Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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The Modified Phemister Operation with the Suture Anchor Added for the Augmentation of Conoid Ligament in Acute Acromioclavicular Dislocation

견봉쇄골 관절의 급성 탈구에서 원추인대 기능의 강화를 위한 봉합 나사못을 추가한 변형된 Phemister 술식

  • Moon, Gi-Hyuk (Department of Orthopedic Surgery, Pohang St. Mary's Hospital) ;
  • Nam, Il-Hyun (Department of Orthopedic Surgery, Pohang St. Mary's Hospital) ;
  • Lee, Yeong-Hyun (Department of Orthopedic Surgery, Pohang St. Mary's Hospital) ;
  • Kim, Ki-Choul (Department of Orthopedic Surgery, Pohang St. Mary's Hospital) ;
  • Lee, Jae-Hoon (Department of Orthopedic Surgery, Pohang St. Mary's Hospital) ;
  • Ahn, Gil-Yeong (Department of Orthopedic Surgery, Pohang St. Mary's Hospital)
  • 문기혁 (포항성모병원 정형외과) ;
  • 남일현 (포항성모병원 정형외과) ;
  • 이영현 (포항성모병원 정형외과) ;
  • 김기철 (포항성모병원 정형외과) ;
  • 이재훈 (포항성모병원 정형외과) ;
  • 안길영 (포항성모병원 정형외과)
  • Received : 2010.04.15
  • Accepted : 2010.06.02
  • Published : 2010.06.15
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Abstract

Purpose: The purpose of this study was to present methods and results for the modified Phemister operation, with a suture anchor added for augmentation of the conoid ligament in cases of acute dislocation of the acromioclavicular joint. Materials and Methods: We evaluated 14 cases of acute dislocation of the acromioclavicular joint. This included 11 cases of Rockwood type 3, and 3 cases of type 5. The mean age of patients was 45.2 years. We operated on them using an anchor for augmentation of the conoid ligament in the modified Phemister operation. The average follow-up period was 14 months and post-operative clinical analysis was conducted using the Weitzman classification, VAS Score, Constant Score and KSS Score. Results: According to Weitzman scores, 13 cases were evaluated as excellent, and one case was good. They had mean joint ranges of forward elevation of $170.7^{\circ}$, lateral elevation of 166.4, external rotation of 68.2, and internal rotation to the level of T7. The mean VAS Score was 1.9, mean Constant Score 90.8, and the mean KSS Score 91. Radiologic analysis indicated that all cases had a good result. Conclusion: The modified Phemister operation with a suture anchor added for augmentation of the conoid ligament is very effective clinically in acute dislocations of the acromioclavicular joint.

목적: 견봉쇄골 관절의 급성 탈구에서 원추인대 기능의 강화를 위한 봉합 나사못을 추가한 변형된 Phemister 술식의 치료 방법을 소개하고 그 결과를 알아보고자 하였다. 대상 및 방법: 14예의 환자를 대상으로 하였으며 Rockwood 제 3형이 11예, 5형이 3예 였고 환자의 평균나이는 45.2세 였다. 변형된 Phemister 술식에 원추인대 기능의 강화를 위한 봉합 나사못을 추가하여 수술하였다. 추시 기간은 평균 14개월이었으며 술 후 임상적 평가는 Weitzman 분류 및 VAS 점수와 Constant 점수, KSS 점수를 사용하였다. 결과: Weitzman 분류상 13예에서 우수, 1예에서 양호로 평가되었고 평균 관절 운동 범위는 전방거상 170.7도, 외전 166.4도, 외회전 68.2도, 내회전 T7 였다. 평균 VAS 점수는 1.9, 평균 Constant 점수는 90.8점, 평균 KSS 점수는 91점이었다. 방사선학적 평가 결과는 모든 예에서 양호한 결과를 얻었다. 결론: 견봉쇄골 관절의 급성 탈구에서 원추인대 기능의 강화를 위한 봉합 나사못을 추가한 변형된 Phemister 술식은 임상적으로 유용한 수술 방법으로 사료된다.

Keywords

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