Browse > Article
http://dx.doi.org/10.5397/CiSE.2010.13.2.188

Treatment of Acromioclavicular Dislocation by Modified Phemister Operation Augmented with Coracoclavicular Sling  

Kim, Deok-Weon (Department of Orthopedic Surgery, Inje University, Seoul Paik Hospital)
Kim, Sung-Tae (Department of Orthopedic Surgery, Inje University, Seoul Paik Hospital)
Publication Information
Clinics in Shoulder and Elbow / v.13, no.2, 2010 , pp. 188-193 More about this Journal
Abstract
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.
Keywords
Acromioclavicular joint dislocation; Modified Phemister; Coracoclavicular ligament augmentation; Ethibond sling;
Citations & Related Records
Times Cited By KSCI : 2  (Citation Analysis)
연도 인용수 순위
1 Mazzocca AD, Santangelo SA, Johnson ST, et al.: A biomechanical evaluation of an anatomical coracoclavicular ligament reconstruction. Am J Sports Med, 34: 236-246, 2006.   DOI
2 Mlasowsky B, Brenner P: Duben W.Repair of complete acromioclavicular dislocation (Tossy stage III)using Basler’s hook plate combined with ligament sutures. Injury, 19: 227-232, 1988.   DOI   ScienceOn
3 Moneim MS, Balduini FC: Coracoid fracture as a complication of the surgical treatment by coracoclavicular tape fixation: a case report. Clin Orthop Relat Res, 168: 133-135, 1982.
4 Motamedi AR, Blevins FT, Willis MC, McNally TP, Shahipoor M: Biomechanics of the coracoclavicular ligament complex and augmentations used in its repair and reconstruction. Am J Sports Med, 28: 380-384, 2000.
5 Panayotis D, Andreas P, Spyros AS, et al.: Double-Loop Suture repair for Acute Acromioclavicular Joint Disruption. Am J Sports Med, 34: 1112-1119, 2006.   DOI
6 Sloan SM, Budoff JE, Hipp JA, Nguyen L: Coracoclavicular ligament reconstruction using the lateral half of the conjoined tendon. J Shoulder Elbow Surg, 13: 186-190, 2004.   DOI   ScienceOn
7 Sim E, Schmarz N, Hocker K, Berzlanovich A: Repair of complete acromioclavicular separations using the acromioclavicular-hook plate. Clin Orthop Relat Res, 314: 134-142, 1995.
8 Smith MJ, Stewart MJ: Acute acromioclavicular separations. A 20-year study. Am J Sports Med, 7: 62-71, 1979.   DOI   ScienceOn
9 Weinstein DM, McCann PD, Mcllveen SJ, et al.: Surgical treatment of complete acromioclavicular dislocation. Am J Sports Med, 23: 324-331, 1995.   DOI   ScienceOn
10 John EB, Gregg TN, Dale CY, et al.: A cadaveric study examining acromioclavicular joint congruity after different methods of coracoclavicular loop repair. J Shoulder Elbow Surg, 12: 595-598, 2003.   DOI   ScienceOn
11 Lancaster S, Horowitz M, Alonso J: Complete acromioclavicular separation: a comparison of operative methods. Clin Orthop Relat Res, 216: 80-88, 1987.
12 Lee KW, Choi YJ, Ahn HS, et al.: Treatment of the Acromioclavicular Joint Dislocation Using a AO Hook Plate. J Korean Shoulder Elbow Soc, 12: 167-172, 2006.   DOI
13 Lee SJ, Nicholas SJ, Akizuki KH, et al.: Reconstruction of the coracoclavicular ligaments with tendon grafts: a comparative biomechanical study. Am J Sports Med, 312: 648-655. 2003.
14 Lee WS, Kim TS, Yoon JR, et al.: Migration of Kwires from the Acromioclavicular Joint to the Neck: case report (2cases). J Korean Shoulder Elbow Soc, 9: 196-201, 2006.   DOI   ScienceOn
15 Lemos MJ: The evaluation and treatment of the injured acromioclavicular joint in athletes. Am J Sports Med, 26: 137-144, 1998.
16 Lizaur A, Marco L, Cebrian R: Acute dislocation of the acromioclavicular joint: traumatic anatomy and the importance of the deltoid and trapezius. J Bone Joint Surg Br, 76: 602-606, 1994.
17 Marcacci M, Gubellini P, Buda R, et al.: Histologis and ulnastructural findings of tissue ingrowth. The Leeds-kelo prosthetic anterior cruciate ligament. Clin Orthop Relat Res, 267: 115-121, 1991.
18 Cox JS: The fate of the acromioclavicular joint in athletic injuries. Am J Sports Med, 9: 50-53. 1981.   DOI   ScienceOn
19 Mathias W, Jan PK, Steffen S, et al.: Coracoclavicular ligament reconstruction: biomechanical comparison of tendon graft repairs to a synthetic double bundle augmentation:Knee Surg Sports Traumatol Arthrosc, 17: 521-528, 2009.   DOI
20 Mazet R Jr: Migration of Kirschner wire from shoulder region into lung: report of two cases. J Bone Joint Surg, 25: 477-483, 1943.
21 Deshmukh AV, Wilson DR, Zilberfarb JL, Perimutter GS: Stability of acromioclavicular joint reconstruction: biomechanical testing of various surgical technique in a cadavaeric model. Am J Sports Med, 32: 1492-1498, 2004.   DOI
22 Fujikawa K, Iseki F, Seedhom BB: Arthroscopy after anterior cruciate reconstruction with the Leeds-kelo ligament. J Bone Joint Surg Br, 71: 566-570, 1989.
23 Fullerton LR Jr: Recurrent third degree acromioclavicular joint separation after faiure of a Dacron ligament prosthesis: a case report. Am J Sports Med, 18: 106-107, 1990.   DOI   ScienceOn
24 Harrel RM, Tong J, Weinhold PS, et al.: Comparison of Mechanical Properties of Different Tension Band Materials and Suture Techniques. J Orthop Trauma, 17: 119-122, 2003.   DOI   ScienceOn
25 Harris RI, Wallace AL, Harper GD, et al.: Structural properties of the intact and the reconstructed coracoclavicular ligament complex. Am J Sports Med, 28: 103-108, 2000.
26 Huang TW, Hsieh PH, Huang KC, et al.: Suspension Suture Augmentation for Repair of Coracoclavicular Ligament Disruptions. Clin Orthop Relat Res, 467: 2142-2148. 2009.   DOI
27 Choi SW, Lee TJ, Moon KH, et al.: Minimally Invasive Coracoclavicular Stabilization with Suture Anchors for Acute Acromioclavicular Dislocation. Am J Sports Med, 36: 961-965. 2008.   DOI   ScienceOn
28 Jerosch J, Filler T, Peuker E, Greig M, Siewering U: Which stabilization technique corrects anatomy best in patients with AC-separation? An experimental study. Knee Surg Sports Traumatol Arthrosc, 7: 365-372, 1999.   DOI
29 Jilang C, Wang M, Rong C: proximally based conjoined tendon transfer for coracoclavicular reconstruction: in the treatment of the acromioclavicular dislocation. J Bone Joint Surg Am, 89: 2408-2412, 2007.   DOI   ScienceOn