag screw, technique.