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Journal of the Korean Shoulder and Elbow Society 1999;2(2):126-132.
Published online December 30, 1999.
Acute TypeⅤ Acromioclavicular Injury Treated by the Modified Bosworth Technique
Seung-Key Kim, Sang-Hoon Yi, Jong Beom Park, Won-Jong Bahk, Il-Seok Jang, Han Chang
Department of Orthopedic Surgery, College of Medicine, Catholic University, Uijongbu St. Mary's Hospital
급성 제 5형 견봉쇄골관절 탈구의 치료
김승기, 이상훈, 박종범, 박원종, 장일석, 장한
가톨릭대학교 의과대학 의정부성모병원 정형외과학교실
Abstract
Purpose
: To evaluate the functional and radiographic outcome of the modified Bosworth method in the surgical treatment of acute typeⅤ acromioclavicular joint dislocation. Materials and methods : From June 1995 to May 1998, 20 patients were operated on for acute and complete acromioclavicular dislocation(Rockwood typeⅤ). The operative technique includes fixation of the coracoclavicular joint with Bosworth screw or 6.5㎜ cancellous screw and imbrication of trapezius and deltoid muscles. The average age was 34 years(range, 19 to 51 years). These 20 patients with an average follow-up of 18 months, were evaluated clinically using the UCLA scoring system. Additional radiographical assessment was performed with stress radiographs.
Results
: Excellent or good clinical results were obtained in 95%(19 cases). And the average coracoclavicular interval ratio was decreased from 3.31(2.2∼6.0) to 1.13(1∼1.4) in stress radiographs. There were 4 cases of heterotopic calcification postoperatively but there was no correlation with clinical result. Posttraumatic A-C joint arthritis was developed in one case. In that case, the distal clavicular resection was done under the arthroscopic technique.
Conclusion
: The severe displacement observed with typeⅤinjuries is incompatible with normal shoulder function if the shoulder is left in its displaced position. In typeⅤ injuries, significant damage to the deltoid and trapezius musculature and overlying fascia occurs, therefore open reduction and good fixation must be obtained with imbrication of trapezius and deltoid muscles. In out typeⅤ acute complete acromioclavicular dislocation, the modified Bosworth technique provides excellent results with a low complication rate.
Key Words: Shoulder, Acute typeⅤ acromioclavicular dislocation, Modified Bosworth method,


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