• Clinics in Shoulder and Elbow
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• v.11 no.2
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• pp.185-188
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• 2008

Acromioclavicular joint injuries usually occur as a result of direct trauma to the superolateral aspect of the shoulder. Roockwood Type IV injuries are relatively uncommon, and they are easily misdiagnosed or neglected in patients who have suffered multiple traumas. Therefore, to correctly treat a patient with type IV injury, we need to take a careful physical examination and conduct proper radiologic evaluation for the acromioclavicular joint. We report here on two cases of modified Weaver-Dunn reconstruction for neglected type IV acromioclavicular joint injuries that were associated with multiple rib fractures.

• Clinics in Shoulder and Elbow
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• v.13 no.2
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• pp.188-193
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• 2010

Purpose: The purpose of this study was to evaluate the clinical and radiological results of a modified Phemister method reinforcing the 4 strands of an Ethibond sling for acromioclavicular joint dislocation. Materials and Methods: Between September 1999 and May 2007, 30 acromioclavicular joint dislocation cases underwent a modified Phemister method reinforcing the 4 strands of an Ethibond sling. The average follow-up period was 28.2 months (range: 24~33 months). Clinical outcomes were evaluated using the Weitzman classification; the state of coracoclavicular space reduction was done using radiologic findings. Results: According to the Weitzman classification, there were 24 excellent, 4 good and 2 fair case outcomes. The average coracoclavicular distance improved from 16.9 mm to 7.3 mm immediately after surgery. The average ratio of coracoclavicular distance comparing to the contralateral side at the final follow-up was 1.24 (range: 0.68~1.71). Complications included retraction of K-wires in 5 cases and restriction of joint motion in 4 cases. Conclusion: The modified Phemister operation using augmentation of the coracoclavicular ligament by 4 strands of Ethibond is an effective treatment modality in acromioclavicular joint dislocation.

• 대한관절경학회:학술대회논문집
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• 2007.04a
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• pp.61-61
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• 2007

• Journal of the Korean Arthroscopy Society
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• v.15 no.1
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• pp.13-18
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• 2011

Purpose: The purpose of this study is to evaluate the radiologic and clinical results of the arthroscopic coracoclavicular fixation of the acute acromioclavicular dislocation using $TightRope^{(R)}$ (Arthrex, Inc, Naples, FL). Materials and Methods: We performed the arthroscopic coracoclavicular fixation using $TightRope^{(R)}$ in twenty patients with the Rockwood type III or V acute acromioclavicular dislocation between February, 2009, and February, 2010. Mean follow-up was 13.4(range 8~22) months. Radiologic results were evaluated by comparing the distances between the clavicle and the coracoid process with those in the contralateral sides using the acromioclavicular stress radiographs. Clinical results were made according to the KSS(Korean Shoulder Scoring System), and the cosmetic satisfaction of the patient was assessed. Results: Radiologically, 18 cases showed excellent, 1 case showed good and 1 case showed fair results. Clinically, KSS was mean 98.5 (range 92~100) points and all cases revealed satisfactory cosmetic results. Because one case complained of skin tenderness and discomfort of palpation, we closed the knot with surrounding muscle & fascia. Then local wound infection occurred, so we treated it by incision and drainage under local anesthesia and antibiotic therapy for 2 weeks. Conclusion: Arthroscopic coracoclavicular fixation using $TightRope^{(R)}$ for treating the Rockwood type III or V acute acromioclavicular dislocation showed satisfactory radiologic and clinical results. It seems to be a good treatment method that has little postoperative complication, provides an early rehabilitation and an excellent cosmetic result, and does not require secondary operation for removal of metal implant.

• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.92-98
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• 2010

Purpose: To analyze results of treating acromioclavicular injuries using clavicle hook plates. Materials and Methods: Between February 2008 and April 2010, 18 patients with acromioclavicular joint injury treated by clavicle hook plates were reviewed. Using the Rockwood classification, 7 dislocations were classified as type III injuries and 11 as type V injuries. Implant removal was done at least 3 months from initial fixation. Simple X-rays were taken for comparing the state of reduction, and clinical outcomes were evaluated by the Korean Shoulder Scoring System and the American Shoulder Elbow Society score. The average follow-up period was 9 months. Results: On weight bearing X-rays, the average coracoclavicular distance showed a 114% increase compared to the contralateral side at the time of injury. It decreased to 23% by the last follow-up. The mean Korean Shoulder Scoring System and the American Shoulder Elbow Society score were 80 and 74 at the last follow-up. Conclusion: The immediate stability these plates provide allows rapid rehabilitation. Clavicle hook plate fixation for acromioclavicular joint dislocation is considered an effective method for ensuring satisfactory results both radiologically and clinically.

• Clinics in Shoulder and Elbow
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• v.13 no.2
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• pp.194-201
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• 2010

Purpose: We evaluated clinical and radiological results for open reduction and internal fixation of acromioclavicular dislocation without coracoclavicular ligament repair after removal of implants. Materials and methods: Clinical and radiological results were obtained for 53 patients who underwent open reduction and internal fixation of an acromioclavicular joint dislocation between 1998 and 2007. A total of 21 patients were treated with a modified-Phemister method and 32 patients were treated with a Hook plate method. All subjects were surveyed after removal of their implants. The Constant scoring system was administered postoperatively to evaluate clinical results. Radiologic outcomes were evaluated by both coracoclavicular intervals on plain films. Results: Constant scores were $87.59{\pm}7.8$ in the Phemister group and $89.35{\pm}5.3$ in the Hook plate group. For both groups, the mean coracoclavicular interval at preoperative radiography was 15.9 mm at the injured site and 8.0 mm at the opposite site. After metal removal, the mean difference between coracoclavicular distances between normal and injured sites were 1.0 mm for the Hook plate group and 1.2 mm for the modified Phemister method group (p>0.05). Conclusion: Open reduction and internal fixation of an acromioclavicular joint without coracoclavicular ligament repair shows good long-term clinical and radiological results.

• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.167-172
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• 2009

Purpose: We wanted to evaluate the results of treating acromioclavicular joint dislocation using an AO hook plate. Materials and Methods: Between February 2008 and September 2009, 10 patients underwent implant removal after surgical treatment of acromioclavicular joint dislocation using a AO hook plate. The Constant-Murley scoring system was administered postoperatively for evaluating the clinical results, and simple X-ray was taken for evaluating the state of reduction. Results: All cases showed satisfactory results on the clinical and radiological study. The mean Constant-Murley score at follow-up was 90.5 (range: 84~95). Three patients had some degree of discomfort with the hook plate, but these symptoms were relieved on removal of the plate. The radiological evaluation showed restoration of the vertical displacement of the clavicle in all the patients. No complications occurred such as infection, plate failure or redislocation after removal of the plate. Conclusion: The short term follow-up results of treating acromioclvicular joint dislocation using an AO hook plate were satisfactory both clinically and radiologically.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2009.03a
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• pp.184-184
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• 2009

• Clinics in Shoulder and Elbow
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• v.11 no.2
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• pp.165-171
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• 2008

Purpose: The purpose of this study was to introduce a new surgical technique and to evaluate the preliminary results after operative treatment with using TightRope$^{(R)}$ for treating acute acromioclavicular joint dislocation. Material and Methods: We studies 10 patients who were followed up for more than 6 months after operative treatment with using an TightRope$^{(R)}$. A longitudinal incision approximately 4cm in length was made from 1cm medial to the acromioclavicular joint to the coracoid process, and then coracocalvicular ligament augmentation using TightRope$^{(R)}$ was done after splitting the deltoid. For postoperative stability, two 1.6 mm Kirschner wires were inserted temporarily across the acromioclavicular joint in all cases. The radiologic results on the serial plain radiographs and the clinical results according to the UCLA score were analyzed. Results: Radiologically, 7 cases showed anatomical reduction, 2 cases showed a slightly loss of reduction and 1 case showed partial loss of reduction. Clinically, 6 cases were excellent, 3 cases were good and 1 case was fair. Conclusion: Coracoclavicular ligament augmentation using TightRope$^{(R)}$ for treating acute acromioclavicular joint dislocation is a minimally invasive, safe procedure that provides satisfactory radiologic and clinical preliminary results. Yet the long-term results have to be analyzed to determine the final results of this procedure.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2006.11a
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• pp.139-144
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• 2006

견봉 쇄골 관절의 관절염 변화 및 골 용해로 인한 통증 및 기능제한은 보존적 치료를 원칙으로 하며, 보존적 치료에 실패하거나, 활동량이 많은 경우 운동선수일 경우 수술적 치료를 고려할 수 있다. 어떤 방법의 치료를 선택하던 간에 이전의 운동 범위를 얻고 통증없이 근력 및 기능회복을 할 수 있어야 하며, 이를 위해서는 잘 조절된 재활치료를 시행하는 것이 무엇보다 중요하다.