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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 16, Issue 2 - Dec 2013
Volume 16, Issue 1 - Jun 2013
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Reverse Total Shoulder Arthroplasty in Patients with Severe Rotator Cuff-Deficient Shoulder - A Minimum Three-Year Follow-up Study -
Kim, Myung-Sun ; Yeo, Je-Hyoung ;
Clinics in Shoulder and Elbow, volume 16, issue 2, 2013, Pages 73~83
DOI : 10.5397/CiSE.2013.16.2.73
Purpose: The goal of this study is to evaluate the minimum three-year follow-up results of reverse total shoulder arthroplasty (RTSA) for glenohumeral (GH) arthritic and pseudoparalytic patients with severe rotator cuff deficiency. Materials and Methods: We evaluated 13 patients (three males and 10 females) who underwent RTSA from July 2007 to July 2010. The average follow-up duration was 54.2 months (range, 37~74 months). Clinical results were evaluated using the Visual Analog Scale (VAS) for pain, active Range of Motion (ROM): active forward flexion (aFF); active external rotation at the side (aERs); active internal rotation to the back (aIRb), American Shoulder and Elbow Surgeons (ASES) score, Korean Shoulder Score (KSS), and intraoperative and postoperative complications. Results: VAS score improved from 7.5(6~10) points to 1.5(0~4), and ROM of active forward elevation improved from
. In addition, ASES score improved from preoperative 32.9 (11.7~46.7) points to 80.2(58.3~95.0) postoperatively, and KSS score improved from 36.8(24~47) points to 78.4 (61~92). Twelve out of 13 cases showed various degrees of scapular notching at the last follow-up. There was one case of intraoperative anterior glenoid fracture and two cases of temporary nerve injury. Revision surgery was performed in two cases for treatment of delayed postoperative deep infection. Conclusion: According to minimum three-year follow-up results, RTSA may be an effective treatment option for glenohumeral (GH) arthritic and pseudoparalytic patients. However, considering the possibility of complications related to delayed deep infection or surgeon`s technique, RTSA should be judiciously and carefully indicated by expert surgeons.
Clinical Result of Layered Suture Bridge Technique in Arthroscopic Repair for Delaminated Rotator Cuff Tear
Choi, Eui-Sung ; Park, Kyoung-Jin ; Kim, Yong-Min ; Kim, Dong-Soo ; Shon, Hyun-Chul ; Cho, Byung-Ki ; Park, Ji-Kang ; Kim, Dong-Whan ; Keum, Sang-Wook ; Cha, Jung-Kwon ;
Clinics in Shoulder and Elbow, volume 16, issue 2, 2013, Pages 84~93
DOI : 10.5397/CiSE.2013.16.2.84
Purpose: The purpose of this study was to evaluate the repair integrity and clinical outcomes of delaminated tears following arthroscopic layered suture bridge rotator cuff repair in a prospective fashion. Materials and Methods: A consecutive series of 67 patients with delaminated rotator cuff tears who underwent surgery using the arthroscopic Layered Suture Bridge Technique were followed prospectively. Of 67 shoulders, 26 patients were male and 40 patients were female (one patient had bilateral tears); the mean age was 58.8(40~76) years. The clinical evaluation was performed according to ASES, UCLA, and KSS (Korea Shoulder Scoring System) scores with an average follow up period of 33 months. Repair integrity was estimated using MRI, which was performed six months postoperatively. Results: The average clinical outcome in ASES, UCLA, and KSS scores showed significant improvement at the time of the final follow-up compared to preoperatively, from 50.2 to 92.3, 15 to 31.3, and 54.4 to 90.7, respectively (p<0.001 for all scores). Follow up by MRI showed that 16 shoulders had a type-I; 14, a type-II; five, a type-III; two, a type-IV; one, a type-V re-tear. The overall rate of re-tear (types IV and V) was 7.9%. Conclusion: Use of the Arthroscopic Layered Suture Bridge Technique can result in improved functional and structural outcome in cases of delaminated rotator cuff tear.
Clinical Results of Arthroscopic Biceps Long Head Tenodesis Above the Pectoralis Major Using an Interference Screw
Choi, Sang Su ; Kang, Hong Je ; Kim, Jeong Woo ; Kim, Jong Yun ; Kim, Dong Moon ; Kim, Kwang Mee ;
Clinics in Shoulder and Elbow, volume 16, issue 2, 2013, Pages 94~99
DOI : 10.5397/CiSE.2013.16.2.94
Purpose: The purpose of this study is to evaluate the clinical results of arthroscopic biceps long head suprapectoral tenodesis using an interference screw. Materials and Methods: We reviewed the cases of 30 patients who underwent arthroscopic biceps long head suprapectoral tenodesis using an interference screw between January 2008 and January 2010. The minimum follow up period was one year. Twenty patients had rotator cuff tears. The results were analyzed by VAS, ASES, tenderness in the bicipital groove, fixation failure, and the degree of deformity. Results: VAS, ASES scores showed a statistically significant increase during the final observation in all patients, compared with those before surgery. However, five patients (17%) had anterior shoulder pain and tenderness in the biceps groove, and three patients (10%) had Popeye deformity. Better results were achieved in patients without rotator cuff tear than in patients with rotator cuff tear (p<0.05). Conclusion: Arthroscopic biceps long head tenodesis above the pectoralis major using an interference screw in patients with a pathologic lesion of the proximal biceps tendon showed good results at the last follow up. However, further study for tenderness in the biceps groove in 17% of patients is needed.
Relationship of Trochlear Medial Facet Osteophyte to Elbow Flexion in Elbow Joint without Trauma History
Kim, Byung Sung ; Park, SungYong ; Park, Kang Hee ; Song, Hyun Seok ; Kim, Hyung Tae ; Yoon, Hong Kee ; Nho, Jae Hwi ;
Clinics in Shoulder and Elbow, volume 16, issue 2, 2013, Pages 100~106
DOI : 10.5397/CiSE.2013.16.2.100
Purpose: The purpose of this study is to evaluate the relationship between trochlear medial facet osteophyte (TMFO) and elbow flexion in the elbow joints without trauma history. Materials and Methods: Twenty five patients, who underwent computed tomography without elbow trauma history, were reviewed. Patients were checked for osteophyte or loose bodies in the coronoid and olecranon sides. The height and length of TMFO were measured. Results: The average elbow flexion contracture was
, and further flexion was
. The TMFO height and length was 2.2 mm and 4.7 mm, respectively. The average elbow further flexion was
in the coronoid block group (n
Clinical and Radiographical Follow-up for Residual Displacement of Fracture Fragments after Interlocking Intramedullary Nailing in Humeral Shaft Fractures
Yum, Jae-Kwang ; Lim, Dong-Ju ; Jung, Eui-Yub ; Sohn, Su-Een ;
Clinics in Shoulder and Elbow, volume 16, issue 2, 2013, Pages 107~114
DOI : 10.5397/CiSE.2013.16.2.107
Purpose: This study is designed to evaluate the clinical and radiographical results for the displacement of fracture fragments after interlocking intramedullary nailing in humeral shaft fractures. Materials and Methods: We retrospectively reviewed the results of 8 cases of humeral shaft fractures that have displacements of over 10 mm and under 20 mm after interlocking intramedullary nailing between July 2004 and August 2011. The mean age was 54.1 years (range, 43 to 70 years) and there were 3 male and 5 female patients. Radiographically, the time to bony union, change of displacement and angulation of the fracture site, and degree of improvement of these two factors were measured. Clinically, the range of motion of shoulder and elbow joints, postoperative pain and complications were evaluated. Results: All cases showed complete bony union in last follow-up. The mean time to bony union was 16.1 weeks. At the last follow-up, almost all cases had normal range of motion of shoulder and elbow joints. But, one case had stiffness of shoulder joint. Therefore, arthroscopic capsular release and manipulation was performed. One case had transient shoulder pain and the other case had transient elbow pain. In the two cases, pull-out of proximal interlocking screw were noted, but they finally had bony union. Conclusion: Although considerable displacement of fracture fragments after interlocking intramedullary nailing in humeral shaft fractures was present, we had excellent radiographical and clinical outcomes. Therefore, an additional procedure, such as open reduction or another fixation for the fracture site, was not necessary.
Coracoclavicular Ligament Augmentation Using Tight-Rope
for Acute Acromioclavicular Joint Dislocation - Preliminary Report -
Kweon, Seok Hyun ; Choi, Sang Su ; Lee, Seong In ; Kim, Jeong Woo ; Kim, Kwang Mee ;
Clinics in Shoulder and Elbow, volume 16, issue 2, 2013, Pages 115~122
DOI : 10.5397/CiSE.2013.16.2.115
Purpose: The purpose of this study is to analyze the results of acute acromioclavicular joint dislocation treatment with coracoclavicular ligament augmentation using Tight-Rope
(Arthrex). Materials and Methods: From October 2009 to March 2011, 30 patients with acute acromioclavicular joint dislocation underwent coracoclavicular ligament augmentation using Tight-Rope
and were followed up for at least 12 months after surgery. The radiologic results were qualified according to serial plain radiographs, and the clinical results according to University of California - Los Angeles (UCLA) Shoulder Scale, Constant score, and VAS pain score. Results: Using the UCLA scoring system, excellent results were observed in 22 cases (73%), good results in five cases (17%), fair results in two cases (7%), and a poor result in one case (3%). The average Constant score was
. According to radiologic results, anatomical reduction was achieved in 26 cases, and two cases showed a moderate loss of reduction, and two cases showed complete re-dislocation. Clinical results for patients with re-dislocation were unsatisfactory and reoperation was required. Conclusion: Coracoclavicular ligament augmentation using Tight-Rope
is a good option providing reliable functional results in patients with acute acromioclavicular joint dislocation.
Surgical Treatment of Unstable Distal Clavicle Fractures: Comparison of Transacromial Pin Fixation and Hook Plate Fixation
Kim, Young Sung ; Lee, Ho Min ; Jang, Han Gil ;
Clinics in Shoulder and Elbow, volume 16, issue 2, 2013, Pages 123~129
DOI : 10.5397/CiSE.2013.16.2.123
Purpose: The purpose of this study is to compare the clinical and radiological outcomes of two surgical treatments, transacromial pin fixation and hook plate fixation, for unstable distal clavicle fractures. Materials and Methods: Twenty four patients with Neer type II distal clavicle fractures who underwent surgery with transacromial pin fixation (Group I: 12 patients) and hook plate fixation (Group II: 12 patients) were included. Reduction and union were evaluated using plain radiographs. Functional evaluation was performed according to UCLA score and Constant-Murley score at last follow-up. Results: All 24 cases showed bone union. Complete union took an average of 10 weeks for group I and 11.7 weeks for group II. Average UCLA score was 33 (group I) and 32.8 (group II). Average Constant score was 88.5 (group I) and 88.8 (group II). No significant difference for each variable was observed between the two groups. Conclusion: For the surgical treatment of Neer type II distal clavicle fractures, transacromial pin fixation and hook plate fixation are both useful methods.
Treatment of Pseudoarthrosis due to Nonunion of the Acromial Fracture with LCP - Case Report -
Kim, Yong-Min ; Park, Kyoung-Jin ; Kim, Dong-Soo ; Choi, Eui-Sung ; Shon, Hyun-Chul ; Cho, Byung-Ki ; Park, Ji-Kang ; Keum, Sang-Wook ; Jeong, Ho-Seung ;
Clinics in Shoulder and Elbow, volume 16, issue 2, 2013, Pages 130~134
DOI : 10.5397/CiSE.2013.16.2.130
A painful pseudoarthrosis will develop due to a delay in diagnosis and treatment, and surgical care is required. Treatment of pseudoarthrosis is really difficult because the acromion is a thin flat bone that is difficult to be fixed firmly. A 52-year-old woman with multiple trauma had an acromial fracture that was not detected until it had caused pain after ambulation. Open reduction and internal fixation with a variable angle locking compression plate for distal radius and autogenous iliac bone graft were performed. At nine months after the operation, there was partial tear in the supraspinatus tendon, and arthroscopic repair of the supraspinatus tendon was performed. At nine months after the operation, radiographs showed a complete union. At three months after tendon repair, the patient had excellent function of the shoulder. We have reported a case of a successful treatment of nonunion and pseudoarthrosis of acromial fracture that is difficult to be fixed.
Recurrent Shoulder Dislocation and Proximal Humerus Fracture in Neurofibromatosis Type I - A Case Report -
Hwang, Tae Hyok ; Cho, Hyung Lae ; Wang, Tae Hyun ; Yang, Hui Sun ;
Clinics in Shoulder and Elbow, volume 16, issue 2, 2013, Pages 135~140
DOI : 10.5397/CiSE.2013.16.2.135
We report a case of recurrent shoulder dislocation and combined proximal humerus fracture in neurofibromatosis type I. A twenty-year-old male patient with known neurofibromatosis type I presented with right shoulder dislocation and proximal humerus fracture following a minor trauma. His injured arm also had large plexiform neurofibromas on the elbow, and the dislocation of the shoulder joint was proven to be recurrent. Bony deformation of the humerus and scapula were revealed on X-ray and computed tomography, as well as multiple neurofibromatic changes of the deltoid and periscapular muscles were noted on magnetic resonance imaging. Open reduction and capsular reconstruction were performed and humeral fracture was stabilized with a reconstruction plate. Satisfactory union and functional result were achieved and the dislocation did not recur until the 7-month followup after the procedure. Recurrent shoulder dislocation and combined proximal humerus fracture in neurofibromatosis type I are rare complications. However, it should still be considered in the orthopaedic evaluation process of the diseases.
Acute Osteomyelitis of the Humeral Head after Arthroscopic Rotator Cuff Repair
Shin, Sang-Jin ; Jeong, Byoung-Jin ; Kook, Seung Hwan ; Shin, Sung-Joon ;
Clinics in Shoulder and Elbow, volume 16, issue 2, 2013, Pages 141~147
DOI : 10.5397/CiSE.2013.16.2.141
A 57-year-old man who simultaneously underwent an operation for repair of rotator cuff and a revision operation for nonunion of a Pilon fracture presented with osteomyelitis of the humeral head on the
day after surgery due to MRSA (Methicillin-resistant Staphylococcus aureus) infection. Infection was controlled after administration of appropriate intravenous antibiotic therapy and performance of several surgical procedures. However, devastating defects at the humeral head and the rotator cuff remained. No case of short term MRSA induced osteomyelitis has been reported.
Simultaneous Anterior and Posterior Interosseous Nerve Syndrome Following Shoulder Arthroscopy in the Lateral Decubitus Position - Case Report -
Seo, Jae Sung ; Kim, Jee Hoon ; Kang, Dong Hwa ;
Clinics in Shoulder and Elbow, volume 16, issue 2, 2013, Pages 148~152
DOI : 10.5397/CiSE.2013.16.2.148
We report a case of simultaneous anterior and posterior interosseous nerve syndrome in association with shoulder arthroscopy. Shoulder arthroscopy was performed in a 45-year-old male patient with left shoulder instability. In the right lateral decubitus position, under general anesthesia, traction was applied with elbow extension for 2 hours. One week after surgery, the patient revisited the clinic for weakness of the flexor of the thumb, index finger, and extensor of the fingers. Recovery was not achieved after four months of observation. Therefore, nerve exploration was performed in the anterior and posterior interosseous nerve and hourglass-like fascicular constriction was detected in the posterior interosseous nerve. The area of constriction was removed and epineural neurorrhaphy was performed. Three months after exploration, the extension function of the fingers was recovered. Recovery was achieved gradually, and, five months after nerve exploration, the symptoms were completely recovered. Simultaneous anterior and posterior interosseous nerve syndrome following shoulder arthroscopy is rare. However, it could occur due to the traction and position of the patient. Thus, the operator should be careful of traction and position of the patient.
Arthroscopic Bony Procedure During of Rotator Cuff Repair - Acromioplasty, Distal Clavicle Resection, Footprint Preparation and Coracoplasty -
Oh, Joo Han ; Park, Hae Bong ; Lee, Ye Hyun ;
Clinics in Shoulder and Elbow, volume 16, issue 2, 2013, Pages 153~162
DOI : 10.5397/CiSE.2013.16.2.153
The arthroscopic bony procedures during rotator cuff repair include acromioplasty, distal clavicle resection, footprint preparation and coracoplasty. The indication of each bony procedure is based on the theoretical reasons, and various types of surgical techniques are available. The purpose of this review article is to review the backgrounds of the indication and surgical techniques in the arthroscopic bony procedures during rotator cuff repair.
Unlinked and Convertible Total Elbow Arthroplasty
Moon, Jun-Gyu ; Chun, Sung-Kwang ;
Clinics in Shoulder and Elbow, volume 16, issue 2, 2013, Pages 163~169
DOI : 10.5397/CiSE.2013.16.2.163
Designs of total elbow arthroplasty have been evolving with clinical experiences. Newer implants are expected to resolve current limitations and improve long term outcomes. This review article focuses on the basic knowledge of unlinked and convertible total elbow arthroplasty. There have been a variety of designs of unlinked total elbow prostheses. Some implants are still used in the market, while others are no longer commercially available. Modified and newer designs include more congruent contact surface, stemmed implant, and radiocapitellar arthroplasty. Two convertible elbow prostheses have been developed, and one implant is currently available in Korea. Conversion from an unlinked to a linked mode is performed by adding a linking cap. Unlinked total elbow arthroplasty, which restores native elbow kinematics, has a biomechanical rationale of lowering polyethylene wear and loosening of implants. It can be indicated in younger and higher demand patients, who have adequate bone stock and soft tissues. Convertible total elbow arthroplasty broadens implant selection and simplifies revision surgery. These newer prostheses possibly improve the long term outcomes and resolve disadvantages of linked prostheses in total elbow arthroplasty.
Linked (Semi-constrained) Total Elbow Arthroplasty
Jung, Hong Jun ; Jeon, In-Ho ; Chun, Jae-Myeung ; Lee, Tae Kyoon ;
Clinics in Shoulder and Elbow, volume 16, issue 2, 2013, Pages 170~177
DOI : 10.5397/CiSE.2013.16.2.170
Total elbow arthroplasty is still in its infancy compared with other arthroplasties, such as knee or hip arthroplasties. Implant design has been evolving with clinical experiences; however, there are only limited data on the long-term clinical outcome of elbow arthroplasty in the literature. The design of total elbow prostheses can be divided into three categories: linked (constrained or semi-constrained), unlinked (unconstrained), and convertible types. The choice between an unlinked (unconstrained) implant and a linked (semi-constrained) implant depends on joint stability and adequacy of the bone stock. Linked elbow arthroplasty has provided high patient satisfaction, and pain relief thanks to proper patient selection, advancement of implant design, improvement in cement techniques, meticulous surgical technique, and appropriate postoperative rehabilitation. Concerns remain about the use of this implant in young or high-demand patients. This article focuses on the linked (semi-constrained) prostheses, which provides an overview of the current state of linked total elbow arthroplasty.