Acromio-Clavicular Joint Dislocation Types IV to VI: Does the Outcome with the modified Weaver-Dunn Procedure Justify the Treatment?

@#clavicular joint (ACJ) injuries remains controversial. Themodified Weaver-Dunn (WD) procedure is one of thefrequently used techniques. Recently when it was comparedwith anatomical autogenous tendon graft reconstructionprocedures, the results were inferior. However, theseanatomical procedures are technically more demanding withsmall margin of error and they have tendency forpostoperative pain because of extra donor site incision.Materials and Methods: Forty patients with type IV to VIACJ dislocations were treated by modified WD procedureusing non-absorbable synthetic suture passed through thebase of coracoid process for augmentation of transferredcoraco-acromial (CA) ligament. Functional outcome wasassessed using the Oxford Shoulder Score, NottinghamClavicular Score and Visual Analog Score (VAS) at the finalfollow-up after surgery.Results: The mean pre-operative Oxford Shoulder Scoreimproved from 25.22±2.64 (range 20 to 30) to 44.75±1.99(range 40 to 48) and mean pre-operative NottinghamShoulder Score improved from 49.25±4.91 (range 39 to 58)to 87.27±4.39 (range 79 to 96) at last follow-up after surgerywith p-value <0.001. Thirty-five (87.5%) patients hadexcellent outcomes, four (10%) patients had good outcomesand one (2.5%) patient had fair outcome. Thirty-eight (95%)patients had no pain while two (5%) had moderate painbased on VAS score.Conclusion: Modified Weaver-Dunn is a simple wellestablished technique for grade IV to VI ACJ dislocation.We cannot consider this procedure as old and outdated on theargument that the long term functional outcomes are notsubopti

Clinical Applicability of Absorbable Synthetic Suture Materials (Safil(R)/Safil(R) Quick/Monosyn(R)) in Obstetrical Surgeries / 대한주산의학회잡지

OBJECTIVE: To evaluate the clinical applicability and safety of absorbable synthetic suture materials (Safil(R)/Safil(R)Quick/Monosyn(R)) in obstetrical surgeries. METHODS: This clinical trial includes 100 patients who delivered vaginally and 198 patients who were undergone cesarean section from April 2004 to September 2004. In cases of vaginal delivery, patients were divided with the same number into the study group in which Safil(R) Quick was used and the control group in which chromic catgut was used for episiotomy and perineal laceration repair. In case of cesarean delivery, patients were divided into two groups. The first group which included 100 patients was subdivided with the same number into the study group in which Monosyn(R) was used and the control group in which chromic catgut was used for uterine repair. The second group which included 98 patients was subdivided with the same number into the study group in which Safil(R) was used and the control group in which Vicryl was used for rectus fascia repair. Wound healing status and complications are assessed during postoperative stage, at hospital discharge, and at postpartum out-patients follow-up. RESULTS: Compared with chromic catgut groups, Safil(R) Quick group showed no difference in hospital stay from vaginal delivery, wound healing status and surgical complications and Monosyn(R) group showed no difference in operating time, decrease in hemoglobin at postoperative day 3 and surgical complications. Safil(R) group showed no difference in operating time, postoperative pain and surgical complications compared with Vicryl group. CONCLUSION: Safil(R)/Safil(R) Quick/Monosyn(R) were equivalent with regard to most aspects of their clinical suitability and may be useful alternative suture materials in obstetrical surgeries.