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REFERENCE LINKING PLATFORM OF KOREA S&T JOURNALS
> Journal Vol & Issue
Clinics in Shoulder and Elbow
Journal Basic Information
Journal DOI :
Korean Shoulder and Elbow Society
Editor in Chief :
Volume & Issues
Volume 10, Issue 2 - Dec 2007
Volume 10, Issue 1 - Jun 2007
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Arthroscopic Rotator Cuff Repair: Single Row Technique
Park, Hyung-Bin ;
Clinics in Shoulder and Elbow, volume 10, issue 2, 2007, Pages 155~159
DOI : 10.5397/CiSE.2007.10.2.155
Arthroscopic single-row rotator cuff repair is a well established surgical technique for the treatment of rotator cuff tears. However, the problem of postoperative retear remains a concern. Various avenues are being explored to address this problem. Some studies have suggested that restoring the anatomical footprint may improve the healing and initial strength of the repaired rotator cuff tendon. The double-row technique was introduced as a method of reconstructing the anatomical footprint. According to biomechanical studies on cadavers, this technique improved mechanical strength and reduced gap formation. However, the biological properties of reattached tendon such as tension, and vascularity have not been proved yet. Furthermore, the apparent mechanical superiority of the double-row over the single-row construction has not resulted in better functional outcomes. Therefore, the less complicated and less costly single-row technique is still the recommended treatment for rotator cuff repairs.
Primary Repair in Tears Affecting Two or More Rotator Cuff Tendons
Kim, Jin-Young ; Kang, Ki-Ser ; Tae, Suk-Kee ;
Clinics in Shoulder and Elbow, volume 10, issue 2, 2007, Pages 160~166
DOI : 10.5397/CiSE.2007.10.2.160
Purpose: The current study assessed the factors affecting outcomes of primary repair procedures in tears of multiple rotator cuff tendons. Materials and Methods: Among the cases of rotator cuff tears involving two or more tendons receiving operations between 1997 and 2003, The clinical results of 19 cases with more than 2 years follow-up were evaluated by the UCLA score. We evaluated the correlation of trauma, active motion, acromiohumeral distance, tear size, and surface area with the UCLA score using Pearson's linear correlation coefficient (PLCC). Results: UCLA scores increased significantly in all cases, from 9 to 26.1 on average. However, the results were good in 53%, and poor in 47% according to Ellman's criteria. Trauma, active elevation, acromiohumeral distance, and tear size did not correlate with the UCLA score, but the tear surface area was inversely correlated with the score (PLCC=-0.696). Cases with degeneration of the infraspinatus muscle above Goutallier grade III on MRI showed worse results than cases with less degeneration. Conclusion: The clinical results of primary repair of rotator cuff tears involving multiple tendons were satisfactory in 53% of patients. Large tear surface area and severe degeneration of the infraspinatus were poor prognostic factors.
Conservative and Arthroscopic Treatment of Calcific Tendinitis
Choi, Chang-Hyuk ; Kim, Shin-Kun ; Lee, Ho-Hyoung ;
Clinics in Shoulder and Elbow, volume 10, issue 2, 2007, Pages 167~174
DOI : 10.5397/CiSE.2007.10.2.167
Purpose: We evaluated calcium resolution and clinical improvement of calcific tendinitis after conservative and arthroscopic treatment. Materials and Methods: We reviewed 126 patients of calcific tendinitis treated from January, 2002 to April, 2005. Average age was 53 and female dominant in 77% of the cases. Calcium deposits were involved in supraspinatus tendon in 84% of the cases. We compared clinical changes for 64 cases treated with injection, and 12 cases treated by arthroscopic decompression with 6 month follow-up. Results: 77%(49/64) of the cases with steroid injection showed symptom improvement. Even though complete resolution of calcific deposit occurred in 36%(23/64), incomplete resolution in 17%(11/64) and no change in 47%(30/64), Pain was relieved in 87%(20/23), 82%(9/11) and 67%(20/30), respectively. With arthroscopic treatment, calcium deposit completely resolved in 83%(10/12), and all cases showed pain free motion after 6 months. Conclusion: Conservative treatment with steroid injection was effective for acute pain in resorptive phase. In cases of arthroscopic treatment, there was no need for complete removal of calcium deposit during the procedure, but clinical symptoms improved with resolution of the deposit.
Comparison of Superior Labral Anterior Posterior (SLAP) Lesions: Sports versus Non-sports Induced Injury
Lee, Kwang-Won ; Lee, Seung-Hun ; Yang, Dong-Hyun ; Kam, Byoung-Sup ; Choy, Won-Sik ;
Clinics in Shoulder and Elbow, volume 10, issue 2, 2007, Pages 175~182
DOI : 10.5397/CiSE.2007.10.2.175
Purpose: This study compared the SLAP lesions caused by a sports-induced injury with those caused by a non-sports-induced injury. Materials and Methods: The study was performed on 54 patients who had undergone arthroscopic surgery for a SLAP lesion. There were 21 sports-induced-injury patients (group I) and 36 non-sports-induced injury patients (group II). The mean age of the men was 36 years and that of the women was 48 years. In both groups, the frequency of a concomitant injury and the clinical outcomes at the last follow-up was evaluated using the UCLA score, Rowe score, and the ASES score. Results: According to their injury mechanism, , there were 14 cases (67%) of repeated microtrauma injury in group I and 25 cases (75%) of compression injury type in group II. As a concomitant pathology, there was 11 cases of shoulder instability and 5 cases of a rotator cuff tear in group I, and 23 cases of rotator cuff tears and 14 cases of shoulder instability in group II. At the last follow up, group I showed slightly better clinical satisfaction (P>0.05). Conclusion: The possibility of a SLAP lesion accompanying other diseases is high. Therefore, an accurate assessment of concomitant injury lesions before surgery is important for the treatment outcome.
The Short Term Clinical Results of Hemiarthroplasty to Treat Humeral Head Osteonecrosis
Sohn, Kang-Min ; Sung, Chang-Meen ; Park, Hyung-Bin ;
Clinics in Shoulder and Elbow, volume 10, issue 2, 2007, Pages 183~189
DOI : 10.5397/CiSE.2007.10.2.183
Introduction: While uncommon, humeral head osteonecrosis is an indication for arthroplasty when the humeral head collapse is advanced. The current authors report the short-term clinical results of 7 hemiarthroplasties to treat humeral head osteonecrosis. Materials and Methods: This study focused on 7 reconstructed shoulders of 5 patients whose humeral head osteonecrosis was treated with hemiarthroplasty. The postulated causes were alcohol-induced (4 cases) and steroidinduced (3 cases). The minimum follow-up was 12 months. This study compared the preoperative and postoperative shoulder pain, range of motion, and ASES scores. The postoperative patient satisfaction was assessed. Results: The level of pain during exercise was reduced from a preoperative average of 7.6 to a postoperative average of 1.9. The range of motion, in terms of forward flexion, abduction, and external rotation, improved from preoperative averages of
to postoperative averages of
, respectively. The ASES scores increased from a preoperative mean of 39.0 to a postoperative mean of 84.1. The patients' ratings of the outcomes were excellent (5 cases) and good (2 cases). Conclusions: These short-term results indicate that hemiarthroplasty is a reliable treatment method for humeral head osteonecrosis improving shoulder pain, range of motion, and patient satisfaction.
Total Elbow Arthroplasty after Failed Surgical Treatment for Elbow Fracture or Dislocation
Yi, Jin-Woong ; Roh, Jun-Ha ; Song, Jong-Hoon ; Rhee, Yong-Girl ;
Clinics in Shoulder and Elbow, volume 10, issue 2, 2007, Pages 190~198
DOI : 10.5397/CiSE.2007.10.2.190
Purpose: The current study reports the clinical results of total elbow arthroplasties (TEA) which were Performed on patients with poor clinical and radiological results after initial surgeries for elbow fractures or dislocations. Materials and Methods: The clinical outcomes of twelve consecutive patients who underwent TEA after failed surgeries for elbow fractures or dislocations from january, 1995 to December, 2005 were evaluated. The initial diagnoses were distal humeral fractures in 8 cases and fracture-dislocations in 4 cases. The Mean period from the initial operations to the TEAs was 12 months. The mean folloow up period after TEA was 43 months. Results: The mean range of motion, in terms of active extension, activeflexion, supination, and pronation, improved from
, respectively (p<0.05). RAdiolucent lines were found in 3 cases, which were 1 case of type 3, and 2 cases of type 4. All three loosening cases underwent revision TEAs. The mean postoperative Mayo elvow performance score was 79 point. There were 6 cases of excellent, 2 cases of good, and 4 cases in poor. Conclusion: Good clinical results were obtained after TEA performed in failed surgeries for elbow fractures of dislocations.
Coronoid view: A New Radiograph for the Evaluation of the Coronoid Fractures
Song, Joo-Hyoun ; Lee, Joo-Yup ; Yang, Sung-Cheol ; Lee, Han-Yong ; Kim, Jong-Ik ;
Clinics in Shoulder and Elbow, volume 10, issue 2, 2007, Pages 199~203
DOI : 10.5397/CiSE.2007.10.2.199
Purpose: It is very important to evaluate and fix coronoid process fractures because they are a critical element for a stable, effective elbow function. The lateral view of the elbow joint is used for a radiographic evaluation of the coronoid but an understanding of the fracture pattern is often difficult because of overlap of the radial head and obliquity of the fracture line. We developed the coronoid view, which is a new radiograph for an evaluation of the coronoid process fracture, and discuss its advantages for a postoperative follow-up. Materials and Methods: The coronoid view was designed for an evaluation of the anteromedial fragment of the coronoid process. After the patient sat on his side, the shoulder was abducted
and the elbow was flexed
. The X-ray beam was shot perpendicular to the table. Since shoulder was abducted
the fracture line of the coronoid process can be parallel to the X-ray beam, and the radial head can be cleared. Conclusion: The coronoid view can be a good alternative radiograph for an evaluation of a coronoid process fracture because the beam is parallel to the fracture line. The coronoid view can be particularly useful in postoperative patient follow-up where computed tomography is impractical due to metal implants and cost.
Treatment of Two- and Three-Part Fracture of Proximal Humerus using LCP
Shin, Sung-Il ; Song, Kyung-Won ; Lee, Jin-Young ; Lee, Seung-Yong ; Kim, Gab-Rae ; Hyun, Yoon-Suk ; Park, Deok-Yong ;
Clinics in Shoulder and Elbow, volume 10, issue 2, 2007, Pages 204~211
DOI : 10.5397/CiSE.2007.10.2.204
Purpose: To evaluate the result and complication of treatment using Locking Compression Plate (LCP) for fracture of proximal humerus. Materials and Methods: Between 2004 and 2006, 21 patients with two-part and three-part fractures of the proximal humerus were treated by LCP fixation. Their average age was 54.9 years. Postoperative mean follow-up period was 22.9 months. The reduction was qualified and complication were assessed with final radiographs. The functional outcome was evaluated by Neer's rating system. Results: By Neer's functional evaluation, mean score of shoulder function was 86.3 and 18 case (86%) had excellent or satisfactory results. There was one case of nonunion but no infection or avascular necrosis of the humeral head. No correlation was found between the final result and the type of fracture, age, gender or quality of reduction. Conclusion: We obtained satisfactory result of LCP fixation for fracture of proximal humerus in this study. LCP fixation for proximal humerus fracture is a reliable method to obtain satisfactory reduction, rigid fixation and early exercise.
The Operative Treatment of Scapular Glenoid Fracture
Kang, Ho-Jung ; Jung, Sung-Hoon ; Jung, Min ; Hahn, Soo-Bong ; Kim, Sung-Jae ; Kim, Jong-Min ;
Clinics in Shoulder and Elbow, volume 10, issue 2, 2007, Pages 212~219
DOI : 10.5397/CiSE.2007.10.2.212
Purpose: To determine the causes of the surgical treatment results in glenoid fracture by a retrospective analysis. Materials and methods: From March 1999 to February 2004, 9 patients who underwent an open reduction due to a glenoid fracture were reviewed. The modified Ideberg classification was used. There were 1, 3, 2, 1 and 2 cases of modified Ideberg type I, II, III, V, and VI, respectively. The internal fixators were a reconstruction plate, a small plate, a one-third tubular plate, a small screw, and a cannulated screw in 6, 1, 3, 3 and 1 case, respectively. The constant score and Adam's functional assessment method were used to evaluate the postoperative shoulder function. Results: The average time for fracture union was 7 weeks. The functional assessment was excellent in 4 cases, good in 3 cases, and fair in 2 cases. There were two complications related to surgery; articular screw encroachment, and inferior glenoid bone resorption without instability. Conclusion: A glenoid fracture with glenohumeral instability or displaced that was treated by open surgery showed good clinical results. Moreover, the more comminuted fracture had a lower functional score.
Operative Treatment of Distal Clavicle Fracture Nonunion
Kang, Ho-Jung ; Yoon, Hang-Seob ; Hahn, Soo-Bong ; Kim, Sung-Jae ;
Clinics in Shoulder and Elbow, volume 10, issue 2, 2007, Pages 220~226
DOI : 10.5397/CiSE.2007.10.2.220
Purpose: The distal clavicle has a biomechanical structure different from that of the proximal or middle 1/3 clavicle, and delayed union or nonunion occurs frequently in a distal clavicle fracture. The authors obtained favorable results from an open reduction and bone grafting of the distal clavicle nonunion. We report the results together with review of the relevant literature. Materials and Methods: The subjects were 8 patients(average age, 38.9) who had undergone surgery for distal clavicle nonunion from August 2003 to May 2006. Nonunion occurred after surgical treatment in 4 cases, and after conservative treatment in the other 4. In all cases, the patients complained of pain. Results: The mean follow-up duration was 14 months, and radiological union was observed in 8 weeks on average. In all cases, the range of shoulder joint motion was normal at the end of the follow-up observation. In the functional evaluation, 7 cases showed excellent results and 1 case showed good results. Conclusion: Surgical treatment is a safe and reliable treatment for distal clavicle fracture nonunion because it can achieve early rehabilitation and union.
Posterior Shoulder Dislocation with a Greater Tuberosity Fracture and Total Rupture of Rotator Cuff - A Case Report -
Shin, Sung-Ryong ; Kim, Do-Young ; Lee, Sang-Soo ; Ryu, Yun-Sik ; Jung, Un-Seob ; Choi, Hyun-Seok ;
Clinics in Shoulder and Elbow, volume 10, issue 2, 2007, Pages 227~231
DOI : 10.5397/CiSE.2007.10.2.227
A posterior shoulder dislocation with a fracture is rare. Most fractures are impression fractures of the humeral head or lesser tuberosity fractures. However, there are no reports of a complete rupture of the rotator cuff with a combined posterior glenohumeral dislocation. We report a unique case of a posterior shoulder dislocation with an avulsion fracture of the greater tuberosity and a complete rupture of infraspinatus, teres minor and subscapularis tendons, which were treated surgically.
Multiple Rice Bodies in Subacromial Space - A Case Report -
Min, Kyoung-Dae ; Ryu, Ki-Hoon ; Lee, Jae-Sang ; Lee, Byung-Ill ;
Clinics in Shoulder and Elbow, volume 10, issue 2, 2007, Pages 232~235
DOI : 10.5397/CiSE.2007.10.2.232
Multiple rice bodies are a rare disorder that is most commonly observed in chronic rheumatoid arthritis patients and as a complication of chronic inflammation in the bursa. However, it can occur in the absence of an underlying systemic disorder. Although it resembles synovial chondromatosis clinically and on imaging, the condition can be discriminated by an analysis of the radiographic and MR appearances. We encountered a case of multiple rice body formation with subacromial bursitis on the shoulder of a 37-year old man suffering from pain and motion limitation. The patient was treated by arthroscopic removal of the multiple rice bodies and a subacromial bursectomy. We present this case with a review of the relevant literature.
Congenital Pseudoarthrosis of the Clavicle Related with Neurofibromatosis - A Case Report -
Yun, Ho-Hyun ; Ahn, Gil-Yeong ; Nam, Il-Hyun ; Moon, Gi-Huk ; Lee, Jung-Ik ; Yoo, Yon-Sik ;
Clinics in Shoulder and Elbow, volume 10, issue 2, 2007, Pages 236~240
DOI : 10.5397/CiSE.2007.10.2.236
Reports of bowing and pseudarthrosis of the humerus and clavicle are rare. Most patients with congenital pseudoarthrosis of the clavicle involving the right side and midportion of clavicle tended to heal better than congenital pseudoarthrosis of the tibia. We experienced a patient who had special features in terms of location, pseudoarthrosis pattern, and neurofibromatosis, and report on this case here.
Bilateral Elastofibroma Dorsi of the Shoulder - Case Report -
Lee, Woo-Seung ; Kim, Taik-Seon ; Kim, Young-Bae ; Kang, Jong-Woo ;
Clinics in Shoulder and Elbow, volume 10, issue 2, 2007, Pages 241~245
DOI : 10.5397/CiSE.2007.10.2.241
We report a case of an 86-year-old man diagnosed with bilateral elastofibroma dorsi who was managed conservatively after a two year follow-up. An elastofibroma dorsi is a benign, slow-growing tumor that is most often located in the inferior periscapular area in elderly patients. It should be considered to differentiate them from other soft tissue tumors located at the inferior periscapular region. Increased awareness of these characteristics will decrease the incidence of a misdiagnosis of elastofibroma dorsi as a malignancy and avoid unnecessary surgery.
Total Elbow Arthroplasty for the Fracture of Elbow Arthrodesis Site - A Case Report -
Kim, Myung-Ho ; Seo, Joong-Bae ; Hwang, Sung-Su ;
Clinics in Shoulder and Elbow, volume 10, issue 2, 2007, Pages 246~250
DOI : 10.5397/CiSE.2007.10.2.246
Total elbow arthroplasty is a relatively rare procedure compared with total knee or total hip arthroplasty. Total elbow arthroplasty for bony ankylosis is even rarer, and the results are often unsatisfactory. We report a patient who gained good mobility of the elbow after total elbow arthroplasty for the treatment of fractured arthrodesis site with which the patient had lived with for 12 years.