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REFERENCE LINKING PLATFORM OF KOREA S&T JOURNALS
> Journal Vol & Issue
Clinics in Shoulder and Elbow
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Journal DOI :
Korean Shoulder and Elbow Society
Editor in Chief :
Volume & Issues
Volume 16, Issue 2 - Dec 2013
Volume 16, Issue 1 - Jun 2013
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Correlation Between Degree of Torn Rotator Cuff in MRI and Degenerative Change of Acromion and Greater Tuberosity in Simple Radiography
Choi, Jung-Yun ; Yum, Jae-Kwang ; Song, Min-Cheol ;
Clinics in Shoulder and Elbow, volume 16, issue 1, 2013, Pages 1~9
DOI : 10.5397/CiSE.2013.16.1.1
Purpose: The purpose of this study is to analyze the correlation between the degree of torn rotator cuff as recorded by MRI and degenerative change of acromion and greater tuberosity of humerus determined by simple radiographs. Materials and Methods: Of the 518 cases included in this study, a group of 234 cases had a chronic rotator cuff tear and a control group of 284 cases had an intact rotator cuff in shoulder MRI. The degree of degenerative changes was classified according to the length of spur and morphological change of acromion and greater tuberosity through the true anteroposterior simple radiograph in supraspinatus outlet view. The degree of tear (partial-thickness or full-thickness tear) and the size of complete rotator cuff tear were analyzed according to the MRI findings of shoulder. The authors also evaluated the correlation between the degree and size of torn rotator cuff and the degenerative change of acromion and greater tuberosity. Results: There were significant differences in the size and extent of torn rotator cuff according to the age, sex and degenerative change of acromion and greater tuberosity of humerus (p<0.001). More degenerative changes of acromion and greater tuberosity in simple shoulder radiographs showed the increased degree and size of torn rotator cuff (p<0.001). In addition, the higher degree and larger size of torn rotator cuff were noted in older age subjects (p<0.001) and in the female group (p<0.001). Conclusion: More degenerative changes of acromion and greater tuberosity in simple shoulder radiographs showed the increased degree and size of torn rotator cuff. Therefore, if a high degree of degenerative change of the acromion and greater tuberosity on simple radiograph is noted, the possibility of degenerative rotator cuff tear should be considered. In addition, the age and sex could be associative factors for larger size of torn rotator cuff.
Comparison of Preoperative Magnetic Resonance Image (MRI) and Arthroscopic Rotator Cuff Tear Size according to Timing of MRI
Park, Chang-Min ; Chae, Seung-Bum ; Choi, Chang-Hyuk ;
Clinics in Shoulder and Elbow, volume 16, issue 1, 2013, Pages 10~16
DOI : 10.5397/CiSE.2013.16.1.10
Purpose: To know if magnetic resonance image (MRI) re-examination is needed before surgery, we compared the pre-operative MRI recorded at different time points and the corresponding arthroscopic findings. Materials and Methods: Depending on the timing of evaluation, the MRI was classified into three groups: group A, MRI was taken 1 month before the surgery (44 cases, average 16 days); group B, 1-6 months before the surgery (41 cases, average 91 days); and group C, 6-12 months before the surgery (25 cases, average 230 days). The anterior to posterior tear size (length) and medial retraction size (width) of rotator cuff tear were measured for each group and they were compared with the actual arthroscopic findings. Results: Results of this study showed that arthroscopic rotator cuff tear length and width were larger than those of MRI. The difference of the rotator cuff tear size was 3.6(
) mm of length and 0.6(
) mm of width in group A, 4.2(
) mm and 2.4(
) mm in group B, and 4.5(
) mm and 3.0(
) mm in group C. There was a tendency of the larger size difference for longer pre-operative period, but it was not statistically significant. Conclusion: The rotator cuff tear size did not show remarkable differences between pre-operative MRI taken within 1 year before surgery and the actual arthroscopy. It is concluded that additional MRI evaluation is not required within 1 year.
Comparison Study of Different Approach (Deltoid Splitting Approach and Delto-pectoral Interval Approach) for Proximal Humeral Fractures
Kim, Seung-Hee ; Dan, Jinmyoung ; Kim, Byoung-Kook ; Lee, Yun-Seok ; Kim, Hyoeng-Jung ; Ryu, Keun-Jeong ; Lee, Jin-Hyun ; Kim, Jae-Hwa ;
Clinics in Shoulder and Elbow, volume 16, issue 1, 2013, Pages 17~26
DOI : 10.5397/CiSE.2013.16.1.17
Purpose: A comparison of the radiographic and the clinical outcomes between two different surgical approaches-Deltoid splitting and Delto-pectoral interval-on the proximal humerus fractures treated by locking compressive plate (LCP), is done. Materials and Methods: Medical records and pre- and postoperative radiographs were reviewed retrospectively for 75 adult patients who underwent surgical fixations with locking compressive plates from May 2005 to December 2011. Patients were divided into two groups according to the surgical methods. Differences in the neck-shaft angle between immediate postoperative period and final follow-up were compared between the two groups. Differences in constant score and Korean shoulder score (KSS) between affected arms and contralateral arms at final follow-up were also compared. Results: The differences in the neck-shaft angle between immediate postoperative period and at final follow-up was 12.04 degrees on average in Deltoid splitting approach and 10.20 degrees in Delto-pectoral interval approach, which was not statistically significant. Differences in constant score/KSS between the affected arm and the contralateral arm were 13.78/22.74 points in deltoid-splitting approach on average and 19.41/31.13 points in Delto-pectoral interval approach, showing that deltoid-splitting approach is significantly superior. Conclusion: Deltoid-splitting approach showed better functional outcomes in the fracture reduction and internal fixation using LCP for the treatment of unstable proximal humerus fractures.
The Treatment of Humerus Shaft Simple Fracture by MIPO Technique
Ko, Sang-Hun ; Lee, Sun-Ho ; Cho, Bum-Keun ;
Clinics in Shoulder and Elbow, volume 16, issue 1, 2013, Pages 27~32
DOI : 10.5397/CiSE.2013.16.1.27
Purpose: The purpose of this study is to evaluate the clinical and radiological outcomes of treatment of humerus shaft simple fracture by minimally invasive percutaneous osteosynthesis (MIPO) technique using locking compression plate (LCP). Materials and Methods: Six patients who were operated for humerus shaft simple fracture from August 2010 to May 2011 were enrolled for this study. We checked the cause of injury and the accompanying injuries and evaluated the operation time, the clinical and radiological period of union, postoperative range of motion of the shoulder and elbow joint, pain, activities in daily living, radiologic alignment, and other complications. Results: The clinical period of bone union was 7.2 weeks on average, and the radiologic period of bone union was 8 weeks on average. Follow-up period was more than 12 months in all cases. The angulation through postoperative alignment was 2.8 degrees in AP view and 2 degrees in lateral view. The postoperative range of motion was 167 degrees in forward flexion, 50 degrees in external rotation, and thoracic vertebra 12 level in internal rotation. The average value of visual analogue scale (VAS) was 1.2 and that of KSS was 91.3. The American Shoulder and Elbow Surgeons' score (ASES) was 26.5 and the UCLA score was 31.5. Conclusion: MIPO technique for the humerus shaft simple fracture showed good functional and radiological outcomes and may be considered as one of the treatment options for humerus shaft simple fracture.
Double Tension Band Osteosynthesis in Intra-articular Fractures of the Distal Humerus (AO type C) in Elderly Osteoporotic Patients
Cheon, Sang Jin ; Lee, Dong Ho ; Goh, Tae Sik ;
Clinics in Shoulder and Elbow, volume 16, issue 1, 2013, Pages 33~39
DOI : 10.5397/CiSE.2013.16.1.33
Purpose: The aim of this study is to evaluate the clinical result of intra-articular fractures of the distal humerus (AO type C) in elderly osteoporotic patients treated with double tension band osteosynthesis. Materials and Methods: From January 2006 to December 2010, 10 elderly osteoporotic patients(1 male, 9 females) with intra-articular fractures of the distal humerus (AO type C) were treated with double tension band osteosynthesis. The mean age of patients at the time of surgery was 74.6(66~84) years and the mean follow-up period was 39.2(20~74) months. The fracture union and complications were assessed and the functional result was evaluated by the rating system of Jupiter et al. and the Mayo elbow performance index. Results: Bone union was achieved in all patients with no secondary displacement. The mean time for union was 16.6(13~22) weeks. The average postoperative arc of elbow flexion was 119(100~140) degrees with a mean flexion contracture of 8.5(0~15) degrees. The recovery in two patients was rated as excellent, in 7 as good, and in 1 as fair in terms of the Mayo elbow performance index with average value of 82(70~90) points. Seven patients were rated as excellent, 1 as good, and 2 as fair in terms of the rating system of Jupiter et al. Changing tension band wiring was performed in one patient as skin irritation was noticed due to tension band knots. Heterotopic ossification developed in one patient but had no symptom. Conclusion: Double tension band osteosynthesis in intra-articular fractures of distal humerus (AO type C) in elderly osteoporotic patients can provide sufficient and secure stability to allow early rehabilitation.
Symptomatic Benign Intraosseous Osteolytic Lesions of the Glenoid: Report of 3 cases
Kim, Young Kyu ; Cho, Seung Hyun ; Moon, Sung Hoon ;
Clinics in Shoulder and Elbow, volume 16, issue 1, 2013, Pages 40~46
DOI : 10.5397/CiSE.2013.16.1.40
Benign intraosseous osteolytic lesions of the glenoid are very rare. The present study reports on three cases of symptomatic intraosseous osteolytic lesions of the glenoid in which surgical interventions were made. Of the three, two cases presented with intraosseous ganglion and one case with fibrous dysplasia. In all the cases, the lesion was located at the posteroinferior portion of the glenoid, and it seems to be related to posterior shoulder pain. If intraosseous osteolytic lesions have symptoms or the risk for chondral defects or cortical breakage, surgical intervention is needed and bone curettage with or without bone grafting will be a useful treatment option.
Lesions of the Long Head Biceps Pulley
Kim, Chul Hong ; Lee, Myung Jin ; Kang, Min Soo ;
Clinics in Shoulder and Elbow, volume 16, issue 1, 2013, Pages 47~52
DOI : 10.5397/CiSE.2013.16.1.47
Lesions of the long head biceps tendon pulley are frequent causes of shoulder dysfunction and pain. These lesions cause instability of the long head of the biceps tendon (LHB), and intra-articular tear of the subscapularis and the supraspinatus tendon might result from them. The arthroscopic repair of these lesions has not gained widespread acceptance as an effective procedure. Predictable results can be obtained by treating these lesions more definitively with tenotomy or tenodesis. The purpose of this article is to review the anatomy and properties of the LHB pulley and to provide treatment strategies for alleviating pulley lesions.
Calculation of Sample Size in Clinical Trials
Lee, Hyo-Jin ; Kim, Yang-Soo ; Park, In ;
Clinics in Shoulder and Elbow, volume 16, issue 1, 2013, Pages 53~57
DOI : 10.5397/CiSE.2013.16.1.53
Purpose: This review aims to explain the definition and basic principle of statistical analysis and to clarify statistical issues related to the sample size calculation. Materials and Methods: Many formulas are available that can be applied for different types of data and study design. Results: The sample size is the number of patients or other experimental units that need to be calculated prior to the study. Determining the appropriate sample size is required to answer the research question. Conclusion: Caution is needed when applying formula for the calculation of the sample size, as it is sensitive to error and even small differences in selected parameters can lead to large differences in the sample size.
Randomization, What is the Proper Method?
Hong, Jin Ho ; Yoo, Jae Chul ;
Clinics in Shoulder and Elbow, volume 16, issue 1, 2013, Pages 58~62
DOI : 10.5397/CiSE.2013.16.1.58
Purpose: Among the numerous clinical researches and following articles, there are few cases that apply proper methodology, which guarantees high reliability. By understanding the right concept and randomization of proper methods, research bias could be minimized. Materials and Methods: By reviewing the recently published articles about randomization, the basic concept and the necessity of applying the technique was described. Then proper methodologies for good randomization such as simple randomization, permuted-block randomization, and stratification were briefly introduced with examples. Results and Conclusion: Randomization lowers the possibility of bias and leads to higher reliability in clinical research. To obtain more reliable research results, understanding the right concept and proposition of proper methodologies of randomization is essential for researchers.
Multivariate Analysis for Clinicians
Oh, Joo Han ; Chung, Seok Won ;
Clinics in Shoulder and Elbow, volume 16, issue 1, 2013, Pages 63~72
DOI : 10.5397/CiSE.2013.16.1.63
In medical research, multivariate analysis, especially multiple regression analysis, is used to analyze the influence of multiple variables on the result. Multiple regression analysis should include variables in the model and the problem of multi-collinearity as there are many variables as well as the basic assumption of regression analysis. The multiple regression model is expressed as the coefficient of determination,
and the influence of independent variables on result as a regression coefficient,
. Multiple regression analysis can be divided into multiple linear regression analysis, multiple logistic regression analysis, and Cox regression analysis according to the type of dependent variables (continuous variable, categorical variable (binary logit), and state variable, respectively), and the influence of variables on the result is evaluated by regression coefficient
, odds ratio, and hazard ratio, respectively. The knowledge of multivariate analysis enables clinicians to analyze the result accurately and to design the further research efficiently.