• Clinics in Shoulder and Elbow
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• v.1 no.2
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• pp.180-185
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• 1998

There has been considerable controversy as to the treatment method of dislocation of the acromioclavicular joint, so various operative treatment modalities have been suggested. We analyzed the results of 40 patients with acromio­clavicular dislocation, in whom twenty patients were treated by modified Phemister method and 20 patients by modified Weaver-Dunn method above follow-up two years. The purpose of this study was to compare the clinical results of two operative methods. According to Weitzman criteriae for clinical results, 12 cases were excellent, six cases good and two cases fair in modified Phemister method. But in modified Weaver-Dunn method, ten cases were excellent, eight cases good, one case fair and one case poor. In radiological result, coracoclavicular distance was measured at preoperative, postoperative and last follow-up period. The modified Phemister method was 6.lmm, 1.5mm and 2.4mm respectively, and the modified Weaver-Dunn method 7.8mm, 2.lmm and 2.5mm respectively. The complications were two cases of heterotopic ossification, one case of inadequate fixation and one case of K-wire breakage in modified Phemister method, and two cases of early fixation loss and one case of heterotopic ossification in modified Weaver-Dunn method. We obtained that the clinical, functional and radiological results showed no significant difference in two methods. The modified Phemister method was effective treatment for old patients in acute injuries due to short operation time and simple technique. The modified Weaver-Dunn method, as a reconstructive operation that reduces various complications for young and active male patients, was also good for getting the stability of coraco­clavicular ligament through clavicular bony union.

• Clinics in Shoulder and Elbow
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• v.9 no.2
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• pp.155-161
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• 2006

Purpose: To compare the clinical and radiological results between the modified Weaver-Dunn method and modified Phemister method in the acute acromioclavicular joint dislocation. Materials and Methods: We reviewed 19 patients who were treated for the acute acromioclavicular joint dislocation from 2001 to 2002. 10 patients were operated with the modified Weaver-Dunn method (group A) and the others with modified Phemister method (group B). The classification of preoperative injury was analyzed by using the Rockwood system, the clinical assessment of preoperative and postoperative by the modified UCLA rating scale and the radiological assessment by simple x-ray. Results: With the modified UCLA rating scale, group A showed 5 cases(50%) of excellent and 5 cases(50%) of good, group B showed 4 cases(44.4%) of excellent and 5 cases(55.6%) of good. In the radiologic findings of the coracoclavicular distances, group A was 16.2 mm at preoperative, 8.8 mm at postoperative, 9.7 mm at last follow-up and group B was 12.9 mm, 6.7 mm and 7.9 mm respectively. Postoperatively there were no complications such as surgical wound infection and failure of Kirschner wires. Conclusion: Both the modified Weaver-Dunn and modified Phemister methods have shown satisfied clinical and radiologic results, and there was no difference in these result between two groups (p>0.05).

• 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.1 no.1
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• pp.26-34
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• 1998

The management of acute acromioclavicular dislocations has usually followed the accepted principles of obtaining an anatomical reduction of the joint and maintaining it until soft tissue healing has occurred. So, the preferred treatment for acute acromioclavicular dislocation is controversial. We analysed operatively treated twenty-eight cases for acute acromioclavicular dislocation between February 1994 and January 1997 and reviewed postoperatively to evaluate the results of three different methods. We collected retrospectively the data via clinical history, associated injury, type of injury, radiographic review, Taft score, and final results. Follow up time averaged 14 months. (range, 12 to 21 ) In according to Rockwood's classification, ]7 cases were type Ⅲ, 1 case was type IV, and 10 cases were type V. Ten cases were treated with the modified Phemister method, ten cases with the modified Bosworth method and eight cases with the modified Weaver-Dunn method. ]n patients treated by modified Phemister method, the Taft score was 9.4 points and 8 cases achieved good or excellent results. In patients treated by modified Bosworth method, the Taft score was 9.8 points and 8 cases achieved good or excellent results. In patients treated by modified Weaver-Dunn method, the Taft score was 10.3 points and 7 cases achieved good or excellent results. The overall Taft score was 9.9 points and 23 cases achieved good or excellent results. There were four complications, such as calcification or metallic loosening or breakage of K-wire, but did not influence late results. In conclusions, there was no significant difference of results regarding the different three methods. However, our results indicated that the coracoclavicular ligament reconstruction by transfer of coracoacromial ligament produced better results.

• 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.