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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 1, Issue 2 - Nov 1998
Volume 1, Issue 1 - Mar 1998
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Subscapularis Tendon Rupture with Medial Dislocation of Biceps Tendon - Case Report -
Lee Byung-Ill ; Kim Dong-Wook ; Kim Dong-Jin ; Min Kyung-Dae ; Rah Soo-Kyoon ;
Clinics in Shoulder and Elbow, volume 1, issue 2, 1998, Pages 147~153
Biceps tendon dislocation combined with rupture of subscapularis tendon is not a common lesion and there has been few case reported in Korea. We experienced one fifty Six years old male patient who shows typical features on physical examination and roentgenographic finding. He was injured by direct trauma on his right shoulder in adducted and external rotated position. He showed positive findings on passive external rotation test and lift-off test. On MR!, the subscpaularis tendon was totally ruptured and the biceps tendon was dislocated to anteromedial aspect of the glenoid labrum, which was typical finding. On the arthroscopic examination, the subscapularis tendon was totally ruptured from its humeral attachment and the biceps tendon was not seen in its normal anatomical position and it was dislocated antermedially to the glenoid labrum. We repaired the subscapularis tendon to humerus by use of suture anchor and the biceps tendon was relocated to its normal anatomical position in the intertubercular groove. On the post operative 6 months follow up, the patient shows improvements in his subjective symptoms and active range of motion.
Acute Traumatic Medial Dislocation of the Tendon of the Long Head of the Biceps Brachii with Concomitant Subscapularis Rupture - A Case Report -
Kim Seung Key ; Park Jong Beom ; Choi Woo-Sung ; Kim Ho- Tae ; Chang Han ;
Clinics in Shoulder and Elbow, volume 1, issue 2, 1998, Pages 154~159
Medial dislocation of the long head of the biceps brachii is a rare condition that usually occurs in association with tears of the subscapularis, chronic impingement, capsular defects or a fracture of the lesser tuberosity. Less commonly, a biceps tendon dislocation may occur after an acute traumatic event. Following a dislocation, the biceps tendon will assume either an intra- or extra-articular position depending on whether or not the subscapularis tendon detaches from its humeral insertion. Magnetic resonance imaging has been found to provide valuable information concerning the location of the biceps tendon and the integrity of the subscapularis tendon. We present a patient with a traumatic dislocation of the biceps brachii tendon in which the diagnosis remained elusive for an extended period of time. In this case, he was evaluated using MRI and reconstruction was performed by restoring the tendon to its anatomical position.
Arthroscopic Subacromial Decompression for Chronic Impingement
Lee Kwang-Won ; Park Jong-Hyeun ; Choy Won-Sik ;
Clinics in Shoulder and Elbow, volume 1, issue 2, 1998, Pages 160~166
The purpose of this study was to assess the results of arthroscopic subacromial decompression in patients with chronic impingement and to evaluate the results according to the rotator cuff pathology. We evaluated the clinical results of treatment for chronic impingement syndrome in 28 patients from Feb 1996 to Feb 1997. There were twenty men and eight women in age from 24 to 72 years (mean age 51) with dominant arm involvement in sixteen patients. Follow up evaluations averaged 15(range 12-24)months. The average duration of symptoms were 15(range 660)months. The final diagnoses which were based on the physical examination, plain radiographs and arthroscopic findings, were stage II impingement in 16 patients and stage ill impingement in 12 patients. We excluded the patients with acromioclavicular arthritis or glenohumeral instability in this study. All patients were managed non-operatively a minimum of six months. During the operation we performed contouring and smoothing the acromial undersurface and only resecting of the anterolateral band of the coracoacromial ligament. The clinical results were quantitated using UCLA shoulder rating score. Satisfactory results were obtained in 23(80%) patients. Unsatisfactory results were obtained in 5(18%) patients with posterior cuff tear. The average UCLA pain score showed significant improvement from 2.8(constant pain) to 7.2(present during heavy activities) at final follow up. The function and active forward flexion scores also increased from their preoperative value. There was no significant differences according to the surface and severity of tear and NeeI' stage (P>0.05). These results compared favorably with those reported following open acromioplasty. While arthroscopic subacromial decompression is a demanding technique with a learning curve, it is a reliable treatment for chronic impingement syndrome. A less aggressive approach to subacromial decompression and preserving the posteromedial band of the coracoacromialligament does not appear to compromise results.
Transient Inferior Subluxation of the Shoulder
Tae Suk-Kee ; Jung Young Bok ; Park Keun-Hyung ; Song Kwang-Sup ;
Clinics in Shoulder and Elbow, volume 1, issue 2, 1998, Pages 167~174
Since the first description by Cotton, there have been sporadic reports about the inferior subluxation of the shoulder. Nevertheless there is still a lack of consensus regarding the mechanism of occurrence, evolution and treatment. We have experienced six cases of inferior sublusation(five cases after trauma and one case after surgery) which resolved over time. Analysis of the clinical informations including serial radiographs, data from clinical examination and electromyography(EMG) revealed the following results. All the five post-traumatic inferior subluxations were noted in women with an average age of 59 years after direct trauma resulting in fracture of the proxiaml hrnerus(4) or clavicle(1), of which nerve injury was proven by EMG in three. One case occurred after Bankart repair by stretch injury to the axillary nerve. The presenting symptom was unusually severe pain on passive motion. Absence of anterior or posterior displacement wasl confirmed by radiographs. All the cases seemed to have delayed onset of subluxation except one. The subluxed hu.meral head was concentrically reduced at an average 11 weeks(range 3-23 weeks) from the supposed time of occurrence and the acromiohumeral interval measUred on the standing anteroposterior radiographs decreased to 9.4 mm ftom 23 mm. Improvement of pain paralled the reduction. In conclusion, the most common cause of transient inferior subluxation was nerve injury in ou~ series and the prognosis was excellent, however protraction of recovery or leaving permanent subluxation would be possible if .the injured nerve is unrecoverable.
Surgical treatment of the Acute Acromioclavicular Dislocation
Lee Kwang-Won ; Hwang In-Sik ; Choy Won-Sik ;
Clinics in Shoulder and Elbow, volume 1, issue 2, 1998, Pages 175~179
The acromioclavicular joint is commonly affected by traumatic and degenerative conditions. Most injuries are due to direct trauma, such as a fall on the shoulder. Although there is general agreement on treatment of type I, Ⅱ, Ⅳ, V and VI acromioclavicular injuries, the treatment of type Ⅲ injuries remains controversial. Sixty patients, ranging in age from 19 to 57 years(average, 32), were evaluated an average of 57.5 (range, 13 to 96) months after surgical reconstruction for Rockwood type Ⅲ Ⅳ, V acromioclavicular dislocation. Phemister method (47 cases), Bosworth (3 cases), Weaver and Dunn method (10 cases) were used to correct displacement. An increase of the coracoclavicular distance of the injured shoulder over the normal shoulder was average 7.1㎜ at initial, average l㎜ on postoperatively, and average 2㎜ at follow-up. Overall, 54 of 60(90%) patients achieved satisfactory results. Degree of increase of the coracoclavicular distance has no inliluence to clinical results.
The Surgical Treatment of Acromioclavicular Joint Dislocation using Modified Phemister and Modified Weaver-Dunn Operation
Chun Churl-Hong ; Lee Seong-Ho ; Lee Byung-Chang ; Cho Yong-Woo ;
Clinics in Shoulder and Elbow, volume 1, issue 2, 1998, Pages 180~185
There has been considerable controversy as to the treatment method of dislocation of the acromioclavicular joint, so various operative treatment modalities have been suggested. We analyzed the results of 40 patients with acromioclavicular dislocation, in whom twenty patients were treated by modified Phemister method and 20 patients by modified Weaver-Dunn method above follow-up two years. The purpose of this study was to compare the clinical results of two operative methods. According to Weitzman criteriae for clinical results, 12 cases were excellent, six cases good and two cases fair in modified Phemister method. But in modified Weaver-Dunn method, ten cases were excellent, eight cases good, one case fair and one case poor. In radiological result, coracoclavicular distance was measured at preoperative, postoperative and last follow-up period. The modified Phemister method was 6.lmm, 1.5mm and 2.4mm respectively, and the modified Weaver-Dunn method 7.8mm, 2.lmm and 2.5mm respectively. The complications were two cases of heterotopic ossification, one case of inadequate fixation and one case of K-wire breakage in modified Phemister method, and two cases of early fixation loss and one case of heterotopic ossification in modified Weaver-Dunn method. We obtained that the clinical, functional and radiological results showed no significant difference in two methods. The modified Phemister method was effective treatment for old patients in acute injuries due to short operation time and simple technique. The modified Weaver-Dunn method, as a reconstructive operation that reduces various complications for young and active male patients, was also good for getting the stability of coracoclavicular ligament through clavicular bony union.
The Influence of the Glenohumeral Rotation on the Scapulothoracic Motion
Seo Joong-Bae ; Choi Eui-Seong ; Won Choong-Hee ; Kim Yong-Min ; Lee Ho-Seung ; Kim Eung-Rok ;
Clinics in Shoulder and Elbow, volume 1, issue 2, 1998, Pages 186~192
This study was performed to evaluate the influences of the passive glenohumeral rotation on the scapulothoracic motion. We took anteroposterior radiograms of the right shoulders including the thoracic vertebrae with supine position in 10 normal male adults, at 0 degree abduction, 45 degrees abduction and 90 degrees abduction in scapular plane and in neutral rotation, maximal internal rotation and maximal external rotation in each abduction view. The scapulothoracic motion was measured as the distances between the vertical line drawn from the spinous process of the 7th cervical vertebra and the inferior and superior angles of the right scapula respectively. At 0 degree abduction, the distances were not changed in internal rotation relative to neutral rotation, but decreased significantly in external rotation, that is, the scapula shifts medially on external rotation. At 45 degrees abduction, the distances were increased significantly only in internal rotation, that is, the scapula shifts laterally on internal rotation. At 90 degrees abduction, the scapula rotated laterally on internal rotation and medially on external rotation. In conclusion, when a physician examines the rotation of the shoulder joint, he cannot exclude the scapulothoracic motion just by examining the patient with supine position. And we concluded that the rotatory movement of the shoulder is not solely contributed to the glenohumeral motion.
Injection Treatment for Frozen Shoulder ; Trigger Point Injection and Neruologic Blockade
Oh Chang-Wug ; Ihn Joo-Chul ; Hong Jung-Gil ; Park Chan-Sik ;
Clinics in Shoulder and Elbow, volume 1, issue 2, 1998, Pages 193~197
Frozen shoulder is known as a self-limited disease. But, its long duration and pain nature can make the patients debilitative. And most patients cannot tolerate a chronically painful extremity and are concerned about the possibility of developing permanent dysfunction. In painful phase of frozen shoulder, some aggressive mordalties as like trigger point injection or suprascapular nerve block can beneficial to: reduce discomfort and pain. In order to document clinical results, we evaluated the results of 134 frozen shoulders treated with trigger point injection and/or suprascapular nerve block at Kyungpook National University Hospital, from January 1995 to April 1997. The treatment group was divided into 3 modalities: 17 cases in trigger point injection(TPI), 39 cases in suprascapular nerve block(SSB), and 78 cases in both methods. The supportive treatment including oral medication, heat and stretching exercise was also applied. The average age at the time of diagnosis was 57 years old and average follow-up time was 18 months. The results were as follows: Average time of significant improvement in pain was 9 days. Eighty-eight percent (119 cases) was improved in pain and range of motion after injecllion treatments; 82%(14/17) with TPI, 85%(33/39) with SSB, and 92%(72/78) with both. Early improvement of paih within 1 week was 72% in the treatment-responsive group, in which TPI group has 100% response(14/14) and sse has 94% response(31/33)
Operative Treatment of Unstable Fracture of the Proximal Humerus
Kim Young-Kyu ; Jang Young-Hun ; Kim Keon-Beom ;
Clinics in Shoulder and Elbow, volume 1, issue 2, 1998, Pages 198~204
Unstable fractures of the proximal humerus continue to be difficult problems for orthopaedic surgeons. The optimum treatment of these fractures has remained a matter of controversy. We analyzed the clinical results of open reduction and plate fixation underwent for patients of unstable fractures of proximal humerus after minimum 12 months follow up. The purpose of this study is to evaluate the efficacy of open reduction and rigid plate fixation. Twenty-two patients were managed with open reduction and plate fixation. Mean follow up duration was 20.6 months(range, 12 to 28 mon.). Because the age of patient as a maker of degree of osteoporosis was considered the key factor in the success of anatomic reconstruction, we divided into two groups according to age. Group A was comprised of 12 cases with younger than 50 yrs of age. Ten cases of older than 50 yrs of age were Group B. According to Neer's classification, five cases(22%) were two part fracture, 12 cases(64%) were three part fracture, and three cases(14%) were four part fracture. We used the Neer rating system for evaluating the results. In Group A, overall scores were 79.1. In Group B, overall scores were 76.8. Overall scores in two part fracture were 85, overall scores in three part fracture 78.4 and overall scores in three part fracture 68.3. We achieved excellent or good results in nine cases(75%) of Group A and seven cases(70%) of Group B. Also, we obtained excellent or good results in all cases of two part fracture, ten cases(71%) of three fracture and one case(33%) of four part fracture. The complications were three metal loosening, one avascular necrosis of humeral head, one severe stiff shoulder, one superficial wound infection and one ectopic ossification. The results were excellent or good in 16 cases(73%) out of 22 cases. In conclusion, rigid fixation and supervised early exercise would be a good option for unstable fracture of the proximal humerus.
Hemiarthroplasty in Comminuted Fracture and Dislocation of the Proximal Humerus
Hwang Sung-Kwan ; Kim Yong-Seok ;
Clinics in Shoulder and Elbow, volume 1, issue 2, 1998, Pages 205~211
The comminuted fracture and dislocation of the proximal humerus occur more frequently in older patient group and operative treatment is difficult due to poor bone quality. Based on Neer's work, hemiarthroplasty has now become widly accepted for the management of the three-part fracture and four-part fracture-dislocation of the proximal humerus in old age group. The purpose of this study is to evaluate function, pain relief, and patient satisfaction after hemiarthroplasty for proximal humerus fractures and dislocations. Authors reviewed and analyzed 14 prosthetic replacement in comminuted proximal humeral fracture and dislocation at the Department of Orthopaedic Surgery, Yonsei University Wonju College of Medicine from March, 1988 to May, 1997. The results were as follows the average age was 58.9years and the ratio of males and females was 5:9. The most common cause of injury was traffic accident(43%). According to the classification of Neer, three part fracture were three(21%), four-part fracture and four-part fracture-dislocation were eleven(79%). The prosthetic replacement was performed within two weeks in eight patient and six were performed after two weeks. The results were analysed according to Neer's criteria and five cases showed satisfactory results. We concluded that hemiarthroplasty for fracture and dislocation of the proximal humerus facilitated the restoration of humerus length and pain relief, thereby allowing earlier motion to prevent the development of painful shoulder: stiffness
Management of Ipsilateral Fractures of Humerus and Forearm in Adults
Sohn Sung-Keun ; Kim Byeong-Hwan ; Yang Sung-Wook ;
Clinics in Shoulder and Elbow, volume 1, issue 2, 1998, Pages 212~220
Concomitant ipsilateral fractures of the humerus, radius and ulna are uncommon combined injury and are also called "floating elbow". It was found that this injury was usually a result of rather severe trauma and frequently associated injuries to other organ systems. It is controversial in the treatment of the "floating elbow", but the current treatment recommendations are open reduction and internal fixation of both the humerus and the forearm fracture with early initiation of range of motion exercises. The authors reviewed thirteen cases of ipsilateral fractures of the humerus, radius and ulna treated in our clinic from January 1992 to March 1997, and average follow-up period was over 18 months(range, 12 to 36 months). The results obtained were as follows; 1. The most common cause of injury was traffic accident and most common location of fractures was mid-third in both humerus and forearm. 2. The shape of fractures was transverse or comminuted in most cases. 3. The good clinical results were obtained by open reduction and internal fixation of both the humerus and the forearm fracture with early initiation of range of motion exercises. 4. The recovery was affected by the severity of the initial trauma and method of the treatment. 5. According to the Lange and Foster method, the functional result was good in 8 cases, fair in 4 cases and poor in 1 cases.
Normal Range of Shoulder Motion and Fluoroscopic Analysis of Motion Fraction
Choi Chang-Hyuk ; Yun Gi-Hyun ;
Clinics in Shoulder and Elbow, volume 1, issue 2, 1998, Pages 221~229
We measured, with manual goniometer, the active and passive arc of motion of the shoulder in 31 healthy male subjects who were right-hand dominant and who ranged in age from twenty to thirty-one years. Among ten directions through the four motion plane, the range of motion on the dominant side were significantly smaller than those on the non-dominant side in the motion of six directions. We also measured the motion fraction of the glenohumeral and scapulothoracic movement using fluoroscope in 30-degree intervals of arm elevation in the scapular plane. The ratio of glenohumeral to scapulothoracic movement(θGH/θST) was 1.6 for the full range of motion in scapular plane. At the lower angles of abduction, scapulothoracic movement was slight compared with glenohumeral movement. The motion fraction of scapulothoracic joint was increased from 60-degree to 150 degree of arm angle especially between 120 to 150 degree. During arm elevation, scapula was also extended from 42 degrees to 20 degrees tilting as well as internal rotation. The measuring technique of glenohumeral to scapulothoracic movement(θGH/θST) with fluoroscopy could be applied to the simple radiographic measurement at the out-patient clinic in order to identify the pathology and recovery of shoulder motion after treatment
Open Reduction and Internal Fixation of Displaced Intra-Articular Fractures of the Glenoid
Kim Seung Key ; Park Jong Beom ; Choi Woo-Sung ; Kwon Young-Jeong ; Chang Han ;
Clinics in Shoulder and Elbow, volume 1, issue 2, 1998, Pages 230~235
Fractures of the scapula are relatively uncommon injuries and treatment in the vast majority of cases remains nonsurgical and the results have been quite satisfactory. But the scapular fracture itself may be neglected because of its high incidence of many kinds of associated injuries so its delayed treatment sometimes gives bad and unpredictable results. Although open reduction and internal fixation has been accepted as the treatment of choice for displaced intra-articular fractures in many anatomical regions, there has been no definite treatment principles of surgical indications and approaches in the glenohumeral joint. At our institution, II displaced intra-articular fractures of the glenohumeral joint were treated with open reduction and internal fixation from March 1993 to February 1997. This paper reports the results of treating 11 displaced intraarticular fractures of the glenoid by open reduction and internal fixation. There were 10 men and one woman and the fractures were classified according to Ideberg : Type Ⅰa(4), Type Ⅱ(3), Type Ⅲ(1), Type IV(1), Type Va(1), and Type Vc(1).
Lateral Ulnar Collateral Ligament Reconstruction for Posterolateral Rotatory Instability of the Elbow Joint - A Case Report -
Moon Eun-Sun ; Lee Swung-Gi ; Park Chol-Hong ;
Clinics in Shoulder and Elbow, volume 1, issue 2, 1998, Pages 236~241
Recurrent dislocation of elbow joint occurs relatively rarely by the injury of the collateral ligament which contributes elbow joint stability. Among them, posterolateral rotatory instability occurs by the injury to the lateral ulnar collateral ligament. We experienced a case of recurrent dislocation of elbow joint due to posterolateral rotatory instability. We treated operatively with lateral ulnar collateral ligament reconstruction using the palmaris longus tendon by technique of Nestor et al. We report it with literature analysis.
Debridement Arthroplasty for Post-Traumatic Stiff Elbow
Rhee Yong-Girl ; Kim Hee-Seon ; Chun Young-Soo ; Cho Young-Lin ;
Clinics in Shoulder and Elbow, volume 1, issue 2, 1998, Pages 242~249
Stiffness of the elbow joint is relatively common after trauma, ectopic ossification, bum, postoperative scar, and etc. Mild flexion deformity can be reduced by use of active or passive motion exercise, dynamic sling, hinged distractor device, or turnbuckle orthosis. But these methods have disadvantages of difficulty in gaining acceptable range of motion only with stretching exercise, re-contracture after conservative managements and poor results that flexion contracture remained. The common described operative exposures for treatment of the stiff elbow are anterior, lateral, posterior, and medial approach. Through Anterior, lateral and medial approach each has not access to all compartments of the elbow. But, posterior approach has benefits that access to posterior, medial and lateral aspects of the elbow and as needed, fenestration to the olecranon fossa that produces a communication between the anterior and posterior compartments of the elbow are possible. From June 1991 through April 1997, 11 patients who had posttraumatic stiff elbow, were treated with debridement arthroplasty through the posterior approach. The purpose of this study are to introduce technique of the debridement arthroplasty and to evaluate final outcomes. With regarding to preoperative pain degree, mild degree matches to 3 cases, moderate to 3 cases, and severe to 2 cases. In preoperative motion, flexion was average 85° and extension was 30°. Postoperatively nine patients had got the complete relief of pain and two patients continued to have mild pain intermittentely. Postoperative flexion improved to 127° and extension to 2°, so that elbow flexion had improved by an average of 42° and elbow extension by 28°. On the objective scale all patients had good or excellent results and they all felt that they were improved by operation. Debridement arthroplasty is one of excellent procedures for the intractable stiff elbow if it is not unstable or it has not incongrous. But it need a meticulous operative technique and a well-programmed rehabilitation.
Intrusion of Supraspinatus Outlet by the Humeral Head in Rotator Cuff Disease
Chun Jae-Myeung ; Bin Seong-Il ; Kim Eugene ; Lee Hoi-Jin ; Kim Sung-Moon ; Kim Key-Yong ;
Clinics in Shoulder and Elbow, volume 1, issue 2, 1998, Pages 250~255
Purpose of the study was to analyze the supraspinatus outlet image of sagittal MRI in rotator cuff disease. We analyzed the sagittal views of the shoulder MRI of 78 cases without cuff tear. The cases were divided into 51 cases of rotator cuff disease group and 27 cases of control group. Six parameters of acromial tilt, coracoacromial ligament angle, length and height of coracoacromial triangle, length of acromial side of the baseline and distance of intrusion of the humeral head were compared for each group. The distance of intrusion of the humeral head was the most significantly different one, 0.52cm for rotator cuff disease group and 0.15cm for control group. Intrusion of the humeral head to the supraspinatus outlet space from the bottom may be a contributing factor developing rotator cuff disease. The intrusion may precede to tearing of the rotator cuff.
Arthroscopic Global Capsular Release in the Refractory Frozen Shoulder
Rhee Yong-Girl ; Yim Chang-Moo ; Bae Seong-Bum ;
Clinics in Shoulder and Elbow, volume 1, issue 2, 1998, Pages 256~265
Forty two patients who had been treated arthroscopically for idiopathic frozen shoulder were evaluated subjectively and objectively at 15 months to 38 months for follow up(average; 26 months). Most of these patients had severe pain, especially aggravated night pain and markedly restricted humeroscapular motion. The preoperative range of motion averaged 95 degrees of forward elevation, 17 degrees of extemal rotation, and intemal rotation to the level of the fifth lumbar spinous process. In the arthroscopic finding, congested synovitis, especially at anterosuperior capsule existed in all. Synovitis of the biceps tendon was found in 36%, subscapular recess was obliterated in 64%, the superior glenohumeral ligament and the middle glenohumeral ligament each in 92 and 73percent was thickened, around all had thickened inferior glenohumeral ligament. We debrided these hyperemic synovial tissue and released the whole global capsule that might restrict the glenohumeral motion. Thirty two patients(76%) were completely free of pain at the last follow up, seven patients(17%) had intermittent pain only on extreme motion, but all of them could do the activities of daily living well. Three patients(7%) who were diabetics had persistent pain and unsatisfactory final results. Forward elevation was improved upto 168 degrees, extemal rotation to 55 degrees, and internal rotation to the level of the tenth thoracic spinous process. The average preoperative UCLA rating score was 42 points, while the average postarthroscopic UCLA rating score was improved upto 84 points. Therefore arthroscopic global capsular release could be recommended in the treatment of refractory frozen shoulders which failed to respond to conservative management
Arthroscopic Treatment of Partial-thickness Rotator Cuff Tear
Kim Seung-Ho ; Ha Kwon-Ick ;
Clinics in Shoulder and Elbow, volume 1, issue 2, 1998, Pages 266~277
Forty-nine partial thickness rotator cuff tears underwent arthroscopic debridement or repair, and were followed up for a minimum of two years. Follow-up evaluations of the results were completed using a detailed functional questionnaire which was comprised of a rating of the UCLA shoulder scale and return to the previous sports activity and job. The average age of the 49 study patients was 46.5 years(range, 14 to 67 years). The patients were divided into four groups on the basis of the onset of the patient's symptoms. Thirty-five patients(72%) had partial tearing only on the articular surface, six(12%) on the bursal surface, and eight(16%) on both surfaces. Group I consisted of 21 patients with an average age of 56.7. Partial tearing in group I was attributed to the impingement syndrome. In group II, partial tearing of the rotator cuff was related to the anterior instability of the shoulder. This group included 9 patients with an average age of 27.9. In group III, all of the 8 patients were overhead athletes with an average age of 21.8. In this group, no isolated instances of significant trauma were related to the development of the shoulder pain. In group IV, 11 patients noted that a significant traumatic event preceded the onset of their pain. The average age of the patients was 34.9. Overall, 82% of the patients demonstrated satisfactory results and 18% revealed unsatisfactory results. The worst UCLA score and rate of return to the prior activity was noted in group III. In conclusion, partial thickness rotator cuff tear can be caused by subacromial impingement, instability, repetitive microtrauma, and macrotrauma. Arthroscopic debridement of partial tear of the rotator cuff provides a favorable outcome except in overhead athletes.