Journal of Musculoskeletal Trauma

Modified Phemister Technique with Tension Band Wiring in Acromioclaviculr Joint Dislocation: Yu Jin Kim, Hun Kyu Shin, Ji Won Lee; J Korean Fract Soc 2006;19(4):431-436. Published online October 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.4.431

Abstract: PURPOSE
To evaluate the clinical and radiological result of surgical treatment of acromioclavicular joint dislocation, using modified Phemister technique with tension band wiring.
MATERIALS AND METHODS
We chose 17 patients who were able to follow up 1 year or more among the patients who were diagnosed as acromioclavicular joint dislocation in our hospital through January 2000 to Feburary 2005 and took modified Phemister technique with tension band wiring. Evaluation of the surgical results was done with the condition of pain, activity of daily living, range of motion, muscle tone by constant score system, and with preoperative, postoperative and last follow up radiographs.
RESULTS
Clinical evaluation was average 92 point by Constant score system from 84 point to 100 point. Subjective evaluation was 11 excellent (65%), 6 good (35%). Radiological evaluation was 9 excellent (54%), 6 good (38%), 2 fair (12%), and no poor group. On the final follow up, two cases showed inflammatory reaction at where pins were inserted, but after the removal of the pins, the inflammation was subsided.
CONCLUSION
The modified Phemister surgery for acromioclavicular dislocation is one of effective techniques, we can obtain firm fixation, exercise full range of motion early and there is no complication of re-dislocation.

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The Results of Surgical Treatment of Acute Acromio-clavicular Separation, Type III: Sung Ho Hahn, Bo Kyu Yang, Seung Rim Yi, Shun Wook Chung, Dong Ho Lee, Min Seok Kim; J Korean Soc Fract 2003;16(2):235-243. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.235

Abstract PDF: PURPOSE
The purpose of this study is to compare the Phemister technique with the modified Phemister technique for the patients with Rockwood type 3, acromio-clavicular separation.
MATERIALS AND METHODS
The 45 cases of 45 patients received surgical treatment for Rockwood type 3, acute acromio-clavicular separation in our hospital from Feb. 1992 to Aug. 2001 later with the follow-up study were selected as subjects. The average ages were 28.1 years old, male and female were 42, 3 persons, respectively. Physical examination and plain radiography were used for their diagnosis and the intervals between injury and surgical treatment were 7.8 days. In intraoperative finding, we performed Phemister technique in 15 cases according not to be able to repair coraco-clavicular ligament (group I), modified Phemister technique in 30 cases according to be able to repair that (group II). The average follow up period was 16.2 months, and the UCLA shoulder scoring system and the acromio-clavicular separation scoring system were used to obtain clinical results.
RESULTS
Only in Group II, the complication after surgery were associated with superficial infection in two cases and K-wire migration in one case. At last follow up, there were no pain and limitation of range of motion in all cases, and two cases in Group II were found to be subluxation in radiography. Clinical results revealed excellent was 93.3%, good was 6.7% in UCLA shoulder scoring system in both groups, and excellent was 90%, good was 10% for group II in acromio-clavicular separation scoring system.
CONCLUSION
The results are considered to be good with only Phemister technique in type 3, acute injury occurred in working ages.

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Treatment of Acute Acromioclavicular Dislocation with Modified Phemister Technique: Myung Hwan Son, Byung Chul Kim, Nam Wook Kang, Tae Young Choi; J Korean Soc Fract 1999;12(3):686-692. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.686

Abstract PDF: There are various kinds of operative methods for the treatment of acute acromioclavicular dislocation but many complications such as posttraumatic arthritis, limitation of shoulder motion, and recurrence of dislocation would be developed. We have experienced 23 cases of acute acromioclavicular dislocation treated by modified Phemister technique from January 1992 to January 1997 and followed-up at least 1 year at Department of Orthopaedic Surgery, Pusan City Medical Center. The results were as follows: 1. The clinical results were evaluated by Weaver and Dunn were good in 19 cases, fair in 3 cases, poor in 1 case. 2. The radiological results were evaluated by the difference of the distance from the coracoid process to the clavicle between normal and injured site. The comparison of coraco-clavicular distance after surgery(1.76 mm) with that of follow up(2.41 mm) showed no significant difference(P>0.05, by Student t-test). 3. There was no posttraumatic arthritis and limitation of shoulder motion in all cases. So we suggest that modified Phemister technique is a good method for aute acromioclavicular dislocation.

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