Bosworth and modiŞed Phemister techniques revisited. A comparison of intraarticular vs extraarticular acute Rockwood type III acromioclavicular dislocations Şxation methods in the treatment of acute Rockwood type III acromioclavicular dislocations*

Abstract

Objective: The aim of this study was to compare the long-term clinical and radiological results ofAcromioclavicular (AC)Şxation with K-wires (the modiŞed Phemister procedure) and Coracoclavicular(CC)Şxation with the Bosworth screw in the surgical treatment of Type 3 AC joint dislocations.Methods: Thirty-two patients with complete set of medical records and who received surgical treatmentbetween September 2005 and January 2009 due to acute Rockwood Type 3 AC joint dislocation andproperly attended their follow-ups were retrospectively evaluated. Sixteen patients (13 males, 3 females;mean age: 38, range: 24e52 years) were treated with CC Şxation with Bosworth screw (Group 1), and theother 16 (12 males, 4 females; mean age: 53.3, range: 38e64 years) with AC Şxation using K-wires(Group 2).Results: The mean follow-up time was 96 months for Group 1 and 93 months for Group 2 patients(p> 0.05). The mean ConstanteMurley score at the Şnal follow-up was 84.7 in Group 1 and 87.3 in Group2 (p¼ 0.069). Radiological evaluation of the patients revealed AC arthrosis in 2 and 3 patients in Group 1and 2, respectively. In Group 2, one patient had a recurrent dislocation, three patients had AC arthrosisand two patients had ossiŞcation in the CC ligament (Fig. 2).There was no superŞcial or deep wound infection in Group 1, while two patients from Group 2 had asuperŞcial wound infection.Conclusions: Our results suggest that both techniques are reliable and provide adequate reduction andsimilar outcomes in terms of functionality and pain levels, following the reduction of Type 3 AC jointdislocations. With lower rates of wound site infection in the early and AC arthrosis in the late postoperative period, CCŞxation method with the Bosworth screw may be a better surgical option than ACŞxation method with K-wires.Level of Evidence: Level III, Therapeutic study.