• Clinics in Shoulder and Elbow
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• 제1권2호
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• pp.180-185
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• 1998

There has been considerable controversy as to the treatment method of dislocation of the acromioclavicular joint, so various operative treatment modalities have been suggested. We analyzed the results of 40 patients with acromio­clavicular dislocation, in whom twenty patients were treated by modified Phemister method and 20 patients by modified Weaver-Dunn method above follow-up two years. The purpose of this study was to compare the clinical results of two operative methods. According to Weitzman criteriae for clinical results, 12 cases were excellent, six cases good and two cases fair in modified Phemister method. But in modified Weaver-Dunn method, ten cases were excellent, eight cases good, one case fair and one case poor. In radiological result, coracoclavicular distance was measured at preoperative, postoperative and last follow-up period. The modified Phemister method was 6.lmm, 1.5mm and 2.4mm respectively, and the modified Weaver-Dunn method 7.8mm, 2.lmm and 2.5mm respectively. The complications were two cases of heterotopic ossification, one case of inadequate fixation and one case of K-wire breakage in modified Phemister method, and two cases of early fixation loss and one case of heterotopic ossification in modified Weaver-Dunn method. We obtained that the clinical, functional and radiological results showed no significant difference in two methods. The modified Phemister method was effective treatment for old patients in acute injuries due to short operation time and simple technique. The modified Weaver-Dunn method, as a reconstructive operation that reduces various complications for young and active male patients, was also good for getting the stability of coraco­clavicular ligament through clavicular bony union.

• Clinics in Shoulder and Elbow
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• 제9권2호
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• pp.155-161
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• 2006

Purpose: To compare the clinical and radiological results between the modified Weaver-Dunn method and modified Phemister method in the acute acromioclavicular joint dislocation. Materials and Methods: We reviewed 19 patients who were treated for the acute acromioclavicular joint dislocation from 2001 to 2002. 10 patients were operated with the modified Weaver-Dunn method (group A) and the others with modified Phemister method (group B). The classification of preoperative injury was analyzed by using the Rockwood system, the clinical assessment of preoperative and postoperative by the modified UCLA rating scale and the radiological assessment by simple x-ray. Results: With the modified UCLA rating scale, group A showed 5 cases(50%) of excellent and 5 cases(50%) of good, group B showed 4 cases(44.4%) of excellent and 5 cases(55.6%) of good. In the radiologic findings of the coracoclavicular distances, group A was 16.2 mm at preoperative, 8.8 mm at postoperative, 9.7 mm at last follow-up and group B was 12.9 mm, 6.7 mm and 7.9 mm respectively. Postoperatively there were no complications such as surgical wound infection and failure of Kirschner wires. Conclusion: Both the modified Weaver-Dunn and modified Phemister methods have shown satisfied clinical and radiologic results, and there was no difference in these result between two groups (p>0.05).

• Clinics in Shoulder and Elbow
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• 제13권2호
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• pp.209-216
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• 2010

목적: 저자들은 만성 견봉쇄골 관절 손상 환자에 대한 치료방법중, 오구견봉인대만을 이용한 변형 Weaver-Dunn 술식과 Shoji 등에 의해 소개된 골편이 부착된 오구견봉인대 전위술식간의 방사선학적 및 기능적인 평가를 통해 양군간의 치료결과를 비교하고자 하였다. 대상 및 방법: 본 연구는 1997년 1월부터 2009년 6월까지 만성 견봉쇄골관절 손상으로 진단받은 50명의 환자를 대상으로 하였다. 이중 20명은 오구견봉인대만을 이용한 변형 Weaver-Dunn 술식을 이용하여 수술하였고, 나머지 30명은 골편을 이용한 술식을 통하여 수술하였다. 두 군의 평균 추시 기간은 각각 13.1 개월과 14.9 개월이었다. 결과: 술 후 1년째의 변형 Weaver-Dunn 군과 골편 이용군의 평균 오구쇄골간격, VAS 점수 및 ASES 점수는 3.8 mm (-3 to 6 mm); 3 mm (-2 to 6 mm), 3.5 (1.0 to 7.0); 4.2 (1.0 to 7.5) and 91.1 (81.66 to 95); 79.6 (31.66 to 95)였다. 두 군간의 방사선학적, 기능적 평가에서 통계학적으로 유의한 차이를 발견할 수는 없었다. 두 군의 실패환자는 각각 2명, 1명이었다. 결론: Shoji 술식군에서 상대적으로 재전위정도가 낮은 양상임을 알 수 있었고, 변형 Weaver-Dunn 술식에 비견할 만한 치료방법으로 생각된다.

• Clinics in Shoulder and Elbow
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• 제1권1호
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• pp.26-34
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• 1998

The management of acute acromioclavicular dislocations has usually followed the accepted principles of obtaining an anatomical reduction of the joint and maintaining it until soft tissue healing has occurred. So, the preferred treatment for acute acromioclavicular dislocation is controversial. We analysed operatively treated twenty-eight cases for acute acromioclavicular dislocation between February 1994 and January 1997 and reviewed postoperatively to evaluate the results of three different methods. We collected retrospectively the data via clinical history, associated injury, type of injury, radiographic review, Taft score, and final results. Follow up time averaged 14 months. (range, 12 to 21 ) In according to Rockwood's classification, ]7 cases were type Ⅲ, 1 case was type IV, and 10 cases were type V. Ten cases were treated with the modified Phemister method, ten cases with the modified Bosworth method and eight cases with the modified Weaver-Dunn method. ]n patients treated by modified Phemister method, the Taft score was 9.4 points and 8 cases achieved good or excellent results. In patients treated by modified Bosworth method, the Taft score was 9.8 points and 8 cases achieved good or excellent results. In patients treated by modified Weaver-Dunn method, the Taft score was 10.3 points and 7 cases achieved good or excellent results. The overall Taft score was 9.9 points and 23 cases achieved good or excellent results. There were four complications, such as calcification or metallic loosening or breakage of K-wire, but did not influence late results. In conclusions, there was no significant difference of results regarding the different three methods. However, our results indicated that the coracoclavicular ligament reconstruction by transfer of coracoacromial ligament produced better results.

• Clinics in Shoulder and Elbow
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• 제2권1호
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• pp.8-13
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• 1999

The results of the operative treatment of the Grade III acromioclavicular joint injury is defined by the durability of the reduced joint and free of exertional pain. Several surgical techniques have been applied to reduce and stabilize the joints effectively. Resection of clavicular lateral end and subacromial decompression also could be applied to prevent post-operative arthritic change. Biomechanical studies reveals the role of clavicular elevation and rotation to achieve more than 90 degrees of elevation. It also serves as a attachment site of deltoid and trapezius muscle. The stability and mobility of the both acromioclavicular and coracoclavicular joint are important to get full functional recovery. We modified the methods of coracoacromial ligament transfer described by Weaver-Dunn and by Shoji et a!. to pre­vent pullout of the transferred ligament and to get more improved functional results. Main technical point was harvesting full thickness bone block and fix it through the key-hole to reduce pull out angle.