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These unstable injuries have shown a rate of nonunion that oscillates around 30% to 45% when managed conservatively, and surgical strategies often require a second operation for implant removal. We describe an arthroscopic\u2010assisted technique for the treatment of Neer type IIB unstable distal\u2010third clavicle fractures that overcomes the issues related to open surgery, metal hardware, and implant irritation. This technique increases the load to failure of the construct by means of adding a synthetic conoid ligament reconstruction with a nonrigid suspension device, and it allows the diagnosis and treatment of associated glenohumeral injuries. Our technique incorporates a fracture interfragmentary fixation with sutures, thus avoiding a second operation for implant removal.<\/jats:p>\n <\/jats:sec>\n \n Technique Video<\/jats:title>\n \n \n \n video<\/jats:alt-text>\n <\/jats:graphic>\n <\/jats:boxed-text>\n <\/jats:p>\n \n See video under supplementary data.<\/jats:bold>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1016\/j.eats.2015.07.010","type":"journal-article","created":{"date-parts":[[2015,11,9]],"date-time":"2015-11-09T07:15:11Z","timestamp":1447053311000},"update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":7,"title":["Arthroscopic\u2010Assisted Management of Unstable Distal\u2010Third Clavicle Fractures: Conoid Ligament Reconstruction and Fracture Cerclage With Sutures"],"prefix":"10.1002","volume":"4","author":[{"given":"Luis Natera","family":"Cisneros","sequence":"first","affiliation":[{"name":"Hospital de la Santa Creu i Sant Pau Universitat Aut\u00f2noma de Barcelona Barcelona Spain"},{"name":"Hospital General de Catalunya Sant Cugat del Vall\u00e9s Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Sarasquete","family":"Reiriz","sequence":"additional","affiliation":[{"name":"Hospital de la Santa Creu i Sant Pau Universitat Aut\u00f2noma de Barcelona Barcelona Spain"},{"name":"Hospital Quir\u00f3n Teknon Barcelona 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