The Modified Phemister Method with Using Cotton Tape in the Treatment of Acromioclavicular Dislocation

There has been considerable controversies in the method of the treatment of dislocation of the acromioclavicular joint, especially in grade III injury. It is hard to give a direct firm repair having a short ruptured coracoclavicular ligament. Thats why there are lots of difficulties in the treatment. Therefore, in operative treatment, the authors make use of cotton tape on coracoid process and clavicle as a reconstructive technique, because we have thought a simple fixation of acromioclavicular joint adding to a firm fixation of clavicle and coracoid process is inevitable. From January 1991 to December 1995, twenty-nine cases of grade III acromio-clavicular dislocation were treated by the modified Phemister method with using the cotton tape. Twenty-four patients were followed for an average of fifteen months and the following results were obtained. 1. The clinical results were evaluated by Weitzman criteria after average fifteen months follow up. An excellent result was obtained in 19 cases (79.2%), a good result in 3 cases (12.5%) and a fair result in 2 cases (8.3%), consecutively. 2. Clinical result in patients over 60-year old were bad. 3. The comparison of the coracoclavicular interval ratio before surgery with that after surgery facilitated the evaluation of effectiveness of the coracoclavicular ligament reconstruction. 4. The operative technique is through temporary fixation using K-wires which endows horizontal stability, and it fixes clavicle and coracoid process using cotton tape which endows vertical stability.