Abstract
Lateral end clavicle fractures, especially those that are displaced, have a high rate of delayed and non-union. This case series presents three patients with unstable lateral end clavicle fractures successfully treated with TightRope fixation as the sole method of stabilization, demonstrating excellent functional outcomes and minimal complications. The comprehensive literature review reveals mounting evidence with eight reported studies supporting TightRope as an effective standalone treatment option, with the largest published series showing 79% union rates and only 10% complication rates. These findings, combined with the theoretical advantages of avoiding routine hardware removal, lower costs, and compatibility with day-surgery protocols, suggest that TightRope fixation merits serious consideration as a primary treatment modality for appropriately selected patients with lateral end clavicle fractures.