{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T17:42:44Z","timestamp":1773596564629,"version":"3.50.1"},"reference-count":33,"publisher":"British Editorial Society of Bone & Joint Surgery","issue":"7","license":[{"start":{"date-parts":[[2013,7,1]],"date-time":"2013-07-01T00:00:00Z","timestamp":1372636800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/online.boneandjoint.org.uk\/TDM"}],"content-domain":{"domain":["online.boneandjoint.org.uk"],"crossmark-restriction":true},"short-container-title":["The Bone &amp; Joint Journal"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:p>In Neer type II (Robinson type 3B) fractures of the distal clavicle the medial fragment is detached from the coracoclavicular ligaments and displaced upwards, whereas the lateral fragment, which is usually small, maintains its position. Several fixation techniques have been suggested to treat this fracture. The aim of this study was to assess the outcome of patients with type II distal clavicle fractures treated with coracoclavicular suture fixation using three loops of Ethibond. This prospective study included 14 patients with Neer type II fractures treated with open reduction and coracoclavicular fixation. Ethibond sutures were passed under the coracoid and around the clavicle (UCAC loop) without making any drill holes in the proximal or distal fragments. There were 11 men and three women with a mean age of 34.57 years (29 to 41). Patients were followed for a mean of 24.64 months (14 to 31) and evaluated radiologically and clinically using the Constant score. Fracture union was obtained in 13 patients at a mean of 18.23 weeks (13 to 23) and the mean Constant score was 96.07 (91 to 100). One patient developed an asymptomatic fibrous nonunion at one year. This study suggests that open reduction and internal fixation of unstable distal clavicle fractures using UCAC loops can provide rigid fixation and lead to bony union. This technique avoids using metal hardware, preserves the acromioclavicular joint and provides adequate stability with excellent results.<\/jats:p><jats:p>Cite this article: Bone Joint J 2013;95-B:983\u20137.<\/jats:p>","DOI":"10.1302\/0301-620x.95b7.31316","type":"journal-article","created":{"date-parts":[[2013,6,27]],"date-time":"2013-06-27T09:49:11Z","timestamp":1372326551000},"page":"983-987","update-policy":"https:\/\/doi.org\/10.1302\/crossmark-policy","source":"Crossref","is-referenced-by-count":25,"title":["Under-coracoid-around-clavicle (UCAC) loop in type II distal clavicle fractures"],"prefix":"10.1302","volume":"95-B","author":[{"given":"O.","family":"Soliman","sequence":"first","affiliation":[{"name":"Cairo University, Orthopaedic Department, Faculty of Medicine, Cairo, Egypt."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W.","family":"Koptan","sequence":"additional","affiliation":[{"name":"Cairo University, Orthopaedic Department, Faculty of Medicine, Cairo, Egypt."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Zarad","sequence":"additional","affiliation":[{"name":"Cairo University, Orthopaedic Department, Faculty of Medicine, Cairo, Egypt."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"42","reference":[{"key":"r1","doi-asserted-by":"publisher","DOI":"10.1016\/0020-1383(92)90125-C"},{"key":"r2","first-page":"43","volume":"58","year":"1968","journal-title":"Clin Orthop Relat Res"},{"key":"r3","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.80B3.0800476"},{"key":"r4","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-006-0197-3"},{"key":"r5","doi-asserted-by":"publisher","DOI":"10.1177\/230949900701500103"},{"key":"r6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2007.04.012"},{"key":"r7","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2006.08.028"},{"key":"r8","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e318213f5a6"},{"key":"r9","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000203469.66055.6a"},{"key":"r10","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2008.07.021"},{"key":"r11","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-008-0696-7"},{"key":"r12","doi-asserted-by":"publisher","DOI":"10.1016\/S1726-4901(10)70139-8"},{"key":"r13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2006.08.012"},{"key":"r14","first-page":"3334","volume":"469","author":"Anderson JR","year":"2011","journal-title":"Clin Orthop Relat Res"},{"key":"r15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2009.11.056"},{"key":"r16","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.73B2.2005158"},{"key":"r17","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2009.03.013"},{"key":"r18","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1097\/00003086-198701000-00023","volume":"214","author":"Constant CR","year":"1987","journal-title":"Clin Orthop Relat Res"},{"key":"r19","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-196303000-00001"},{"key":"r20","doi-asserted-by":"publisher","DOI":"10.1016\/0020-1383(92)90125-C"},{"key":"r21","doi-asserted-by":"crossref","first-page":"291","DOI":"10.3944\/AOTT.2011.2487","volume":"45","author":"Esenyel CZ","year":"2011","journal-title":"Acta Orthop Traumatol Turc"},{"key":"r22","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-011-2009-5"},{"key":"r23","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-012-1570-z"},{"key":"r24","doi-asserted-by":"crossref","unstructured":"Martetschl\u00e4ger F, Kraus TM, Schiele CS, et al.Treatment for unstable distal clavicle fractures (Neer 2) with locking T-plate and additional PDS cerclage.Knee Surg Sports Traumatol Arthrosc2012;Epub.","DOI":"10.1007\/s00167-012-2089-0"},{"key":"r25","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198769070-00013"},{"key":"r26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2010.03.013"},{"key":"r27","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.92B6.23558"},{"key":"r28","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2010.10.004"},{"key":"r29","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2010.08.007"},{"key":"r30","first-page":"147","volume":"95","author":"Hessmann M","year":"1995","journal-title":"Acta Chir Belg"},{"key":"r31","author":"Rieser GR","year":"2012","journal-title":"J Shoulder Elbow Surg"},{"key":"r32","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2005.10.017"},{"key":"r33","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2005.11.012"}],"container-title":["The Bone &amp; 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