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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 13, Issue 2 - Dec 2010
Volume 13, Issue 1 - Jun 2010
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Antegrade Interlocking Intramedullary Nailing in Humeral Shaft Fractures
Cho, Chul-Hyun ; Song, Kwang-Soon ; Kim, Sin-Ki ;
Clinics in Shoulder and Elbow, volume 13, issue 1, 2010, Pages 1~6
DOI : 10.5397/CiSE.2010.13.1.001
Purpose: To evaluate the results and complications of antegrade intramedullary interlocking nailing in humerus shaft fractures. Materials and Methods: We evaluated the clinical outcomes, radiologic results and complications in 47 patients with humerus shaft fracture treated with antegrade intramedullary interlocking nailing, and followed up until bony union. Bony union was confirmed by serial plain radiographs and the clinical outcomes were assessed according to the ASES scoring system. Results: Bony union was confirmed in 41 (87.2%) out of a total 47 patients, and the mean union period was 14.5 weeks. Major complications were as follows: 6 non-union, 3 delayed union, 2 intraoperative posterior cortex fracture in the distal humerus and 2 permanent shoulder pain, including 1 case of adhesive capsulitis. The clinical outcomes were as follows: 29 excellent, 11 good, 4 fair and 3 poor. Satisfactory outcomes were demonstrated in 40 patients (85.1%). Conclusion: Anterograde intramedullary interlocking nailing as treatment for humerus shaft fracture showed satisfactory bony union and clinical outcomes. It is considered an efficacious treatment, especially in patients with associated injury, such as multiple fractures and segmental fracture.
Short-Term Results of Subpectoral Tenodesis of the Proximal Biceps Tendon Using by Interference Screw
Kim, Jeong-Woo ; Kang, Hong-Je ;
Clinics in Shoulder and Elbow, volume 13, issue 1, 2010, Pages 7~13
DOI : 10.5397/CiSE.2010.13.1.007
Purpose: Our purpose was to retrospectively analyze clinical results of subpectoral tenodesis of the proximal biceps tendon using an interference screw. Materials and Methods: We reviewed 23 cases of patients receiving tenodesis of the proximal biceps tendon between January 2008 and January 2009 for whom we had follow-up data for at least 1 year. Twenty-three cases were operated on using subpectoral tenodesis; 16 of these cases had a rotator cuff tear. The results were judged using a visual analog scale (VAS), ASES, tenderness on the biceps groove, fixation failure and the degree of deformity (BAD). Results: VAS and ASES scores were significantly improved in all patients by the time of the final observation. There were no significant complications or fixation failures. The patients without a tear of the rotator cuff had a better result than patients with a tear of the rotator cuff, but the difference between the two groups was not significant (p>0.05). Conclusion: In patients with pathology of the long head of the biceps brachii, benefits of subpectoral interference screw tenodesis include pain relief, maintenance of functional biceps, muscle strength, and cosmesis. Subpectoral biceps tenodesis using interference screw fixation appears to be a promising, reproducible, reliable technique for addressing anterior shoulder pain related to pathology of the long head of the biceps brachii.
New V-shaped Technique in SLAP Repair (Comparison of Cinical Results Between New V-shaped Repair and Conventional Rapair Technique in Arthroscopic Type II SLAP Surgery)
Hyun, Yoon-Suk ; Shin, Sung-Il ; Kang, Jung-Woo ; Ahn, Joo-Hyun ;
Clinics in Shoulder and Elbow, volume 13, issue 1, 2010, Pages 14~19
DOI : 10.5397/CiSE.2010.13.1.014
Purpose: The purpose of this study was to compare clinical outcomes between the new V-shaped repair method and conventional methods for the arthroscopic repair of Type II SLAP lesions. Materials and Methods: Our study population consisted of 23 people treated with the new V-shaped repair method or conventional methods in the arthroscopic repair of Type II SLAP lesions at our institution between May 2006 and October 2008. Eleven shoulders were treated using the new V-shaped repair method. Twelve shoulders were treated using conventional methods. The average follow up period was 15 months. For evaluation of clinical results, we used UCLA and VAS pain scores. Results: Comparing change scores (preoperative vs. postoperative states) there were no significant differences in UCLA score or VAS score between the two groups. Conclusion: The new V-shaped repair technique elicits similar clinical results with conventional arthroscopic repair techniques and thus can be considered a useful alternative when using an absorbable suture that is anchor linked with only one suture.
The Analysis and Treatment of Rotator Cuff Tear After Shoulder Dislocation in Middle-Aged and Elderly Patients
Ji, Jong-Hun ; Park, Sang-Eun ; Kim, Young-Yul ; Shin, Eun-Su ; Park, Bo-Youn ; Jeong, Jae-Jung ;
Clinics in Shoulder and Elbow, volume 13, issue 1, 2010, Pages 20~26
DOI : 10.5397/CiSE.2010.13.1.020
Purpose: To evaluate clinical features and surgical results for rotator cuff tear secondary to shoulder dislocation in middle-aged and elderly patients. Materials and Methods: We reviewed 19 patients over 50 years of age who had rotator cuff tears combined with shoulder dislocation between October 2004 and October 2008. There were 7 males and 12 females with a mean age 64.7 years (range, 50 to 78 years). The average follow-up duration was 22 months (range, 8 to 56 months). We investigated the number of dislocations, the size of the cuff tear, the presence of Bankart lesions and the time interval from dislocation to surgery. We also investigated the ASES score, UCLA score, SST score, and shoulder range of motion before and after surgery. We analyzed clinical outcomes and contributing factors. Results: ASES scores improved from 30.2 preoperatively to 72.3 postoperatively; UCLA scores improved from 12.9 to 26.5; SST scores improved from 2.4 to 7.3. Range of motion improved significantly: forward flexion, abduction, external rotation and internal rotation were, respectively,
and L5 level preoperatively; postoperatively they were
and L1 level. Age, the presence of Bankart lesions and the number of dislocations were not correlated with clinical outcomes. But the size of the cuff tear was correlated with clinical results. Also, the duration from dislocation to surgery was correlated with postoperative UCLA and SST scores (p=0.039, p=0.038). Conclusion: For shoulder dislocation, it is important to achieve early diagnoses of rotator cuff tears in middle-aged and elderly patients. If these injuries are both present, early rotator cuff repair should be performed for better clinical results.
The Analysis of Conservative Treatment in Midshaft Fractures of Clavicle
Cha, Seung-Do ; Chung, Soo-Tai ; Kim, Yong-Hoon ; Park, Sang-Jun ;
Clinics in Shoulder and Elbow, volume 13, issue 1, 2010, Pages 27~33
DOI : 10.5397/CiSE.2010.13.1.027
Purpose: Most clavicular fractures can be healed by conservative treatment, although there are many factors that influence healing. The aim of the present study was to analyze factors that influence (i) bone union of midshaft fractures of the clavicle treated conservatively and (ii) bone functioning, after union. The long-term goal was to determine which treatments are adequate. Materials and Methods: We evaluated factors that have an effect on bone union and bone function after union. We evaluated age, fracture site, comminution, displacement, shortening and other factors. Among 523 clavicular midshaft fractures that presented between January 2004 and Jun 2009 at our Department of Orthopaedic Surgery, we identified 270 who had conservative treatment and 173 patients who had surgical treatment. Results: The period required for bone union increased with the degree of displacement. For the group below 12 years of age, and the group without comminution, it took half the time to achieve bone union compared with the other groups. Displacement mostly occurred within 2 weeks after conservative treatment. Conclusion: In patients with a comminuted clavicular midshaft fracture, we might, because of expected delays in bone union, delay the start of rehabilitation until patients are more than 13 years old. Because the degree of displacement may be increased within 2 weeks during conservative treatment, we can think about surgical treatments.
The Modified Phemister Operation with the Suture Anchor Added for the Augmentation of Conoid Ligament in Acute Acromioclavicular Dislocation
Moon, Gi-Hyuk ; Nam, Il-Hyun ; Lee, Yeong-Hyun ; Kim, Ki-Choul ; Lee, Jae-Hoon ; Ahn, Gil-Yeong ;
Clinics in Shoulder and Elbow, volume 13, issue 1, 2010, Pages 34~39
DOI : 10.5397/CiSE.2010.13.1.034
Purpose: The purpose of this study was to present methods and results for the modified Phemister operation, with a suture anchor added for augmentation of the conoid ligament in cases of acute dislocation of the acromioclavicular joint. Materials and Methods: We evaluated 14 cases of acute dislocation of the acromioclavicular joint. This included 11 cases of Rockwood type 3, and 3 cases of type 5. The mean age of patients was 45.2 years. We operated on them using an anchor for augmentation of the conoid ligament in the modified Phemister operation. The average follow-up period was 14 months and post-operative clinical analysis was conducted using the Weitzman classification, VAS Score, Constant Score and KSS Score. Results: According to Weitzman scores, 13 cases were evaluated as excellent, and one case was good. They had mean joint ranges of forward elevation of
, lateral elevation of 166.4, external rotation of 68.2, and internal rotation to the level of T7. The mean VAS Score was 1.9, mean Constant Score 90.8, and the mean KSS Score 91. Radiologic analysis indicated that all cases had a good result. Conclusion: The modified Phemister operation with a suture anchor added for augmentation of the conoid ligament is very effective clinically in acute dislocations of the acromioclavicular joint.
One Anchor Double Fixation (OADF) Technique for Arthroscopic Bony Bankart Repair
Choi, Eui-Sung ; Park, Kyoung-Jin ; Kim, Yong-Min ; Kim, Dong-Soo ; Shon, Hyun-Chul ; Cho, Byung-Ki ; Bae, Seung-Hwan ;
Clinics in Shoulder and Elbow, volume 13, issue 1, 2010, Pages 40~46
DOI : 10.5397/CiSE.2010.13.1.040
Purpose: The aim of this study was to evaluate the usefulness of arthroscopic Bony Bankart repair using a One Anchor Double Fixation Technique. Materials and Method: Seventeen patients with a Bony Bankart lesion were treated using the One Anchor Double Fixation Technique (OADF Technique). There were 13 males and 4 females. The average age was 24 years (range 17-42). The average follow-up period was 22.3 months. One 3.0 mm suture anchor with doubly loaded sutures was inserted into the glenoid rim. One suture strand was passed the around the small bony fragment and tied first. Another suture strand was passed through the capsule and tied over the bony fragment. The result was measured using Rowe's evaluation index & KSS score. The glenoid defect & bony fragment were measured by 3D-CT scan. Results: Rowe's evaluation index on the final follow-up showed an overall improvement from an average of 54 (range, 23-71) to 83.4 (range 71-90). Of the 17 cases, 13 were excellent, 3 were good, and 1 was fair. KSS scores showed improvement from an average of 71 (range 49-82) to 92.5 (range 82-94). There were no cases where pain continued to the final follow-up, and no cases being re-dislocated during the follow-up period. For six cases, we confirmed the bony healing of the bony Bankart lesion by CT. Conclusion: Bony Bankart lesion repair using this new method achieves excellent clinical results with low recurrence rates and is considered another choice for bony Bankart lesions.
Arthroscopic Stabilization Using Remplissage Technique In Recurrent Shoulder Instability with Large Hill-Sachs Lesion - Minimum Six Months Follow-Up Results -
Ko, Sang-Hun ; Jung, Kwang-Hwan ; Jeon, Hyung-Min ; Park, Han-Chang ;
Clinics in Shoulder and Elbow, volume 13, issue 1, 2010, Pages 47~52
DOI : 10.5397/CiSE.2010.13.1.047
Purpose: To evaluate shoulder stability, clinical, and functional results more than 6 months after utilizing the 'Remplissage' technique, consisting of an arthroscopic posterior capsulodesis and infraspinatus tenodesis, to fill Hill-Sachs lesions. Materials and Methods: Seven patients were followed-up more than 6 months after the 'Remplissage' procedures performed in our hospital from August 2008 to August 2009. The mean age of the patients was 28.6 years and the mean follow-up time was 10 months. Evaluations included ROM, ASES score, KSSI score, ROWE score, and postoperative MRI. Results: In a functional evaluation of the patients with an average postoperative time of 10 months, the ASES score improved from 51.4 preoperatively to 76.8 postoperatively, the KSSI score improved from 46.5 preoperatively to 76 postoperatively, and the ROWE score improved from 43.5 preoperatively to 76.3 postoperatively. After an average postoperative time of 10 months, the range of motion was nearly normal (>170 degrees in further flexion, and >45 degrees in external rotation). Conclusion: In recurrent shoulder instabilities with large Hill-Sachs lesions, the 'Remplissage' technique resulted in good outcomes in terms of shoulder stability, clinical, and functional results after postoperative times of more than 6 months.
Comparison of Isokinetic Strength between Stage 1,2 Impingement Syndrome and Rotator Cuff Tear
Kim, Deok-Weon ; Joo, Hae-Kyun ; Jung, Jae-Eun ;
Clinics in Shoulder and Elbow, volume 13, issue 1, 2010, Pages 53~57
DOI : 10.5397/CiSE.2010.13.1.053
Purpose: The goal of this study was to evaluate differences in strength deficits between (i) patients with stage 1 or 2 impingement syndrome and (ii) patients with rotator cuff tears. Materials and Methods: We enrolled 43 patients with stage 1 or 2 impingement syndrome (group 1) and 21 patients with rotator cuff tears (group 2). The isokinetic strength of both groups was evaluated at
for external rotation, internal rotation, adduction and abduction. We measured the peak torque, total work, average power of bilateral sides, peak torque relationship to body weight, and the ratio between unilateral agonist and antagonist. Results: The isokinetic strength deficits assessed in ratio of peak torque to body weight for group 1 and group 2 respectively were;
for abduction (p=0.929),
; for adduction (p=0.021),
; for external rotation (p=0.221), and
for internal rotation (p=0.059). For average power and total work, group 2 showed a significantly greater deficit for adduction and internal rotation than group 1. Conclusion: Those with rotator cuff tears have more isokinetic muscle strength deficits than those with stage 1 or 2 impingement syndrome. Progression from stage 1 and 2 impingement syndrome to stage 3 may result in greatest changes in strength deficits for internal rotation and adduction.
Treatment of Refractory Lateral Epicondylitis with Platelet-Rich Plasma
Ko, Sang-Hoon ; Lee, Chae-Chil ; Kang, Byeong-Seong ; Lee, Ki-Jae ; Lee, Seon-Ho ;
Clinics in Shoulder and Elbow, volume 13, issue 1, 2010, Pages 58~63
DOI : 10.5397/CiSE.2010.13.1.058
Purpose: To evaluate clinical results of a single percutaneous injection of platelet-rich plasma in patients with refractory lateral epicondylitis. Materials and Methods: Between Jan and Dec 2009, fifteen patients (5 male, 10 female) received a diagnosis of lateral epicondylitis of the elbow and were evaluated in this study. Their average age was 43.5 years. All patients were initially given a variety of non-surgical treatments for more than 1year. All patients were considering surgery. These patients were given a single percutaneous injection of 3cc of platelet-rich plasma. To assess pain, we used a visual analogue scale (VAS) at rest and during work & the Patient-Rated Tennis Elbow Evaluation (PRTEE) score. We compared the score before treatment with scores 4 and 12 weeks after treatment. Results: Average VAS scores at rest improved from 4.6 before treatment to 2.5 at week 4, and 1.8 at week 12. The average VAS score while working also improved from 7.8 before treatment to 6.2 at week 4, and 4.25 at week 12. The average PRTEE score improved from 60.13 before treatment to 46.12 at week 4 and 24.6 at week 12. Conclusion: Treatment using a single percutaneous injection of platelet-rich plasma in patients with refractory lateral epicondylitis appears to be an effective treatment modality. Platelet-rich plasma should be considered before surgical intervention.
Long Head of the Biceps Tendon Lesion Associated with Rotator Cuff Tear
Kim, Young-Kyu ; Kim, Dong-Wook ; Lee, Jong-Hun ;
Clinics in Shoulder and Elbow, volume 13, issue 1, 2010, Pages 64~71
DOI : 10.5397/CiSE.2010.13.1.064
Purpose: To evaluate pathologic patterns and outcomes of treatment of a biceps tendon lesion associated with a rotator cuff tear. Materials and Methods: We reviewed 92 patients (i) who underwent surgery for a cuff tear, (ii) for whom the biceps lesion could be observed retrospectively, and (iii) had a minimum follow-up of 2 years. The pathology of biceps tendon was classified into 4 types: tenosynovitis, fraying or hypertrophy, tear, and instability. All but the 4 with massive cuff tears were repaired. The biceps lesions were treated with debridement in 30, tenotomy in 10, tenodesis in 8, and recentering in 4. UCLA scoring was used for clinical results. Results: Seventy patients had a biceps lesion, 19 tenosynovitis, 22 fraying or hypertrophy, 21 a tear, and 8 instability. A biceps lesion was observed in 63% of cases of cuff tears below the medium size, and in 88% of cases with cuff tears above the large size. UCLA scores according to the pathology of the biceps lesion were 29.6 in the absence of a biceps lesion, and 28.3 in its presence. UCLA scores in patients with tenotomy or tenodesis for associated biceps tendon lesions were 28.2. Conclusion: There is a greater incidence and severity of a biceps lesion with a larger cuff tear. Therefore, the cause of a biceps lesion might be related to the cause of the cuff tear. Among the several options of treatment for biceps lesion, tenotomy or tenodesis may be particularly effective in providing pain relief.
Arthroscopic Transosseous Suture Repair for Bankart Lesion with a Flexible Drill Device - An Experimental and Preliminary Clinical Report -
Park, Jin-Su ; Won, Ye-Yeon ; Yoo, Jung-Han ; Park, Yong-Wook ; Noh, Kyu-Chul ; Chung, Kuk-Jin ; Kim, Hong-Kyun ; Hwang, Ji-Hyo ; Lee, Young-Bum ; Suh, Il-Woo ;
Clinics in Shoulder and Elbow, volume 13, issue 1, 2010, Pages 72~78
DOI : 10.5397/CiSE.2010.13.1.072
Purpose: Too develop a flexible drill device that can be inserted into the shoulder joint so that arthroscopic transosseous suture repair for Bankart lesion is possible. Materials and Methods: We created a device composed of a flexible drill unit and a guide pipe unit. The flexible drill unit was made of flexible multifilament wires (1.2 mm in diameter) that was twisted into one cord so that it can flex in any direction and a drill bit (1.2 mm in diameter) that is attached onto one end of the flexible wire. The guide pipe unit was a 150 mm long metal pipe (2.0 mm in inner diameter and 3.0 mm in outer diameter), with one end bent to 30 degrees. The flexible drill set was inserted into the shoulder joint through the posterior portal of the joint. The guide pipe component was placed onto the medial wall of the glenoid so that the pipe was placed 5 mm posterior to the margin of the anterior glenoid rim. The flexible drill was driven through the glenoid by the power drill so that holes were made in the glenoid. A non- absorbable suture was passed through the hole. Tying of a sliding knot tying was accomplished over the capsule and labrum after making a stitch through the capsule and labrum with a suture hook loaded with suture passer. The same procedures were done at the 2 and 4 O'Clock positions of the glenoid. Results: Five cases with Bankart lesion received arthroscopic transosseous repair with our flexible drill device. There were no intraoperative problems. Neither redislocation nor subluxation was reported at final follow-up. Conclusion: Arthroscopic transosseous suture repair without suture anchors and easy tying of a sliding knot are possible with a flexible drill set.
Prospective Comparative Study of Arthroscopic Repair Versus Debridement for the Full-Thickness Tear of Upper Subscapularis
Ko, Sang-Hun ; Cha, Jae-Ryong ; Lee, Chae-Chil ; Park, Han-Chang ; Shin, Seung-Myeong ;
Clinics in Shoulder and Elbow, volume 13, issue 1, 2010, Pages 79~85
DOI : 10.5397/CiSE.2010.13.1.079
Purpose: To evaluate the results from arthroscopic repair versus debridement for full-thickness tears of the upper subscapularis tendon. Materials and Methods: Ninety-nine patient outcomes were evaluated and compared prospectively. Sixty-nine patients with full-thickness tears of the upper subscapularis tendon underwent arthroscopic repair (group I) and thirty patients underwent simple debridement (group II) between May 2003 and October 2007. In all patients, the tear was localized to the superior one third of the upper subscapularis tendon. The results of the treatment were assessed by evaluating the UCLA, ASES, and VAS for pain and internal rotation strength scores before and after the operation. Results: In groups I and II, UCLA, ASES, VAS, and internal rotation muscle power (perfect score = 5) scores were improved after surgery. In comparing group I and group II, the UCLA and VAS scores were not significantly different (p>0.05), while the ASES and internal rotation strength scores were significantly different (p<0.05). Conclusion: The arthroscopic repair of full-thickness tears of the upper subscapularis tendon was a better surgical method than simple debridement.
Mini-open Rotator Cuff Repair Using Anterolateral Approach
Cho, Chul-Hyun ; Yeo, Kyung-Ki ; Lee, Sung-Yoon ; Jung, Gu-Hee ;
Clinics in Shoulder and Elbow, volume 13, issue 1, 2010, Pages 86~91
DOI : 10.5397/CiSE.2010.13.1.086
Purpose: To introduce mini-open rotator cuff repair using the anterolateral approach and evaluate its clinical outcomes and effectiveness. Materials and Methods: 59 consecutive cases of rotator cuff tearing which were treated with mini-open repair utilizing the anterolateral approach were evaluated. The population comprised 39 men and 20 women, with an average age of 56.6 years. An average follow-up time period was 26 months. Clinical outcomes were analyzed based on VAS, ADL, and ASES scores. Results: The average respective VAS, ADL, and ASES scores improved from 7.04, 12.37, and 35.32 preoperatively to 1.02, 27.20, and 90.08 postoperatively (p=0.000). There were 41 excellent, 11 good, 2 fair, and 5 poor results. There were satisfactory results in 52 cases (88.1%). There were no statistically significant differences between the final ASES scores and age, sex, duration of symptoms, tear size, and preoperative stiffness (p>0.05). Conclusion: Mini-open rotator cuff repair using the anterolateral approach effective in providing better visualization.
Treatment of Acromioclavicular Joint Injuries Using Clavicle Hook Plates
Kim, Myung-Ho ; Seo, Joong-Bae ; Moon, Sang-Young ;
Clinics in Shoulder and Elbow, volume 13, issue 1, 2010, Pages 92~98
DOI : 10.5397/CiSE.2010.13.1.092
Purpose: To analyze results of treating acromioclavicular injuries using clavicle hook plates. Materials and Methods: Between February 2008 and April 2010, 18 patients with acromioclavicular joint injury treated by clavicle hook plates were reviewed. Using the Rockwood classification, 7 dislocations were classified as type III injuries and 11 as type V injuries. Implant removal was done at least 3 months from initial fixation. Simple X-rays were taken for comparing the state of reduction, and clinical outcomes were evaluated by the Korean Shoulder Scoring System and the American Shoulder Elbow Society score. The average follow-up period was 9 months. Results: On weight bearing X-rays, the average coracoclavicular distance showed a 114% increase compared to the contralateral side at the time of injury. It decreased to 23% by the last follow-up. The mean Korean Shoulder Scoring System and the American Shoulder Elbow Society score were 80 and 74 at the last follow-up. Conclusion: The immediate stability these plates provide allows rapid rehabilitation. Clavicle hook plate fixation for acromioclavicular joint dislocation is considered an effective method for ensuring satisfactory results both radiologically and clinically.
The Surgical Treatment of Pyogenic and Tubercular Infection in the Sternoclavicular Joint - Case Report -
Kim, Young-Yul ; Kwon, Jong-Beum ; Lee, Yeon-Soo ; Kim, Sang-Il ; Ji, Jong-Hun ;
Clinics in Shoulder and Elbow, volume 13, issue 1, 2010, Pages 99~105
DOI : 10.5397/CiSE.2010.13.1.099
Purpose: Here we report clinical results for surgical treatment of 2 cases of pyogenic arthritis and 1 case of tubercular arthritis, which only rarely develops in the sternoclavicular joint. Materials and Methods: From September 2003 to September 2008, we did early marginal resection and thorough debridement of osteomyelitis of the sternum and distal clavicle in 3 patients and evaluated clinical results after short-term follow up. Results: All 3 patients were satisfied with their clinical results and none had any recurrences according to follow up X-rays and laboratory datas. The follow up MRI showed bone edema in the distal clavicle and proximal sternum and a little fluid retention around the sternoclavicular joint. Conclusion: Even though diagnosis of these diseases are made earlier, infection of the adjacent bone and osteomyelitis could already have developed. We did early marginal resection and thorough debridement of osteomyelitis of the sternum and distal clavicle and achieved satisfactory results.
Pyogenic Arthritis of the Shoulder in Patient with Infective Endocarditis -A Case Report-
Shin, Dong-Ju ; Kwon, Ki-Tae ; Huh, Dong-Myeong ; Kim, Ji-Hwan ; Park, Jae-Young ; Lee, Chung-Yeol ;
Clinics in Shoulder and Elbow, volume 13, issue 1, 2010, Pages 106~110
DOI : 10.5397/CiSE.2010.13.1.106
Purpose: We report a case of pyogenic arthritis of the shoulder secondary to infective endocarditis. Materials and Methods: A 70 year-old male who had suffered from pyogenic arthritis of the left shoulder secondary to infective endocarditis was treated with artificial valvuloplasty, arthroscopic synovectomy and drainage. Results: Infection was cured and the patient achieved a good functional outcome. Conclusion: Pyogenic arthritis of the shoulder is rarely associated with infective endocarditis. However, if the symptoms are misdiagnosed as musculoskeletal symptoms associated with infective endocarditis, serious complications may arise. As such, musculoskeletal symptoms associated with infective endocarditis should be paid careful attention.
The Follow Up Results of Residual Spinoglenoid Ganglion Cyst after Arthroscopic Decompression and Superior Labral Repair - Cases Report -
Sung, Chang-Meen ; Lee, Sang-Hyuk ; Park, Hyung-Bin ;
Clinics in Shoulder and Elbow, volume 13, issue 1, 2010, Pages 111~116
DOI : 10.5397/CiSE.2010.13.1.111
Purpose: There are many known treatment modalities for spinoglenoid ganglion cyst accompanied by suprascapular nerve palsy. However, to the author's knowledge, there is no report on the follow-up outcomes focused on remnant cysts. Materials and Methods: Six (n=6) patients with spinoglenoid ganglion cyst accompanied by suprascapular nerve palsy, with a mean follow-up of 15 months (12-23months) following arthroscopic cyst decompression and superior labral repair, were enrolled. Residual cyst was investigated by ultrasonography and MRI. Results: Immediate postoperative ultrasonography revealed complete remission of ganglion cyst in one patient and reduced ganglion cyst size in five patients. Three-month follow-up ultrasonography showed spontaneous complete remission of the residual cysts in all patients. No recurrence on MRI was seen at one-year follow-up. Conclusion: Residual spinoglenoid ganglion cyst remaining after arthroscopic decompression and superior labral repair tends to resolve spontaneously within 3 months of surgery.
Reconstruction of the Glenoid Using Iliac Bone Graft for Recurrent Anterior Shoulder Instability with Severe Glenoid Bone Defect - A Report of Two Cases -
Lee, Seong-Man ; Jung, Won-Ju ; Lee, Hyun-Joo ; Jeon, In-Ho ;
Clinics in Shoulder and Elbow, volume 13, issue 1, 2010, Pages 117~122
DOI : 10.5397/CiSE.2010.13.1.117
Purpose: The purpose of this report was to assess a surgical technique-using an autogenous tricortical iliac crest bone graft in patients with epilepsy-for anatomical glenoid reconstruction for recurrent anterior glenohumeral instability with severe glenoid deficiency. Materials and Methods: We studied two cases of recurrent anterior dislocation of the shoulder due to epilepsy. These cases were treated with anatomical glenoid reconstruction using an autogenous tricortical iliac crest bone graft. Results: Both cases achieved bone union in 5 months. There was no recurrence of instability and pain. Both cases had normal range of motion. Conclusion: Anatomical glenoid reconstruction for recurrent anterior glenohumeral instability with severe glenoid deficiency using an autogenous tricortical iliac crest bone graft is a successful surgical technique for achieving shoulder stability.
Poland Syndrome - A Case Report-
Jeong, Soon-Taek ; Moon, Dong-Kyu ; Sung, Chang-Meen ; Park, Hyung-Bin ;
Clinics in Shoulder and Elbow, volume 13, issue 1, 2010, Pages 123~126
DOI : 10.5397/CiSE.2010.13.1.123
Purpose: Poland syndrome is rare disease which is characterized by absence of unilateral pertoralis major muscle accompanied by ipsilateral syndactyly or brachydactyly, which was described first by Alfred Poland in 1841. Materials and Methods: We performed the physical examination, laboratory test and radiologic evaluation to 18 year old male, who complaint asymmetry of right anterior chest. Results: We diagnosed the Poland syndrome due to absence of right pectoralis major muscle and brachydactyly of right hand. Conclusion: Current authors report a patient who had hypopalsia of pectoralis muscles, which needed differential diagnosis with pectoralis major rupture.
Arthroscopy Assisted Percutaneous Reduction and Screw Fixation of a Displaced Intra-articular Glenoid Fracture - A Case Report -
Ko, Sang-Hun ; Jeon, Hyung-Min ; Shin, Seung-Myeong ;
Clinics in Shoulder and Elbow, volume 13, issue 1, 2010, Pages 127~131
DOI : 10.5397/CiSE.2010.13.1.127
Purpose: The authors used arthroscopy-assisted percutaneous reduction and cannulated screw fixation rather? than conventional arthrotomy for displaced glenoid fracture. Materials and Methods: We used arthroscopy assisted reduction and screw fixation for a 66 year old man who had a clavicle fracture, a displaced glenoid fracture and a scapula fracture. Results: At 9 months postoperatively, the patient had recovered full range of motion and was not inconvenienced by the surgery. Removal of the implant was done 12 months post-operatively under general anesthesia. Conclusion: The advantages of arthroscopy-assisted percutaneous screw fixation are less pain and less bleeding, shorter hospital stay and earlier rehabilitation. Arthroscopic percutaneous screw fixation for a displaced glenoid fracture seems to be a good alternative treatment method.
Massive Rotator Cuff Tears: Arthroplasty
Kim, Myung-Sun ; Moon, Eun-Sun ;
Clinics in Shoulder and Elbow, volume 13, issue 1, 2010, Pages 132~140
DOI : 10.5397/CiSE.2010.13.1.132
Purpose: Surgical treatment of massive rotator cuff tear is challenging and there are various surgical options. The purpose of this article is to describe arthroplasty for the treatment of massive rotator cuff tear. Materials and Methods: We reviewed all publications that focused on and/or mentioned arthroplasty as a treatment option for massive rotator cuff tear. Results: Arthroplasty can be used as primary treatment and represents a salvage option for irreparable rotator cuff tear. Hemi-arthroplasty can provide satisfactory results by Neer's limited goals criteria in patients with intact coracoacromial arch. In addition, reverse total shoulder arthroplasty can be a salvage option for pain relief and restoration of active flexion in elderly patients with pseudoparalysis. Conclusion: In patients with massive rotator cuff tear, proper selection of arthroplasty can provide pain relief and restoration of functional range of motion in shoulder joints.
Biomechanics of the Elbow
Moon, Jun-Gyu ;
Clinics in Shoulder and Elbow, volume 13, issue 1, 2010, Pages 141~145
DOI : 10.5397/CiSE.2010.13.1.141
Purpose: Understanding elbow biomechanics is necessary to understand the pathophysiologic mechanism of elbow injury and to provide a scientific basis for clinical practice. This article provides a summary of key concepts that are relevant to understanding common elbow injuries and their management. Materials and Methods: The biomechanics of the elbow joint can be divided into kinematics, stability and force transmission through the elbow joint. Active and passive stabilizers include bony articular geometry; soft tissues provide joint stability, compression force and motion. Results and Conclusion: Knowledge of elbow biomechanics will help (i) advance surgical procedures and trauma management, (ii) develop new elbow prostheses and (iii) stimulate future research.
Debridement or Tuberoplasty for Massive Rotator Cuff Tear
Cho, Nam-Su ; Oh, Hyun-Sup ; Rhee, Yong-Girl ;
Clinics in Shoulder and Elbow, volume 13, issue 1, 2010, Pages 146~152
DOI : 10.5397/CiSE.2010.13.1.146
Purpose: The purpose of this article was to review the effectiveness of arthroscopic debridement and tuberoplasty, and to evaluate the clinical and radiologic results of our series for irreparable massive rotator cuff tears in the elderly. Materials and Methods: We reviewed articles that focused on the treatment options and decision making for irreparable massive rotator cuff tears. In particular, we summarized the reported results of arthroscopic debridement and tuberoplasty for irreparable massive rotator cuff tears in the elderly. Among consecutive patients who had arthroscopic tuberoplasty for irreparable massive rotator cuff tears in our series, thirty-two patients available for clinical and radiological evaluation at a mean follow-up of 29 months (range, 13-52 months) were enrolled and reviewed for the analysis. Results: At the last follow-up, the range of active forward flexion increased significantly with excellent pain relief and improvement in the ability to perform the activities of daily living. However, the group with less than 2 mm in preoperative acromiohumeral distance showed inferior postoperative results. Conclusion: Arthroscopic tuberoplasty may be an alternative option in irreparable massive rotator cuff tears for pain relief and improvement of range of motion. However, good results can not be expected if the acromiohumeral distance is less than 2 mm preoperatively and decreases postoperatively, or when the preoperative range of motion is less than
on flexion and abduction.
Shoulder Prosthesis Mechanics
Jeong, Jin-Young ;
Clinics in Shoulder and Elbow, volume 13, issue 1, 2010, Pages 153~160
DOI : 10.5397/CiSE.2010.13.1.153
Purpose: The goal of prosthetic replacement of the shoulder is the restoration of the normal anatomy of the joint. Materials and Methods: The physician should review the variations in normal anatomy because it does vary widely and the placement of the prosthetic needs to be modified to accommodate the variations. Results and Conclusion: Several factors including anatomic, prosthetic and surgical ones can lead to the best clinical results, and these are described.
Tendon Transfer for Irreparable Massive Rotator Cuff Tear
Yum, Jae-K. ; Lee, Hee-Sung ; Park, Sung-Bum ;
Clinics in Shoulder and Elbow, volume 13, issue 1, 2010, Pages 161~166
DOI : 10.5397/CiSE.2010.13.1.161
Purpose: Irreparable massive rotator cuff tears pose a distinct clinical challenge for the orthopaedist and non-surgical treatment has had inconsistent results and proven unsuccessful for chronic symptoms, while surgery, including debridement and partial and complete repairs have had varying degrees of success. Materials and Methods: For rotator cuff tears that are deemed irreparable, treatment options are limited. Results and Conclusion: The use of tendon transfers (latissimus dorsi for posterosuperior type cuff defects and pectoralis major for subscapularis defects) in younger patients to reconstruct rotator cuffs and re-establish function and restore shoulder kinematics can be useful in solving this difficult problem.
Massive Rotator Cuff Tear Repair
Shin, Sang-Jin ;
Clinics in Shoulder and Elbow, volume 13, issue 1, 2010, Pages 167~174
DOI : 10.5397/CiSE.2010.13.1.167
Purpose: Anatomical repair of massive rotator cuff tear has been technically challenging because of medial retraction, muscle atrophy and fatty degeneration. Among several treatment options for massive rotator cuff tear, we reviewed rotator cuff repairs and investigated modalities for improvement of clinical outcomes, decreasing the re-tear rate, and increasing healing. Materials and Methods: Patient-related factors and rotator cuff-related factors were the two major groups of factors we considered when choosing a treatment plan. Results: Mobilization of a massive rotator cuff tear was increased by soft tissue release and by the interval slide technique. After meticulous soft tissue release, anatomical repair could be achieved. If the injury was not amenable to anatomical repair, alternative treatment options such as partial repair, the margin convergence technique and augmentation with a tenotomized biceps tendon were considered. Many reports of massive rotator cuff repair demonstrated satisfactory clinical outcomes, decreased pain, recovery of shoulder functions, and increases in muscle strength. However, the re-tear rate had been reported to be relatively high in long-term follow-up. Conclusion: Despite a high re-tear rate after massive rotator cuff repair, a better understanding of the pathogenesis, progression and clinical symptoms of massive rotator cuff tear and improved surgical materials and techniques will lead to satisfactory clinical outcomes.
Biological Characteristics of Rotator Cuff Tendon
Park, Hyung-Bin ; Sung, Chang-Meen ;
Clinics in Shoulder and Elbow, volume 13, issue 1, 2010, Pages 175~179
DOI : 10.5397/CiSE.2010.13.1.175
Purpose: Rotator cuff disease is the most common shoulder disease. Rotator cuff tear, which is related to cuff tendon degeneration, is commonly encountered in clinical practice. Materials and Methods: Knowledge about the biology of the normal rotator cuff is fundamental to understanding the pathophysiology of and degenerative processes in rotator cuff tendon tears. Furthermore, such basic knowledge provides a rationale for and facilitates the development of treatment modalities. Results and Conclusion: Therefore, we reviewed the biology of the normal rotator cuff tendon, theories to explain the pathophysiology of rotator cuff tendon tear, and current research on apoptosis of rotator cuff tenofibroblasts.