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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 12, Issue 2 - Dec 2009
Volume 12, Issue 1 - Jun 2009
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Mini-T Plate Fixation for Neer Type II Distal Clavicle Fracture
Yum, Jae-Kwang ; Lee, Sang-Lim ; Ra, Ho-Jong ;
Clinics in Shoulder and Elbow, volume 12, issue 1, 2009, Pages 1~6
DOI : 10.5397/CiSE.2009.12.1.001
Purpose: To evaluate and report the clinical and radiological outcomes of open reduction and internal fixation with a mini-T plate for unstable distal clavicle fractures. Materials and Methods: From December 2004 to July 2007, fifteen patients who had a fracture of the distal clavicle (Neer type II fracture) were treated with an open reduction and internal fixation using a mini-T plate. They were followed up for a minimum of one year and the clinical and radiological results were analyzed. Results: The average time to fracture union was 3.1(3~4) months. There were no complications, such as deep infection or fixation loss. The mean ASES score was 97 points (85~100points) at the last follow up period, and 14 patients had a full range of motion of the shoulder. Conclusion: Open reduction and internal fixation with a mini-T plate for unstable distal clavicle fracture is a good surgical method with good clinical and radiological results.
Tuberoplasty for Irreparable Massive Rotator Cuff Tears
Yi, Jin-Woong ; Cho, Nam-Su ; Cho, Seung-Hyun ; Cho, Hyung-Jun ; Rhee, Yong-Girl ;
Clinics in Shoulder and Elbow, volume 12, issue 1, 2009, Pages 7~13
DOI : 10.5397/CiSE.2009.12.1.007
Purpose: To evaluate the clinical and radiological results of arthroscopic tuberoplasty for irreparable massive rotator cuff tears. Materials and Methods: Eleven patients underwent arthroscopic tuberoplasty for irreparable massive rotator cuff tears between December 2004 and April 2007. The mean follow-up period was 17.3 months, and the average age at the time of surgery was 61.7-year-old. Five cases underwent arthroscopic tuberoplasty and 6 cases had arthroscopic subacromial decompression and tuberoplasty, simultaneously. Results: The average Constant score improved from 61.8 to 86.9 and the average UCLA score changed from 14.8 to 31.8 with 6 excellent, 3 good and 2 poor results (p=0.003). The active forward flexion improved from
(p=0.011). The acromiohumeral interval increased from 3.94 mm preoperatively to 4.22 mm postoperatively (p=0.12). In the poor UCLA score group, the acromiohumeral interval changed from 1.67 mm preoperatively to 0.94 mm postoperatively. Conclusion: Arthroscopic tuberoplasty may be a second option to relieve the pain of irreparable massive rotator cuff tears and improve the range of motion. However, good results could not be expected if the acromiohumeral interval is < 2 mm preoperatively and decreased postoperatively.
Treatment of Type 2 Distal Clavicle Fracture using Wolter Plate
Shin, Sung-Il ; Song, Kyung-Won ; Lee, Jin-Young ; Lee, Seung-Yong ; Kim, Gab-Rae ; Hyun, Yoon-Suk ; Lee, Kwang-Nam ; Lee, Eun-Soo ;
Clinics in Shoulder and Elbow, volume 12, issue 1, 2009, Pages 14~20
DOI : 10.5397/CiSE.2009.12.1.014
Purpose: This study examined the clinical results of the treatment of type 2 distal clavicle fracture with using a Wolter plate. Materials and Methods: Between 2004 and 2007, 16 patient treated for type 2 distal clavicle fracture using a Wolter plate were included in this study. Their average age was 32.6 years and the postoperative mean follow-up period was 22.9 months. The reduction and union were qualified according to the immediate post-operative and final radiographs. The functional outcome was evaluated by Kona's system and the Constant score Results: By Kona's functional evaluation, there were 12 cases with excellent results, 3 cases with good results and 1 case of fair results and the average Constant score was 90. All 16 cases showed bony union. As complications, there was 1 case in which the protruded hook of the plate could be palpated at the skin, and 1 case showed an acromial fracture, but all the cases dispalyed successful bony union and there was no acromioclavicular joint arthritis, infection or any other complications. Conclusion: Wolter plate fixation for type 2 distal clavicle fracture is a reliable surgical method for satisfactory reduction and rigid fixation, a lower incidence of nonunion and excellent clinical result.
Dose-related Effect of Extracorporeal Shock Wave Therapy for Lateral Epicondylitis - Prospective Randomized Double Blind Comparative Study -
Oh, Joo-Han ; Yoon, Jong-Pil ; Oh, Chung-Hee ; Jo, Ki-Hyun ; Gong, Hyun-Sik ;
Clinics in Shoulder and Elbow, volume 12, issue 1, 2009, Pages 21~26
DOI : 10.5397/CiSE.2009.12.1.021
Purpose: The aim of this study was to examine the dose-related effect of extracorporeal shock wave therapy (ESWT) for lateral epicondylitis. Materials and methods: Thirty patients with refractory lateral epicondylitis despite conservative treatment for 6 months were enrolled in this study. The patients were divided randomly into a low- and high-energy group. All patients were treated 3 times with ESWT with an interval of 1 week in a double blinded manner. The mean energy level in the low- and high-energy group was
, respectively. The upper extremity functional scales and Mayo elbow scores were measured prospectively at the baseline, 1, 3 and 6 months after ESWT. Results: Significant clinical improvement was observed in both groups after ESWT. The high-energy group showed better pain improvement at 6 months after ESWT (p=0.019). The effect of ESWT was dominant between 1 and 6 months after ESWT than within 1 month. Conclusion: ESWT for lateral epicondylitis demonstrated showed good results regardless of the energy dose. However, a high-energy level was more effective in pain improvement after 6 months of treatment.
Arthroscopic Reconstruction in Anterior Shoulder Instability - Prospective Comparison of Anteroinferior Plication Versus Inferior Plication -
JP, Warner Jon ; Ko, Sang-Hun ; Jeon, Hyung-Min ;
Clinics in Shoulder and Elbow, volume 12, issue 1, 2009, Pages 27~32
DOI : 10.5397/CiSE.2009.12.1.027
Purpose: We wanted to evaluate the effectiveness of inferior capsular plication for treating the anterior instability of the shoulder by comparing the prospective outcomes and the incidence of complications of the group (group1) that underwent arthroscopic vertical shift of the anteroinferior capsulo-labral complex and plication of the anterior band of inferior glenohumeral ligament and the group (group2) that underwent inferior capsular plication that was augmentated by the same method. Materials and Methods: From March 2005 to August 2007, we compared group 1 (42 cases) that underwent arthroscopic vertical shift of the anteroinferior capsulo-labral complex and plication of the anterior band of the inferior glenohumeral ligament and group 2 (33 cases) that underwent augmentated inferior capsular plication for recurrent anterior instability of the shoulder. The mean age was 22.5 years (range: 17~31 years) in group I, and 21.8 years (range: 16~30 years) in group II. The mean follow up was 23.5 months (range: 12~45 months in group I, and 20.1 months (range: 12~49 months) in group II. We checked the Rowe score and ROM preoperatively and at postoperative 6 months, 1 year and at the last follow up and we compared the incidence of complications. Results: The Rowe score increased from a preoperative mean of 20.6 to the last follow up mean of 86.8 after surgery in group I, and the Rowe score increased from a preoperative mean of 20.5 to the last follow up mean of 94.1 after surgery in group II. For the anterior instability of the shoulder, arthroscopic reconstruction had a good outcome in all of the cases, but group II had better outcomes and less complications than did group I (p<0.05). Conclusion: We thought that arthroscopic vertical shift of the anteroinferior capsulo-labral complex and plication of the anterior band of the inferior glenohumeral ligament with inferior capsular plication can lower the complication rate and show better outcomes.
Compression Plate Fixation with Autogenous Bone Graft for Humerus Shaft Nonunion
Cho, Chul-Hyun ; Song, Kwang-Soon ; Bae, Ki-Cheor ; Kim, In-Kyoo ; Kwon, Doo-Hyun ;
Clinics in Shoulder and Elbow, volume 12, issue 1, 2009, Pages 33~37
DOI : 10.5397/CiSE.2009.12.1.033
Purpose: To evaluate the results of the compression plate fixation and autogenous bone graft in the management of humerus shaft nonunion. Materials and Methods: Eighteen cases were treated for humerus shaft nonunion using compression plate fixation and an autogenous iliac bone graft. The mean follow-up period was 28 months. Bony union was confirmed from the serial radiographs and the clinical outcomes were assessed according to ASES scoring system. Results: In 12 cases of initial plate fixation, the causes of nonunion were 6 cases of inadequate plate length, 2 with a broken plate, 2 with screw loosening, 1 infection and 1 noncompliance of a psychiatric patient. In 3 cases of initial intramedullary fixation, the cause of nonunion was a distraction of the fracture site. In 3 cases of external fixation, the cause of nonunion was inadequate fixation. All cases showed bony union after an average of 24 weeks. The clinical outcomes were 11 excellent, 6 good and 1 fair. Conclusion: In the treatment for nonunion, compression plate fixation with autogeneous bone graft after complete removal of the fibrous and necrotic tissue is believed to give satisfactory results.
Comparative Study of MR-arthrography and Arthroscopy in Partial Thickness Rotator Cuff Tears
Kwon, Oh-Soo ; Park, Sang-Eun ; Shin, Eun-Su ;
Clinics in Shoulder and Elbow, volume 12, issue 1, 2009, Pages 38~43
DOI : 10.5397/CiSE.2009.12.1.038
Purpose: The purpose of this study was to assess the efficacy of MR arthrography to detect partial thickness rotator cuff tears. Materials and Methods: One hundred and seventy seven patients with a high suspicion for rotator cuff disease were studied by performing MR-arthrography and subsequent arthroscopy. The ability of MR-arthrography to detect partial thickness tears was evaluated according to the location of the tears. We determined the correspondence between the measurements of the articular side partial tears on MR arthrography and those on the arthroscopic findings. Results: The arthroscopic diagnosis of partial thickness rotator cuff tears was divided into 3 groups according to their location. There were 63 cases on the articular side, 41 cases on the bursal side and 20 cases on both sides. The sensitivity of MR-arthrography was 82% for the articular side tears and 11% for the bursal tears. The specificity was 88% for the articular side tears and 100% for the bursal tears. MR-arthrographic measurement correctly predicted 72% in 28 repaired cases of 56 articular side partial thickness tears. Conclusions: MR-arthrography may be a reliable tool for diagnosing articular side partial thickness rotator cuff tears, but it has limitations for bursal side tears.
Internal Fixation of Proximal Humerus Fracture with Locking Compression Plate
Park, Chul-Hyun ; Park, Sung-Hyuk ; Seo, Jae-Sung ;
Clinics in Shoulder and Elbow, volume 12, issue 1, 2009, Pages 44~52
DOI : 10.5397/CiSE.2009.12.1.044
Purpose: We assessed the radiographic and clinical results of one surgeon's experience treating proximal humerus fractures with a locked proximal humeral plate. Materials and Methods: Twenty patients with unstable proximal humerus fractures were treated with a locking compression plate between February 2005 and September 2007. The average age of the patients was 60.6 years, and the average postoperative follow-up period was 22.3 months. The clinical results were evaluated using the Constant and DASH scores. The radiologic results were evaluated by the Paavolainen method, which measures the neck shaft angle and humeral head height. Results: At the last follow-up examination, the mean Constant score was 75.3 and 15 cases (75%) had excellent or good results; the mean DASH score was 16.4. The mean neck shaft angle was
, and 19 cases (95%) had good results by the Paavolainen method. There was one delayed union, malunion, and screw loosening. Conclusion: The patients treated with a locking compression plate had relatively good clinical and radiologic results, and a low complication rate. Moreover, the patients could exercise earlier due to good reduction and initial stability. Treatment of unstable proximal humerus fractures with a locking compression plate is a reliable method.
Results of Arthroscopic Debridement of the Elbow Osteoarthritis
Chun, Churl-Hong ; Kim, Jung-Woo ; Lim, Jae-Chang ;
Clinics in Shoulder and Elbow, volume 12, issue 1, 2009, Pages 53~60
DOI : 10.5397/CiSE.2009.12.1.053
Purpose: Primary osteoarthritis on the elbow is the result of the growth of osteophytes and contracture of the capsule. It often causes disability on joint motion and pain while exercising. As arthroscopy has developed, the arthroscopic diagnosis and treatment of the elbow have recently become more generalized as well. Therefore, we like to report on arthroscopy for treating elbow arthritis and its results. Materials and Methods: This study includes 23 cases of elbow arthritis that were seen between 2005 June to 2007 June and these patients didn't response to conservative treatment. From this we excluded 18 cases that underwent arthroscopic surgery and among these 18 cases, 6 cases underwent ulnar nerve transfer. The average observation time was 21.3 months and the average age was 48.4 years (range: 22-66 years). The pre and post operative pain was evaluated with using the Visual Analogue Scale (VAS) and functional evaluation was done with using the Mayo elbow Performance Score (MEPS) with the range of joint motion. Results: The VAS score at the last follow up was significantly decreased from 3.4 to 1.9 compare to the preoperative score. The range of joint motion was improved by 25 (0-40) to 8.5 (0-20) in extension and 101.7 (80-140) to 125.2 (85-140) in flexion (p<0.05). The MEPS always showed significant improvement by showing an increase from 65.4 (40-85) to 87.9 (55-100). However, 3 cases showed a decreased range of motion after the operation. One case showed ulnar nerve symptoms after surgery. Conclusion: An arthroscopic procedure can treat the pathologic processes associated with arthritis of the elbow and it was safe and effective in this series.
Comparison of Results Between Immediate Fixation Group and Delayed Reconstruction Group in Displaced Mid-shaft Fractures of the Clavicle
Kim, Doo-Sub ; Rah, Jung-Ho ; Yoon, Yeo-Seung ; Lee, Chang-Ho ;
Clinics in Shoulder and Elbow, volume 12, issue 1, 2009, Pages 61~66
DOI : 10.5397/CiSE.2009.12.1.061
Purpose: Several authors have reported excellent results of delayed reconstruction of non-union & malunion in displaced mid-shaft fractures of the clavicle and these results were equal to that of immediate fixation. But direct comparison between these treatments is rare. We evaluated the results between the immediate fixation group and delayed reconstruction group for treating displaced mid-shaft fractures of the clavicle. Materials and Methods: We studied the results of 18 cases with immediate fixation of displaced mid-shaft fractures of the clavicle and 15 cases with delayed reconstruction of non-union & malunion after conservative management, and these cases were seen from March 2000 to February, 2006. The final postoperative outcome was analyzed according to the clinical outcomes with using the Constant score and the radiological findings of bony union. Results: The constant score was low in the delayed reconstruction group compare to that of the immediate fixation group (p value=0.045). For the pain score & the activities of daily living score, a statistically significant difference was seen between the two groups (p<0.05), but not for the range of motion score & the power score (p>0.05). Radiological findings of bony union were seen for both groups at an average of 8.8 weeks for the immediate fixation group and at an average of 9.8 weeks for the delayed reconstruction group. Conclusion: Though the delayed reconstruction group was shown good clinical and radiological results, the immediate fixation group had a significantly better pain score, a better activities of daily living score and a better Constant score. It is important to choose the initial treatment option for displaced mid-shaft fractures of the clavicle after sufficient explanation to patients about the merits and demerits between these two treatment options.
Debridement Arthroplasty using Posteromedial Approach in Elbow Joint with Pain and Bony Limitation of Motion
Cheon, Sang-Jin ; Lee, Dong-Ho ; Cha, Seung-Han ; Kim, Hui-Taek ; Suh, Jeung-Tak ;
Clinics in Shoulder and Elbow, volume 12, issue 1, 2009, Pages 67~75
DOI : 10.5397/CiSE.2009.12.1.067
Purpose: This study evaluated the clinical outcomes of debridement arthroplasty using the posteromedial approach in elbow joints with pain and bony limitation of motion. Materials and Methods: This study involved 16 elbows in 16 patients with pain and bony limitation of motion, which were treated by debridement arthroplasty using the posteromedial approach from March 2005 to March 2008. The mean follow up period was 27.6 (13~52) months. The clinical outcomes were analyzed using the Visual Analogue Scale(VAS) for pain scale, the preoperative and postoperative range of motion and the Mayo Elbow Performance Scores(MEPS). Results: The VAS was decreased significantly from a preoperative mean of 4.5 to a postoperative mean 1.1 (p<0.001). The average arc of motion improved significantly from
postoperatively (p<0.001). The MEPS also improved significantly from 59.4 to 85.6 postoperatively (p<0.001). There were no complications, such as hematoma and elbow instability. Conclusion: Debridement arthroplasty using the posteromedial approach is a useful surgical procedure in the elbow joint with pain and bony limitation of motion, where all compartments can be debrided, the ulnar nerve can be manipulated easily and damage to the medial collateral ligament can be minimized.
Recurrent Traumatic Glenohumeral Instability Associated with Glenoid Bone Defect - 3 Case Report -
Tae, Suk-Kee ; Oh, Jong-Soo ; Kim, Jin-Young ;
Clinics in Shoulder and Elbow, volume 12, issue 1, 2009, Pages 76~79
DOI : 10.5397/CiSE.2009.12.1.076
Purpose: Capsulolabral reconstruction in a traumatic anterior instability of the glenohumeral joint is successful not only for the prevention of recurrent instability but also for the restoration of function. Materials and Methods: However, a capsulolabral procedure alone cannot guarantee a successful result when there is severe bone loss of the glenoid. Results: We report the surgical technique and results of capsulolabral repair and extraarticular bone block with an autogenous iliac crest graft performed on three cases (all male, average age 28 years, minimum follow-up 12 months) with traumatic anterior instability associated with more than 30% glenoid bone loss.
Triple Labral Lesion of Shoulder - A Case Report -
Choi, Nam-Yong ; Song, Hyun-Seok ; Yoon, Jae-Woong ;
Clinics in Shoulder and Elbow, volume 12, issue 1, 2009, Pages 80~83
DOI : 10.5397/CiSE.2009.12.1.080
Purpose: A triple labral lesion represents a combination of injuries of the anterior, posterior and superior glenoid labrum. The injury mechanism and symptoms is not completely understood. Materials and Methods: We encountered a triple labral injury in a 39-year-old male complaining pain and active abduction difficulty after a motor vehicle accident. Currently, he does not complain any instability symptoms. The labrum was repaired using bio-absorbable suture anchors and a suture hook. Results: Eighteen months following surgery, the active range of motion was restored and he had no difficulty in his daily activities.
Idiopathic Calcium Pyrophosphate Dihydrate (CPPD) Crystal Deposition Disease in a Young Female Patient - A Case Report -
Choi, Eui-Sung ; Park, Kyoung-Jin ; Kim, Yong-Min ; Kim, Dong-Soo ; Shon, Hyun-Chul ; Cho, Byung-Ki ; Lee, Hyun-Chul ;
Clinics in Shoulder and Elbow, volume 12, issue 1, 2009, Pages 84~88
DOI : 10.5397/CiSE.2009.12.1.084
Purpose: Calcium pyrophosphate dihydrate crystal deposition disease(CPPD) is a disease of the elderly and extremely rare in young individuals. If young people develop CPPD crystal deposition disease, it may be associated with metabolic diseases, such as hemochromatosis, hyperparathyroidism, hypophosphatasia, hypomagnesemia, Wilson's disease, hypothyroidism, and gout. Materials and Methods: Therefore, in young-onset CPPD crystal deposition disease, an investigation of any predisposing metabolic conditions is warranted. Conclusion: We report a case of a young female patient who presented with idiopathic CPPD crystal deposition disease at 25 years of age.
Kimura's Disease of the Elbow - A Case Report -
Cho, Chul-Hyun ; Sohn, Sung-Won ; Kang, Chul-Hyung ; Oh, Geon-Myung ;
Clinics in Shoulder and Elbow, volume 12, issue 1, 2009, Pages 89~93
DOI : 10.5397/CiSE.2009.12.1.089
Purpose: Kimura's disease is an uncommon benign lymphoproliferative inflammatory disorder with an unknown etiology. The recurrence rate after surgical excision is relatively high and renal involvement is its only systemic manifestation. The condition mainly involves the head and neck, and peripheral involvement is extremely rare. Materials and Methods: We encountered the case of a 28-year-old man who had a non-tender mass with mild brownish skin color changes and pruritus around the medial side of the distal arm and elbow. Results: The peripheral blood investigation revealed peripheral eosinophilia and elevated serum IgE levels. Magnetic resonance imaging showed an isointensity signal relative to the muscle on the T1-weighted images and hyperintensity signal relative to the muscle on the T2-weighted images. Conclusion: A marginal resection of the lesion was performed and there was no recurrence at 2 years postoperatively.
Hibernoma of Right Shoulder - A Case Report -
Kang, Ho-Jung ; Hwang, Bo-Hyun ; Jung, Min ; Koo, Ja-Seung ; Shin, Kyoo-Ho ; Hahn, Soo-Bong ; Kim, Sung-Jae ;
Clinics in Shoulder and Elbow, volume 12, issue 1, 2009, Pages 94~97
DOI : 10.5397/CiSE.2009.12.1.094
Purpose: Hibernoma is a very rare benign soft tissue tumor of the hypervascularized brown fat tissue with no malignant potential. Materials and Methods: However, it is difficult to differentiate a hibernoma from other malignant tumors, such as liposarcoma using computed tomography and magnetic resonance imaging, and a surgical resection with histological confirmation is the treatment of choice. Results: Histopathologically, hibernoma is composed of brown adipose cells that are polygonal and multivacuolated with a centrally located nucleus and granular cytoplasm, unlike white adipose cells. Conclusion: This article describes a patient with a histologically-confirmed hibernoma of the right shoulder.
Arthroscopic Bankart Repair for Post-seizure Anterior Instabilities of Shoulder - 2 Cases Report -
Moon, Young-Lae ; Yang, Hun ; Gorthi, Venkat ;
Clinics in Shoulder and Elbow, volume 12, issue 1, 2009, Pages 98~101
DOI : 10.5397/CiSE.2009.12.1.098
Purpose: These case reports have been prepared to highlight the uncommon occurrence of anterior shoulder dislocation after an epileptic seizure, the recognition of which is important as this type of injury is associated with bony lesions and a high incidence of recurrence. Materials and Methods: We report two cases of recurrent anterior dislocation of the shoulder due to grand mal epilepsy. These cases were treated as usual anterior dislocations of the shoulder, and were regularly followed to detect any recurrence of shoulder instability. Results: Outcome of the surgery in the two cases was different because of the differences in seizure control. In the patient in whom seizures were well-controlled, there was no recurrence of instability, while the patient with poorly controlled seizures developed a recurrence of the dislocation following shoulder repair. Conclusion: The authors emphasize the need to control seizures in order to prevent injury recurrence in this subset of patients.
Arthroscopic Technique of Bone Defect in Anterior Shoulder Instability
Ko, Sang-Hun ; Park, Ki-Bong ;
Clinics in Shoulder and Elbow, volume 12, issue 1, 2009, Pages 102~108
DOI : 10.5397/CiSE.2009.12.1.102
Purpose: The bone defects that are associated with shoulder anterior instability may be the causes of failure of arthroscopic surgery. For the treatment of traumatic shoulder instability, we tried to determine the arthroscopic techniques that can be used for the bone defect of the glenoid and the humeral head. The purpose of this study is to assess the surgical techniques for the arthroscopic reconstruction of the shoulder with anterior instability and bone defects. Materials and Methods: We analyzed the articles that have been recently published on anterior shoulder instability and we assessed the arthroscopic surgical techniques. We compared the articles and the methods of arthroscopic surgical techniques for treating bone defects of the anteroinferior glenoid and the posterolateral humeral head, which were considered as the causes of recurrence of shoulder instability. Results: There are the anteroinferior bone defects of the glenoid and Hill-Sachs lesions in the bone defects that appear in patients with anterior shoulder instability. These bone defects are currently the causes of failure of arthroscopic surgery. Conclusion: Open shoulder surgery may be the treatment of the choice for a shoulder with instability and significant bone defects of the glenoid and the humeral head. But efforts are being made to overcome the weaknesses of open surgery by the use of arthroscopy.