• Clinics in Shoulder and Elbow
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• v.8 no.2
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• pp.88-96
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• 2005

Purpose: To compare and analyze the outcome of primary clavicular lateral end resection method and conventional acromioclavicular (AC) joint reduction method in type III AC dislocation patients over 45 years. Materials and Methods: This study was performed on selected 24 cases of type III AC dislocation patients, over 45 years of age, operated at our hospital from 1998 to 2002. Group I consist of 12 patients who underwent primary clavicular lateral end resection methods (average age: 54.3 years$(45{\sim}72)$). Group II consist of 7 patients using Bosworth methods and 5 patients using Phemister methods (average age: 54.4 years$(45{\sim}71)$). Clinical outcome was evaluated by Weaver and Dunn method. Radiological results were compared by measuring coracoclavicular distance between normal and injured side. Results: As clinical outcome, good was 10 cases(83%); fair 2(17%) in Group I, and good 6(50%); fair 3(25%); poor 3(25%) in Group II. In contrast, the difference of coracoclavicular distance was not statistically significant between two groups before or after surgery, and last follow up. At the last follow up, there was no special correlation between the difference of coracoclavicular distance and clinical outcome. Conclusion: We considered that primary clavicular lateral end resection may be effective for prevention of arthrosis in AC joint in type III AC dislocation patients over 45 years.

• Clinics in Shoulder and Elbow
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• v.2 no.1
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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.