The Modified Phemister Operation with the Suture Anchor Added for the Augmentation of Conoid Ligament in Acute Acromioclavicular Dislocation

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 170.7degrees, 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.

Operative Treatment of Acromioclavicular Dilocation: Comparative Study Between Two Operative Methods / 대한정형외과학회잡지

Acromioclavicular joint dislocations are frequently seen with industrial accident, sports activity and traffic accident. Various operative treatment modalities have been suggested. The purpose of this study is to compare the clinical results of two operative methods in young patients with acromioclavicular dislocation. The authors analyzed the clinical and radiological results of 30 patients with acromioclavicular dislocation, in whom 15 patients were treated by acromioclavicular reduction & fixation with K-wire(Phemister procedure) and 15 patients by acromioclavicular reduction & coracoclavicular fixation by cancellous screw with coracoclavicular ligament repair(Bosworth procedure) from March 1989 to September 1993 at Ansan Hospital, Korea University. They were followed up more than 12 months. The results obtained were as follows: 1. The difference of coracoclavicular distance compared with normal side after operation was 2.6mm in Phemister operations and 1.6 mm in Bosworth operations. And these differences were not changed at follow up significantly. 2. The complications were two K-wire migrations, one superficial infection, and one recurred gross deformity after pin removal in Phemister operations and two mild upward migrations of screw after Bosworth operations. 3. We obtained similar good results after Phemister and Bosworth operations. But less complications were visible, and anatomical reduction and early ROM exercise were possible after Bosworth operations.