Abstract
We report the results of a modified Neviaser's procedure for Tossy's Type III injuries of the acromioclavicular joint.
Eighteen cases were treated (14 men and 4 women). The average age at the time of surgery was 39.1 years and the average follow-up period was 24.2 months.
From the results, there were 10 excellent cases, 4 good cases, 4 fair cases and no poor case, evaluated by the Kawabe's criteria. Almost all the patients showed excellent range of motion of the shoulder, but 10 cases demonstrated deformity of the acromioclavicular joint later.
The problem of original Neviaser's procedure has shown to be the fixation of the transfered coracoacromial ligament to the clavicle. In order to solve this problem, we modified the original Neviaser's procedure to the following 3 points:
1. The coracoacromial ligament is transfered with a small piece of bone and is fixed to the clavicle by using a screw.
2. The fixed point is as posteriorly and superiorly from the distal end of the clavicle as possible.
3. 2-Kirschner wires are used for the fixation between the acromion and the clavicle.
Although those modifications were used, half of the patients demontrated deformity of the acromioclvicular joint.
