Minimally Invasive Coracoclavicular Ligament Reconstruction Using Semitendinosus Autograft in a Case of Cho's Type IIC Lateral End Clavicle Fracture With Torn Conoid and Trapezoid Ligaments

Clavicle fractures are a common clinical problem that accounts for about 10% of all fractures. Cho's type II fractures compromise the integrity of the coracoclavicular ligament and are thus inherently unstable, necessitating a lengthy healing period and being associated with a high rate of nonunion or malunion. The lowering of these rates is largely dependent on restoring the stability of the distal clavicle. In our case report, a 60-year-old male came to the OPD with complaints of pain over the right shoulder for two days following a fall with his arm in an adducted position. He also complained of an inability to abduct the right shoulder beyond 45 degrees. A plain radiograph was done, which was suggestive of a right lateral end clavicle fracture with increased coracoclavicular distance compared to the uninvolved shoulder. He was taken up for surgery after routine laboratory investigations and pre-anaesthesia check-up and minimally invasive coracoclavicular ligament reconstruction was done using a semitendinosus autograft. Intra-operatively, both the conoid and trapezoid ligaments showed tears. A universal shoulder immobilizer was applied post-surgery and continued for six weeks. Pendular exercises of the shoulder were started as per tolerance, and the patient responded well to surgery.