PURPOSE To evaluate the clinical results after modified Phemister operation for complete dislocation of acromioclavicular joint. MATERIALS AND METHODS Thirty-seven cases of Fifty-three cases complete dislocation of acromioclavicular joint which were treated modified Phemister operation, follow up for at least one year, were evaluated. After operation, applied Kenny-Howard brace for six weeks and removed the inserted pins at ten to twelve weeks postoperatively. The ROM exercise was started at postoperative six weeks and meticulous ROM exercise was begun at pin removal. The clinical results were evaluated with range of movement, comparision of the coracoclavicular distance after surgery with that of follow up, and complications. RESULTS The range of motion were forward elevation 150 degree, external rotation 71 degree, external rotation at 90 degree abduction 77 degree, and internal rotation T8. The comparision of coracoclavicular distance after surgery(0,6mm) with that of follow up(1.0mm) showed no significant ligament laxity. The complication were subluxation in 2 cases, heterotrophic calcification in 3cases, broken K-wire in 2cases, pin site infection in 7cases and distal clavicle osteolysis in 3cases, which were healed at follow up radiographically. CONCLUSION To prevent of redislocation of acromioclavicular joint, we tried to insert the pin during relatively long period for sufficient healing of ruptured coracoclavicular ligament. Although immobilization period was relatively long period, clinical results were good.
There are many procedures for the treatment of acute A-C injury which have many complic ation such as limitation of shoulder motion, post traumatic arthritis and recurrence of dislocation etc. From July 1992 to June 1996 at National Medical Center, 21 patients with A-C injury had been treated by modified Phemister operation. The mean follow up time was 14.6 months.
The following results are obtained. 1. There was no limitation of shoulder motion in 20 cases. 2. The comparison of coraco-clavicular distance after surgery ( 2.24 mm ) with that of fallow up ( 3.95 mm ) showed no significant difference. 3. Clinical resuls showed that good in 18 cases, fair in 2 cases, poor in 1 case. From the above result, we suggest that Modified Phemister method is simple and good procedure in the treatment of acute A-C dislocation.
Acoromioclavicular dislocation occurs frequently in young athletes and recently in automobile accident victims and laborers, and there are various kinds of operative methods for this injury. Authors performed operative treatment for 45 cases of acromioclavicular dislocation: 30 cases of modified Phemister operation and 15 cases of modified Bosworth operation from March 1992 to June 1996. Authors analysed the result of the treatment and the results obtained were as follows.
1. The clinical results evaluated by Weitzman criteria were all satisfactory in both modified Phemister method and modified Bosworth method.
2. The radiologic results were evaluated by the difference of the distance from the coracoid process to the clavicle between the normal and the injured site. And the result was more satisfactory in modified Bosworth method.
3. There were less complications in modified Bosworth method.