Surgical Treatment for Acute Acromioclavicular Joint Dislocation

급성 견봉쇄골관절 탈구의 수술적 치료

There has been considerable controversy concerning the methods for treatment of dislocation of the acromioclavicular joint, especially in grade III injury. The authors have treated 24 cases of the complete dislocation of the acromioclavicular joint from January 1990 to July 2000. We performed 14 cases of coracoclavicular wiring operation, 10 cases of modified Phemister operation and compared the results and complication of wiring operation with modified Phemister. The clinical results in modified phemister operation were excellent in 8 cases(80%), good in 1 case(l0%), fair 1 case(10%). In wiring operation, excellent is 11 case(78%), good is 2 case(14%), fair is 1 case(14%). The complications of modified Phemister operation were breakage and migration of K-wire in 2 cases. In wiring operation, breakage of wire was in 2 cases but migration was not showed. We prefered coracoclavicular wiring operation for dislocation of acromioclavicular joint of active young adults because of the following advantages: 1) violation of acromioclavicular joint can be avoided but rotation of the clavicle was not restricted. 2) The operation is simple to perform. 3) Postoperative immobilization is minimal. 4) Removal of the wire is easy because wire was not migrated when breakage of wire was occured.

1990년부터 2000년까지 본원에서 modified Phemister 방법과 cerclage wiring 방법으로 치료하고 1년이상 추시가 가능했던 견봉쇄골관절탈구 환자 24례를 임상적으로 분석하여 다음과 같은 결과를 얻었다. 1. modified Phemister 방법을 시행한 10례에서 우수 8례(80%), 양호 1례(10%), 보통 1례(10%)이었다. 2. Cerclage wiring 방법을 시행한 14례에서 우수 11례(78%), 양호 1례(14%), 보통 1례(14)이었다. 3. 술후 합병증으로 modified Phemister 방법에서 2례에서 고정강선의 파열 및 이동이 있었으며, cerclage wiring 방법에서 2례에서 아탈구, 2례에서 강선의 파열은 있었으나 이동은 없었다. 4. 이상과 같은 결과로 보아 modified Phemister 방법과 cerclage wiring 방법의 비교시 방사선상 오구돌기와 쇄골간 이완의 정도의 차이와 기능상의 차이는 없었으나 견봉쇄골관절을 고정하지 않음으로서 쇄골의 회전운동을 제한하지않고, 외상성관절염을 피할 수 있고, 강선의 파열시 이동이 없어 제거가 쉬워서 cerclage wiring을 선호하였다.