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REFERENCE LINKING PLATFORM OF KOREA S&T JOURNALS
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Clinics in Shoulder and Elbow
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Korean Shoulder and Elbow Society
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Volume & Issues
Volume 1, Issue 2 - Nov 1998
Volume 1, Issue 1 - Mar 1998
Selecting the target year
Current Trend of Management of the Rotator Cuff Injury
Ha Kwon-Ick ;
Clinics in Shoulder and Elbow, volume 1, issue 1, 1998, Pages 1~5
Rotator cuff disease is the most common cause of shoulder pain. Recent understanding of structure and mechanics enables scientific approach to the treatment of the cuff teat. It is an integral component in the normal movement and function of the shoulder. This article addresses current knowledge of the structure and biomechanics of the rotator cuff, and reviews various kind of operative treatment.
Arthroscopic Treatment of Chronic Calcific Tendinitis of the Shoulder
Kim Jin Sub ; Yoo Jung Han ; Yoo Sun Oh ;
Clinics in Shoulder and Elbow, volume 1, issue 1, 1998, Pages 6~11
Shoulder is a common site for calcific deposit and is frequently asymptomatic. There is a general agreement that calcific tendinitis should be initially treated nonoperatively and excision reserved for cases unresponsive to the conservative measures. There are several reports that arthroscopic excision of symptomatic calcific deposit is proved to be efficient in the calcific tendinitis refractory to nonoperative management. The results of arthroscopic treatment of chronic resistant calcific tendinitis of the shoulder in eleven patients were evaluated. Each patient had shoulder pain for more than one year prior to the arthroscopic surgery. The average age of the patients was 48 years(range 35-70). Arthroscopic calcium removal and subacromial bursectomy was performed in all patients. Arthroscopic acromioplasty was additionally done in four patients. The results turned out to be good in nine patients with full range of motion and complete pain relief. One patient with full motion and occcasional episodes of pain was satisfactory. One patient with persistent pain was unsatisfactory which converted to satisfactory six months later after subacromial injection. So we conclude that the arthroscopic treatment is a reasonable alternative in treatment of the chronic calcific tendinitis resistant to conservative treatment.
Hemiarthroplasty of the Shoulder
Shin Yeong Shik ; Yang Jung Ho ; Kim Dong Keun ;
Clinics in Shoulder and Elbow, volume 1, issue 1, 1998, Pages 12~18
To purpose of this study was to evaluate clinical results between rheumatoid arthritis shoulder cases and traumatic proximal humerus fracture cases. Fourteen patients who had been shoulder hemiarthroplasties between March 1991 to July 1996, six had rheumatoid arthritis and eight had comminuted proximal humerus fracture by the various trauma. Neer II prothesis were implanted in twenty cases and global prothesis were implanted in two cases. The follow up period was 15 months to 36 months. To evaluate this study, we used the UCLA shoulder rating. We were able to follow up thirteen cases for more than fifteen months, of which five cases had excellent, five cases had good, two cases had fair and one case had poor. And the results were better for patients with rheumaroid arthritis than for patients with trauma.
Diagnosis and Arthroscopic Decompression of Impingement Syndrome of the Shoulder
Byun Ki-Yong ; Kwon Soon-Tae ; Lee Jang-Ik ; Rhee, Kwang-Jin ;
Clinics in Shoulder and Elbow, volume 1, issue 1, 1998, Pages 19~25
Appropriate clinical examination and imaging may lead to early diagnosis and treatment of the shoulder impingement syndrome, thus preventing progressing to a complete tear of rotator cuff. The impingement syndrome was caused by repeated entrapment and compression of supraspinatus tendon between the proximal end of humerus inferiorly, particullary its greater tuberosity. and one or m <)re component of coracoacromial arch superiorly. The purpose of this study is to critically, evaluate the result of twenty-five consecutive subacromial decompression with impingement syndrome and to assess the diagnostic accuracy of MR imaging by using oblique coronal and oblique sagittal plan. These patients were treated by arthroscopic subacromial decompression after their pains failed to improve with conservative therapy over three month. The average follow up was 25 month(range, 12 to 50). The mean age was 43 year old. The results were rated based on subjective response and the UCLA shoulder rating scale of the result. Ten patients(40%) were rated as excellent, 11patients(44%) were good. while four patients(16%) were fair. Radiologic evaluation suggested that the oblique sagittal plan of MRI can be helpful in evaluation of bony and soft-tissue structure of the coracoacromial arch and determining depth of bony resection. There were no infection or neurovascular injury. In reviewing our result, it appears that the arthroscopic subacromial decompression can be successful sugery for shoulder impingement syndrome and diagnostic accuracy of supplimentary oblique sagittal view of MRI was relatively higher than oblique coronal view alone for apprqpriate surgical plan.
A Clinical Analysis of Acute Acromioclavicular Dislocation
Kim Young Kyu ; Lee Beom Koo ; Moon Do Hyun ; Ko Jin Hong ; Lee Su Chan ; Park Hong Ki ; Choi Sang Kyu ;
Clinics in Shoulder and Elbow, volume 1, issue 1, 1998, Pages 26~34
The management of acute acromioclavicular dislocations has usually followed the accepted principles of obtaining an anatomical reduction of the joint and maintaining it until soft tissue healing has occurred. So, the preferred treatment for acute acromioclavicular dislocation is controversial. We analysed operatively treated twenty-eight cases for acute acromioclavicular dislocation between February 1994 and January 1997 and reviewed postoperatively to evaluate the results of three different methods. We collected retrospectively the data via clinical history, associated injury, type of injury, radiographic review, Taft score, and final results. Follow up time averaged 14 months. (range, 12 to 21 ) In according to Rockwood's classification, ]7 cases were type Ⅲ, 1 case was type IV, and 10 cases were type V. Ten cases were treated with the modified Phemister method, ten cases with the modified Bosworth method and eight cases with the modified Weaver-Dunn method. ]n patients treated by modified Phemister method, the Taft score was 9.4 points and 8 cases achieved good or excellent results. In patients treated by modified Bosworth method, the Taft score was 9.8 points and 8 cases achieved good or excellent results. In patients treated by modified Weaver-Dunn method, the Taft score was 10.3 points and 7 cases achieved good or excellent results. The overall Taft score was 9.9 points and 23 cases achieved good or excellent results. There were four complications, such as calcification or metallic loosening or breakage of K-wire, but did not influence late results. In conclusions, there was no significant difference of results regarding the different three methods. However, our results indicated that the coracoclavicular ligament reconstruction by transfer of coracoacromial ligament produced better results.
An Analysis of the Efficacy of Local Steroid Injections for the Treatment of Subacromial Impingement Syndrome
Kim, Seung-Key ; Park, Jong-Beom ; Koh, Young-Seok ; Chang-Han, ;
Clinics in Shoulder and Elbow, volume 1, issue 1, 1998, Pages 35~39
From May 1994 to May 1995, we performed a prospective controlled double-blind clinical study of 85 patients(85 shoulders). For inclusion in the study all patients met the following criteria: 1) a diagnosis of impingement syndrome by lidocaine injection test; 2) symptoms for at least three months; 3) no previous subacromial injection; 4) no evidence of rotator cuff tear. We excluded the patients from the study who showed a instability or other clear primary cause. The patients were randomized to receive either 5/subcc/ 2% lidocaine with 4ee of 20mg/cc Depomedrol(Group 1) in 45 cases or 5/subcc/ 2% lidocaine solely(Group 2) in 40 cases. At three month follow-up, all results were better in steroid group than control group. But at one year, improvement of pain and daily activity showed no difference between two groups. So we conclude that the use of subacromial steroid injection is effective for short-term therapy in the treatment of subacromial impingement syndrome, but the long-term effectiveness is doubtful.
Arthroscopic Treatment in Multidirectional Instability of the Shoulder Joint
Rhee Kwang-Jin ; Byun Ki-Yong ; Kwon Soon-Tae ; Kim Sang-Bum ;
Clinics in Shoulder and Elbow, volume 1, issue 1, 1998, Pages 40~45
Multidirectional instability of the shoulder joint is an unusual entity which is not yet well understood. Traditionally recommended treatment is non-operative, but recently arthroscopic treatment has been performed. This is a retrospective review of 20 patients who had multidirectional instability, who had been treated with arthroscopic capsular shift(7 cases), and arthroscopic treatment using Ho:YAG laser(l3 cases) at Department of Orthopaedic Surgery, Chungnam National University Hospital from July, 1988to February, 1997. Results of this study were as follows: 1. In five patients who were treated with arthroscopic anterior capsular shift only, all cases had redislocation of the shoulder joint. But there was no redislocation in two patients who were treated with arthroscopic anterior and posterior capsular shift. 2. ln three patients who were treated with laser-assisted capsular shift only, all cases had redislocation of the shoulder joint. But there was only one redislocation in ten patients treated with laser-assisted capsular shrinkage and capsular plication. Ho: Y AG laser has been found to be a safe and efficacious adjunct to many arthroscopic shoulder procedures. We had satisfactory results by combining a transglenoid capsular shift with laser-assisted capsular shrinkage. Arthroscopic laser-assisted capsular shrinkage and capsular plication is a one of recommendable treatment options in multidirectional instability of the shoulder joint.
Operative Treatment of Ipsilateral Fractures of Clavicle and Scapula
Park Jung Ho ; Suh Seung Woo ; Park Sang Won ; Lee Kwang Suk ;
Clinics in Shoulder and Elbow, volume 1, issue 1, 1998, Pages 46~50
The superior shoulder suspensory complex is composed of glenoid fossa, coracoid process, coracoclavicular ligament, distal clavicle, acromioclavicular ligament, acromion. Traumatic double disruptions of this complex lose its suspensory action on the shoulder joint and result in functional loss and deformity. Careful radiologic evaluation and appropriate management are required for injuries to this complex. Ipsilateral fractures of clavicle and scapula create unstable anatomic situation on shoulder joint. Conservative treatment usually fails to achieve good functional recovery due to rotator cuff weakness, nonunion, delayed union, malunion and neurovascular injury. Authors studied the result of operative treatment of ipsilateral clavicle and scapular fractures to prevent such complications. Seven cases were treated with open reduction and internal fixations of clavicle alone or clavicle and scapula simultaneously and followed up for nineteen months(twelve months - thirty-eight months). All but one patient showed good or excellent functional result according to the scoring system of Rowe. Poor result was developed in the case which had brain injury. Rigid fixations of clavicle alone or clavicle and scapular fractures both can achieve stable reduction of the fractures and prevent sequelae. We concluded that operative treatment of ipsilateral fractures of clavicle and scapula is safe and yields predictable good results.
Treatment for Distal Humeral Fractures by Modified Anatomical Y-Plate
Moon Eun Sun ; Park Jae Hyung ; Lee Young Keun ;
Clinics in Shoulder and Elbow, volume 1, issue 1, 1998, Pages 51~57
Comminuted fracture of the distal end of the humerus in adults is very rare and difficult to treat. In operative treatment, an implant which can achieve accurate anatoraical reduction and rigid fixation is needed. But the preexisting Y -shaped plate had wide and thick limbs and some problems in fixation for most distal humeral fractures. So we devised a modified plate which is more narrow and th1n and has a different hole distance and wing length (long lateral wing). The aim of the study was to evaluate the clinical result of this modified anatomical Y -plate. From 1991 to 1997, we treated 23 cases of distal humeral fractures using modified anatomical plate and the results were as follows. 1. Fracture type in 18 patients(78%) was C-type(C1,C2,C3) which were intraarticular and mostly displaced or comminuted. 2. Bony union was obtained in 22 patients(96%) through rigid fixation and observed radiologically at 3.5 months(2-6months) on the average. 3. In 23 patients, 19 patients(82%) showed satisfactory results after 34 months(6-73months) follow-up. So if the modified anatomical Y-plate is used in the treatment of distal humeral fracture, a satisfactory result can be obtained through a more accurate, easy, and rigid fixation than preexisting plate.
Three-Dimensional Corrective Osteotomy for Treatment of Cubitus Varus after Supracondylar Fracture of the Humerus
Kim Poong Taek ; Ihn Joo Chul ; Kyung Hee Soo ; Oh Seung Hoon ;
Clinics in Shoulder and Elbow, volume 1, issue 1, 1998, Pages 58~65
Cubitus varus deformity after supracondylar fracture of the humerus in children generally includes deformities of varus, hyperextension and internal rotation. Recently almost all corrective osteotomies for treatment of the varus deformity have been limited to correction of only the varus or of the varus and hyperextension deformity. Electromyographic study has revealed unphysiological joint motion and muscle activity around the joint in elbows with cubitus varus, hyperextension and internal rotation deformity. On this basis we have successfully attempted simultaneous correction of all three deformities. The end results in ] 3 elbows have been satisfactory without any complications such as delayed union, limitation of elbow motion or nerve palsy. In conclusion, we recommend simultaneous correction of the three elements of cubitus varus deformity to restore anatomic alignment of the elbow joint.
Treatment for the Rockwood type Ⅱ Fractures of Lateral End of Clavicle
Oh Chang-Wug ; Kyung Hee-Soo ; Park Gun-Wook ;
Clinics in Shoulder and Elbow, volume 1, issue 1, 1998, Pages 66~71
The fractures of lateral end of clavicle can be treated by conservative or operative treatment, but many authors report the higher rate of non-union with conservative treatment and that the operative treatment is more effective for the type II fractures. The authors reviewed and analysed 15 cases of lateral end fracture of clavicle which had been treated at Department of Orthopedic Surgery, Kyungpook National University Hospital from 1991 to 1996. The results were as follows; 1. Among the 15 patients, male was 6,female 9 and the average age was 46.2 years ranged from 21 to 72 years. 2. According to the classification by Rockwood, type II a was 8 cases and II b was 7 cases. 3. We treated operatively 12 cases, 9 cases with tension band wiring and 3 cases with intramedul-Iary K-wire fixation. And we treated conservatively 3 cases with Velpeau cast, but I case of nonunion was treated with tension band wiring. 4. The average follow-up was 3.2 years ranged from 2.1 to 4.7 years. 5. The functional results were evaluated with Weitzman's classification. 6. In the operatively treated cases, there were 4 cases(30.7%) in excellent, 7 cases(53.8%) in good and 2 cases(15.3%) in fair result. But, in the conservatively treated cases, there were 2 cases in good and I case in poor result, and the poor case did not united and had open reduction and internal fixation. 7. In conclusion, the operative treatment revealed good functional results in most cases (10/12) and early open reduction and internal fixation was better method than conservative treatment.
Arthroscopic Anterior Capsular Release of a Post-traumatic Flexion Contracture in the Elbow
Kim, Seung-Key ; Park, Jong-Beom ; Koh, Young-Seok ; Chang-Han, ;
Clinics in Shoulder and Elbow, volume 1, issue 1, 1998, Pages 72~77
We treated 5 elbows with post-traumatic flexion contractures (mean contracture: 51 degrees) by arthroscopic anterior capsular release and post-operative alternative flexion and extension splint. Each elbow had been resistant to at least six months of conservative therapy. An incongruent ulno-humeral articulation was considered to be a contraindication to this procedure. All patients complained of the residual deformity and some functional deficit. All patients, after failure of non-operative therapy, desired a operative treatment. At follow-up(mean 21.8 months), there was a mean post-operative contracture of 19 degrees, which is within a functional range of motion. So we conclude that arthroscopic capsular release in selected patients is reasonable alternative to open release.
Biceps Load Test: A Test of SLAP lesion in the Recurrent Anterior Dislocation of the Shoulder
Kim Seung-Ho ; Ha Kwon-Ick ; Han Kye-Young ;
Clinics in Shoulder and Elbow, volume 1, issue 1, 1998, Pages 78~82
The following will describe a method of evaluating the SLAP lesion in the recurrent anterior dislocation of the shoulder. We have named it the biceps load test. The biceps load test is performed with the patient in the supine position and the arm to be examined is abducted 90/sup°/, and the forearm is in the supinated position. First, the anterior apprehension test is performed. When the patient become apprehensive, the patient is allowed active flexion of the elbow, while the examiner resists elbow flexion. If the apprehension is relieved or diminished, the test is negative. If aggravated or unchanged, the test is positive. A prospective study was performed, in which 75 patients who were diagnosed as having recurrent unilateral anterior instability of the shoulder underwent the biceps load test and arthroscopic examination. The biceps load test showed negative results in 64 of these patients, of which the superior labral-biceps complex was intact'in 63 cases and only I shoulder revealed a type n SLAP lesion. E]even patients with a positive test were confirmed to have type n SLAP lesions. A positive biceps load test represents an unstable SLAP lesion in a patient with recurrent anterior dislocation of the shoulder. The biceps load test is a reliable test for evaluating the SLAP lesion in the recurrent anterior dislocation of the shoulder(sensitivity: ,9] .7%, specificity: 100%, positive predictive value: 1.00 and negative predictive value: 0.98). Biceps contraction increases the torsional rigidity ?of the glenohumeral joint and long head of biceps tendan act as internal rotator of the shoulder in the abducted and externally rotated position. These stabilize the shoulder in abduction and external rotation position in the biceps load test
Results of the Closed Treatment of Displaced Middle-Third Fractures of The Clavicle
Lee Kwang-Won ; Song Dae-Hwa ; Ong Sang-Suk ; You Soo-Guen ; Choy Won-Sik ;
Clinics in Shoulder and Elbow, volume 1, issue 1, 1998, Pages 83~92
Fractures of the clavicles are extremely common, accounting for 5 to 10% of all injuries in the adult skeletal trauma. Despite this, nonunions and symptomatic malunions after clavicular fracture are uncommon. When these complications occur, however, they may be associated with 11 pattern of disability that includes not only pain but also impairment of upper extremity function. The purpose of this study was to clarify the outcome of clavicular fractures treated by conservatively, and emphasize treatment and factors that possibly predispose a clavicular fracture to poor function or nonunion. We evaluated 9] consecutive fractures of the middle-third of the clavicle in adults which had been treated conservatively. There were 59 males and 33 females ranging in age from 17 to 80 years (average 36.8 years). Nine of the 91 fractures (10%) had developed nonunion, and 4 fractures (4.4%) reported unsatisfactory results. No patients had significant impairment of range of motion or strength as a result of the injury. We found that initial shortening at the fracture of≥20mm(6 cases) had a highly significantly association with nonunion(P<0.0001). Final shortening of 20mm or more (4 cases) was associated with an unsatisfactory result, but not with nonunion(P<0.0001). Our results have led us to recommend the open reduction and internal fixation of severely displaced fractures of the middle third of the clavicle in adults patients.
Normal Glenohumeral and Scapulothoracic Movement at the Coronal Plane
Rhee Yong-Girl ; Vim Chang-Moo ;
Clinics in Shoulder and Elbow, volume 1, issue 1, 1998, Pages 93~99
We measured the glenohumeral and scapulothoracic movements during abduction of the arm in the coronal plane with radiologic analysis in the 30 shoulders of normal male adults who were without pain, limitation of motion, and history of trauma. In the resting position, the glenoid cavity of the scapula faced somewhat superiorly in over 80 percents of the individuals, the mean superior tilting was 5.7 degrees. The mean total scapulothoracic movement was 65.8 degrees and the mean total glenohumeral movement was 106.8 degrees during abduction of arm in the coronal plane. The mean ratio of the glenohumeral movement to the scapulothoracic movement was 1.6 and this GH/ST ratio was decreased toward the extreme abduction. When the arm was abducted, external rotation of the humeral head occurred and this external rotation was increased smoothly during 0 degree through 90 degrees, but steeply above 90 degrees. The acromiohumeral interval was 10.9 mm at the resting positon, and this interval decreased during the arm abduction. The superior migration of the humeral head was 3.1 mm while abducting the arm. Our measurement of the relationships of glenohumeral and scapulothoracic movements at the coronal plane would be useful in the understandings of the biomechanics of shoulder, but further study would be required for the analysis of the three dimensional relationship because of the limitation of our two dimensional analysis.
Medial Epicondylectomy for the Treatment of Cubital Thnnel Syndrome - A Retrospective Comparison with Anterior Subcutaneous Transposition -
Chung Moon-Sang ; Baek Goo-Hyun ; Kim Sang-Lim ; Park Young-Chun ;
Clinics in Shoulder and Elbow, volume 1, issue 1, 1998, Pages 100~108
Surgical treatment of cubital tunnel syndrome has been reported according to a wide variety of techniques since the end of the last century. Theses range from simple decompression to various forms of nerve transposition and medial epicondylectomy. However, we could find only few reports which compare the results between different types of operations. The treatment results of medial epicondylectomy and anterior subcutaneous transposition, were analysed retrospectively. From March 1984 to January 1996, a total of 110 patients had operations for cubital tunnel syndrome. Seventy four of them were followed-up for more than one year, and only they were included in this study. Anterior subcutaneous transposition was performed in 26 patients; and medial epicondylectomy in 48 patients. There were 52 males and 22 females, with an average age of 34 years (range, 13 to 75). The average follow-up period was 40 months (range, 12 to 132). Grading system by Gabel and Amadio were used for evaluation of the patients; pain, sensory and motor dysfunction were checked preoperatively and at last follow-up. In 26 patients of anterior subcutaneous transposition, 7 (27%) were graded as excellent, 11 (42%) good, 3 (12%) fair and 5 (19%) poor. In 48 patients of medial epicondylectomy, 16 (34%) were excellent, 27 (56%) good, 3 (6%) fair and 2 (4%) poor. Sixty nine percent were excellent or good in anterior subcutaneous transposition group, while ninty percent in medial epicondylectomy group. This difference was significant statistically (p<0.01 )., From our experiences, we suggest medial epicondylectomy for the treatment of cubital tunnel syndrome, rather than anterior subcutaneous transposition.
Arthroscopic Versus Open ACJJ'omioplasty for Impingement Syndrome and Partial Thickness Rotator Cuff Tear
Rhee Yong-Gir ; Chang Ki-Seong ;
Clinics in Shoulder and Elbow, volume 1, issue 1, 1998, Pages 109~117
We evaluated the results of the surgery for impingement syndromes and partial thickness tears of the rotator cuff with an average follow-up period of 15 months. One group(group I) of 43 patients, 46 cases underwent arthroscopic subacromial decompression. The other comparable group(group Ⅱ) of 10 patients, II cases underwent open acromioplasty. The average age at operation was 48 years, old. Arthroscopic subacromial decompression achieved slightly better pain relief, the range of the acti ve forward flexion, function, strength and the overall score with improvement from the preoperative condition than open acromioplasty. The patient's satisfaction was better in group I as well. Using the UCLA Shoulder Rating Scale, 89% of group I and 82% of group n had good or excellent results. Preservation of the origin of the deltoid during an arthroscopic acromioplasty reduced the postoperative morbidity and made it possible to start rehabilitation sooner and to achieve the better and more predictable results.
Osteolysis in Kudo Type Total Elbow Arthroplasty
Kim Jung-Man ; Chang Cheong-Ho ; Ha Joo-Hyun ;
Clinics in Shoulder and Elbow, volume 1, issue 1, 1998, Pages 118~122
This study evaluated the development of osteolysis of Kudo total elbow arthroplasties according to the fixation with or without cement. Twenty-four elbows of nineteen patients of rheumatoid arthritis underwent total elbow arthroplasty from 1986 to 1993. The patients were followed for an average of 42 months ranging from 36 months to 59 months. In cemented humeri, 1 of 13 (7.7%) showed osteolysis. In the humeri of cementless fixation, 5 of II (45.5%) revealed osteolysis, representing higher rate compared to cement fixation (P<0.05). In the ulna, osteolysis was identified in none of 16 (0%) of cement fixation, which was significantly less than the incidence of osteolysis in cement less fixation (3 of 8,37.5%) (P<0.01). It was concluded that the cement fixation result in less osteolysis than the cementless fixation in Kudo type total elbow arthroplasty.
Scapulothoracic Dissociation (A Case Report)
Han Chang-Whan ; Sung Jin-Hyung ; Kim Weon-Yoo ; Yoo Jae-Duk ; Cha, Weon-Jin ; Kim Jin-Young ;
Clinics in Shoulder and Elbow, volume 1, issue 1, 1998, Pages 123~127
Scapulothoracic dissociation is a rare entity that consists of the disruption of the scapulothoracic articulation. The mechanism of injury is probably traction caused by a blunt force to the shoulder girdle. This lesion is characterized by massive soft-tissue swelling of the shoulder; lateral displacement of the scapula, an injury to bone, and a severe neurovascular injury. An l8-year-old man sustained a scapulothoracic dissociation as a result of severe shoulder girdle trauma. We report the diagnostic method, clinical and surgical management
Acromioclavicular Joint Dislocation Associated with Clavicular Fracture and Brachial Plexus Injury
Lee Kwang-Won ; Kim, Kyou-Hyeun ; Park Jong-Hyeun ; Hwang In-Sik ; Choy Won-Sik ;
Clinics in Shoulder and Elbow, volume 1, issue 1, 1998, Pages 128~131
Fracture of the clavicle and dislocation of the acromioclavicular joint occur commonly as separate injuries. However, complete acromioclavicular dislocation with an ipsilateral clavicle fracture is quite rare. We experienced a case of acromioclavicular joint dislocation associated with fracture of clavicle and brachial plexus injury treated by open reduction and internal fixation.
Hypoplagia of Right Clavicle Associated with Neurofibromatosis (A Case Report)
Choi Chang-Hyuk ; Kwun Koing-Woo ; Kim Shin-Kun ; Lee Sang-Wook ; Yun Gi-Hyun ; Kim Yong-Jin ;
Clinics in Shoulder and Elbow, volume 1, issue 1, 1998, Pages 132~137
Neurofibromatosis is characterized by its skeletal involvement and cutaneous manifestation. Some patients develop focal area of hypoplasia and atrophy at limbs. We present the case of a 13-year-old boy with a fracture of the hypoplastic clavicle associated with neurofibromatosis and brownish cutaneous macules. The patient received open reduction and internal fixation with a semitubular plate and biopsy was done in order to clarify the pathology.
Congenital Hemihypertrophy of Upper Extremity (A Case Report)
Choi Chang-Hyuk ; Kwun Koing-Woo ; Kim Shin-Kun ; Lee Sang-Wook ; Kim Kyung-Ho ; Park Jae-Bok ;
Clinics in Shoulder and Elbow, volume 1, issue 1, 1998, Pages 139~145
This report describes a rare, congenital hypertrophy of the left upper extremity that appeared after compressive bandage of right arm at the age of two. He is eighteen years old, and hypertrophy was aggravated for about 2 years since he started weight training exercise. Recently, skin turgor changed and he visited the Dermatology department. Skin biopsy revealed increased thickness of the dermis. On Orthopaedic examination, the left arm showed nonspecific neuro-muscular changes other than easy fatigability a.nd increased skin consistency after exercise, compared to the right arm. The differences of circumference were 2.5 to 4cm according to the level of the upper limb. But the relative proportion of hypertrophy of the limb was balanced., On X-ray examination, bony changes were not shown. Through the MRI, we could find edematous changes of subcutaneous fatty tissue. Muscular structures showed unremarkable changes. Through the endurance test of both arms, we could find a decrease in endurance of the left upper arm musculatures. On histologic examination, infrequent focal necrosis and peri fascicular degeneration of the muscle fiber were present.