• The Academic Congress of Korean Shoulder and Elbow Society
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• 2001.03a
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• pp.88-88
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• 2001

• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.240-244
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• 2009

Purpose: This study examined the outcomes of closed reduction and fixation of the coracoid process fracture using a suture anchor in a patient with combined acromioclavicular dislocation for which the coraco-clavicular ligament was intact. Materials and Methods: A 26 year-old male patient with a coracoid process fracture that was associated with a type III acromioclavicular joint dislocation was operated on with anchor suture fixation. This is the first trial of this operative procedure. Results: At the postoperative follow-up at 3 months, complete union of the coracoid process fracture was seen. The shoulder had a full range of motion and the shoulder function was normal. Conclusion: Closed reduction and fixation using one suture anchor for treating coracoid process fracture is a safe, effective procedure.

• Clinics in Shoulder and Elbow
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• v.16 no.2
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• pp.115-122
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• 2013

Purpose: The purpose of this study is to analyze the results of acute acromioclavicular joint dislocation treatment with coracoclavicular ligament augmentation using Tight-Rope$^{(R)}$ (Arthrex). Materials and Methods: From October 2009 to March 2011, 30 patients with acute acromioclavicular joint dislocation underwent coracoclavicular ligament augmentation using Tight-Rope$^{(R)}$ and were followed up for at least 12 months after surgery. The radiologic results were qualified according to serial plain radiographs, and the clinical results according to University of California - Los Angeles (UCLA) Shoulder Scale, Constant score, and VAS pain score. Results: Using the UCLA scoring system, excellent results were observed in 22 cases (73%), good results in five cases (17%), fair results in two cases (7%), and a poor result in one case (3%). The average Constant score was $92.5{\pm}7.5$. According to radiologic results, anatomical reduction was achieved in 26 cases, and two cases showed a moderate loss of reduction, and two cases showed complete re-dislocation. Clinical results for patients with re-dislocation were unsatisfactory and reoperation was required. Conclusion: Coracoclavicular ligament augmentation using Tight-Rope$^{(R)}$ is a good option providing reliable functional results in patients with acute acromioclavicular joint dislocation.

• Clinics in Shoulder and Elbow
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• v.13 no.2
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• pp.209-216
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• 2010

Purpose: The purpose of our study was to compare treatment results of two different surgical techniques for chronic acromioclavicular joint dislocations. Materials and Methods: Fifty consecutive patients diagnosed as chronic acromioclavicular joint dislocations between January 1997 and June 2009 were included in the study. Patients were randomized into two different groups. Patients in the first group (n=20) were treated using a modified Weaver and Dunn method using a simple coracoacromial ligament transfer method. Patients in the other group (n=30) were treated with acromial bone-block transfer containing coracoacromial ligament. Mean follow-up times for the two groups were 13.1 and 14.9 months, respectively. Results: At 1 year postoperatively, mean coracoclavicular distance, the VAS score and the ASES score for the Weaver-Dunn method group; for the bone block transfer method group were 3.8 mm (-3 to 6 mm), 3.5 (1.0 to 7.0) and 91.1 (81.66 to 95); 3 mm (-2 to 6 mm), 4.2 (1.0 to 7.5) and 79.6 (31.66 to 95). There were no significant differences in radiologic (p=0.377) and functional (p=0.093) results between the two groups. Failures in the former and latter group were, respectively, two and one. Conclusion: The bone block transfer method shows a tendency to maintain coracoclavicular distance and appeared to yield similar results as the modified Weaver Dunn method.

• Clinics in Shoulder and Elbow
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• v.8 no.2
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• pp.131-134
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• 2005

Distal clavicle tunnel widening was observed in coracoclavicular ligament reconstruction with semitendinous tendon autografts in a patient with acromioclavicular joint injury. Acromioclavicular joint separation, in a 44 years-old man was treated by coracoclavicular ligament reconstruction. We have performed x-ray evaluation on 2years 10months after surgery. The immediate postoperative tunnel size was measured 4.5mm in diameter. At postoperative 2years 10month the tunnel diameter was from 9.3 to 11.4mm. But the weightbearing clavicle view showed no significant acromioclavicular joint separation. Moreover the patient complained only minor intermittent shoulder discomfort.

• Journal of the Korean Arthroscopy Society
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• v.6 no.2
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• pp.171-176
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• 2002

Purpose : To evaluate effectiveness of arthroscopic distal clavicle resection for chronic stage 2 acromioclavicular dislocation. Material: 6 patients who had failed to respond to physical therapy were evaluate more than 6 months prospectively, which were treated with arthroscopic distal clavicular resection from february 1998 to January 2001. Result : The median preoperative Constant score changed from 32 of 100 to 37 of 100 at 3 to 6 weeks, to 49 of 100 at 3 months and to 69 of 100 at 6months. Improvement was achived at mean follow up more than 6 months after surgery. Overal $83\%$ of patient were satisfied with this procedure. but the remained case was unsatisfied because symptom was not improved more than 6 months Conclusion : Arthroscopic distal clavicle resection is useful method to treatment for chronic stage 2 acromioclavicular dislocation.

• 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.

• Clinics in Shoulder and Elbow
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• v.2 no.2
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• pp.138-142
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• 1999

Coracoclavicular ligament is main restraint to superior instability of the distal clavicle. Coracoacromial ligament, extensor tendon of toe, palmaris longus tendon, and Dacron tape have been used to reconstruct coracoclavicular ligament. We used semitedinosus tendon to reconstruct coracoclavicular ligament. The semitendinosus tendon was harvested as a usual fashion. After the distal clavicle and coracoid process were exposed, a hole of six millimeter diameter was made on the center of whole thickness of the distal clavicle. A malleolar screw was fixed from distal clavicle to coracoid process to maintain the reduced position of the acromioclavicular joint. The leading suture of tendon graft was passed through the hole of the distal clavicle and looped under the coracoid process. After leading portion of ten­don graft was looped over the clavicle, sutures were made between each end of the tendon graft with nonabsorbable suture materials.

• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.59-66
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• 2011

Purpose: We wanted to evaluate the clinical and radiological outcomes and the prognosis of various surgical treatments for the distal clavicle fracture with an acromioclavicular joint injury. Materials and Methods: A retrospective study of 21 patients with a minimum of 12 months follow up was done. We classified acromioclavicular (AC) injury into type I (only intra-articular fracture (IAF), 5 cases), type II (IAF with widening of the AC joint > 7 mm, 9 cases) and type III (IAF with AC joint superior subluxation > 50%, 7 cases). The distal clavicle fractures were fixed using plate (9 cases), mini screws (1 case), K wire and tension band wiring (10 cases) and transarticular pinning (1 case). Acromioclavicular or coracoacromial ligament reconstruction was not done in all the cases. Results: In 20 of 21 cases, bone union was achieved at an average of 8.4 weeks. Traumatic arthritis (5 cases), AC joint widening (4 cases) and AC joint subluxation (2 cases) were noted at the last follow up. The average UCLA score was 32.6 in the type I AC joint injuries, 34 in type II and 34.1 in type III. There was no relationship between the clinical outcomes and the preoperative AC joint injury pattern, postoperative traumatic arthritis, AC joint widening or AC joint subluxation (p>0.05). Conclusion: Satisfactory results were achieved by acute reduction and firm fixation of the distal clavicle fracture with AC joint injury. There was no relationship between the pattern of AC joint injury, the residual radiologic findings and the functional outcome.

• Journal of Korean Orthopaedic Sports Medicine
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• v.5 no.2
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• pp.123-128
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• 2006

Purpose: Surgical reconstruction is usually indicated for type II distal clavicle fracture due to high rate of nonunion and delayed union. We report the clinical outcome of a surgical technique for type II distal clavicle fracture using Mersilen tape and K-wire. Materials and Methods: From 1999 through 2003, this technique has been used on 11 patients with type II distal clavicle fracture. The procedure consist of fracture reduction with a Mersilene tape, repair of torn coracoclavicular ligament, and K-wire fixation of the fracture fragment. All patients with at least 12 months of complete postoperative follow-up were included for functional and radiographic evaluation. We used simple X-ray and UCLA scoring system and constant scoring system for evaluation at last follow up in OPD. Results: Solid union of the fracture could be achieved at 11 weeks after operation in all patients. All patients could return to the same level of preinjury activity. Good and excellent results were obtained in all patients according to UCLA system. Conclusion: This technique was simple procedure and allowed for stable fixation with early mobilization and early return to work and sports.