J Korean Orthop Assoc.  2024 Feb;59(1):51-55. 10.4055/jkoa.2024.59.1.51 .

Treatment of Nonunion after a Fracture of the Clavicle at the Sling Area in a Patient with an Acromioclavicular Joint Dislocation Using the Modified Phemister Procedure Augmented with Coracoclavicular Sling: A Case Report

• Lee YH
• Lee YS
• Ahn GY
• Woo SW

• KMID: 2553348
• DOI: http://doi.org/10.4055/jkoa.2024.59.1.51

Abstract

The modified Phemister technique, which fixes the acromioclavicular joint with a k-wire and fixes the coronoid process and clavicle with a sling, has often been used as surgical treatment for dislocation of the acromioclavicular joint. This technique has the advantage of allowing early rehabilitation exercises with accurate anatomical reduction and firm fixation. On the other hand, some complications have been reported, such as infection, deformation recurrence, fixation complications, erosion of the distal clavicle or fracture of the sling, and secondary arthritis. This study presents a patient who experienced shoulder pain and functional impairment after conservative treatment for a sling area insufficiency fracture that arose from using the modified Phemister technique. Locking screw plate fixation with tricortical iliac bone grafting and matchstick-shaped cancellous bone grafting were used, and successful outcomes were achieved. This paper reports this case with a review of the relevant literature.

Keyword

acromioclavicular joint dislocation; modified phemister technique; coracoclavicular sling; clavicle fracture; nonunion