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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
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Volume & Issues
Volume 17, Issue 4 - Dec 2014
Volume 17, Issue 3 - Sep 2014
Volume 17, Issue 2 - Jun 2014
Volume 17, Issue 1 - Mar 2014
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Indirect Reduction Technique in Proximal Humeral Fractures Stabilized by Locking Plates
Rhee, Yong Girl ; Cho, Nam Su ; Cha, Sang Won ; Moon, Seong Cheol ; Hwang, Sang Phil ;
Clinics in Shoulder and Elbow, volume 17, issue 1, 2014, Pages 2~9
DOI : 10.5397/cise.2014.17.1.2
Background: Indirect reduction technique offers a valid option in the treatment of proximal humerus fracture. The purpose of this study is to evaluate the functional outcome and the complication rate after indirect reduction and internal fixation of unstable proximal humeral fractures with use of a locking plate. Methods: Twenty four patients with acute proximal humerus fracture were managed with indirect reduction and internal fixation with a locking plate. The mean follow-up period was 15.5 months. Results: The anatomical reduction of the medial cortex buttress was seen in 16 patients (66%) of the Group A and the non-anatomical reduction was seen in 8 patients (33%) of the Group B. Mean union time was
months; it was
months in the Group A and
months in the Group B (p < 0.05). In our series, there were 6 cases of complications and these include 2 cases of varus malunion, 2 cases of shoulder stiffness, 1 case of heterotrophic ossification, 2 cases of screw perforation and 1 case of impingement. Conclusions: We conclude from our studies that indirect reduction and internal fixation using locking plate for acute proximal humerus fracture can give good results with bony union and predictable good overall functional outcome. If the medial cortex buttress is well maintained, a better anatomical reduction would be achieved, the union would be prompted, the pain would be further reduced and the range of the motion would be recovered more promptly.
The Analysis of the Treatment Outcomes of Proximal Humeral Fractures with Locking Plates
Lee, Kwang-Won ; Hwang, Yoon-Sub ; Kim, Choon-Myeon ; Yang, Dae-Suk ; Park, Tae-Soo ;
Clinics in Shoulder and Elbow, volume 17, issue 1, 2014, Pages 10~17
DOI : 10.5397/cise.2014.17.1.10
Background: The aim of this study was to assess the clinical outcomes after treatment of proximal humeral fractures with locking plates, and to determine which factors influence the clinical and radiological outcomes. Methods: Fifty six patients who were treated with locking plates for proximal humeral fractures and had been followed for more than 1 year were enrolled in this study. We performed functional evaluation using the Constant score and analyzed radiographic results. The following factors that may potentially influence the clinical outcomes were assessed: age, gender, type of fracture, presence of medial metaphyseal comminution, bone mineral density, anatomical reduction, restoration of medial mechanical support, and postoperative complications. Results: The mean Constant score was 70.1 points at the final follow-up. Female gender, 4-part fractures, AO type-C fractures, and fractures with medial metaphyseal comminution were associated with a poor clinical outcome. On the other hand, restoration of medial mechanical support and accurate anatomical reduction had a positive influence on clinical outcomes. Postoperative complications resulted in 3 patients (intra-articular screw perforation: 1 patient, varus deformity with screw loosening: 1 patient, nonunion: 1 patient). Conclusions: When treating proximal humeral fractures with locking plate fixation, following factors: a female gender, Neer type 4-part fracture, AO type C fracture, and medial metaphyseal comminution are important risk factors that surgeons should take into consideration. Factors that contribute to better clinical outcomes of operative treatment for humeral fractures are accurate anatomical reduction and restoration of medial mechanical support.
Efficacy of the Subclavian Portal Approach in Arthroscopic Repair of Isolated Subscapularis Tendon Tear
Chae, Seung Bum ; Choi, Chang Hyuk ; Jung, Suk-Han ;
Clinics in Shoulder and Elbow, volume 17, issue 1, 2014, Pages 18~24
DOI : 10.5397/cise.2014.17.1.18
Background: To evaluate the efficacy of the subclavian portal approach for the arthroscopic repair of isolated subscapularis tendon tear. Methods: We used the subclavian portal to carry out arthroscopic repair of the isolated subscapularis tendon tear. The surgery was carried out in 18 cases (average age of 53) from May 2006 to December 2009 with a mean follow-up period of 35 months. Of these cases, 13 patients had the tear in their dominant arms, 16 were male, and 12 were from traumatic ruptures with on average 7.6 months of symptom period to operation. Additional surgery, acromioplasty and subacromial debridement, were carried out on 4 cases each during the subscapularis repair. The integrity of cuff status was assessed by ultrasonographic examination at 6 months and at 1 year after operation. Results: The initial average range of motion in forward flexion, external rotation, and internal rotation were
and L4, respectively. At the 1 year follow-up period, these improved to
and T12, respectively. The initial average functional scores were assessed by KSS, ASES, UCLA, and Constant scoring systems, which were 67, 60, 26, and 65, respectively. These scores improved progressively with time. At 3 months after operation, the scores were 74, 67, 27, and 74; at 6 months, 83, 77, 31, and 75; at 1 year, 88, 86, 32, and 79; and at the final follow-up of 35 months, 84, 92, 34, and 84. Conclusions: In the repair of isolated subscapularis tendon tear, the subclavian portal approach provided a good angle for anchor insertion and sufficient space to manage the upper portion of the tendon tear. In turn, these provisions resulted in satisfactory clinical results.
In vivo 3D Kinematics of Axis of Rotation in Malunited Monteggia Fracture Dislocation
Kim, Eugene ; Park, Se-Jin ; Jeong, Haw-Jae ; Ahn, Jin Whan ; Shin, Hun-Kyu ; Park, Jai Hyung ; Lee, Mi Yeon ; Tsuyoshi, Murase ; Sumika, Ikemototo ; Kazuomi, Sugamoto ; Choi, Young-Min ;
Clinics in Shoulder and Elbow, volume 17, issue 1, 2014, Pages 25~30
DOI : 10.5397/cise.2014.17.1.25
Background: Normal elbow joint kinematics has been widely studied in cadaver, whilst in vivo study, especially of the forearm, is rare. Our study analyses, in vivo, the kinematics of normal forearm and of malunited forearm using a three-dimensional computerized simulation system. Methods: We examined 8 patients with malunited Monteggia fracture and 4 controls with normal elbow joint. The ulna and radius were reconstructed from CT data placing the forearm in three different positions; full pronation, neutral, and full supination using computer bone models. We analyzed the axis of rotation 3-dimentionally based on the axes during forearm rotation from full pronation to full supination. Results: Axis of rotation of normal forearm was pitch line, with a mean range of 2 mm, from full pronation to full supination, connecting the radial head center proximally and ulnar fovea distally. In normal forearm, the mean range was 1.32 mm at the proximal radioulnar joint and 1.51 mm at the distal radioulnar joint. However in Monteggia fracture patients, this range changed to 7.65 mm at proximal and 4.99 mm at distal radoulnar joint. Conclusions: During forearm rotation, the axis of rotation was constant in normal elbow joint but unstable in malunited Monteggia fracture patients as seen with radial head instability. Therefore, consideration should be given not only to correcting deformity but also to restoring AOR by 3D kinematics analysis before surgical treatment of such fractures.
Pulmonary Embolism after Arthroscopic Rotator Cuff Repair - A Case Report
Gwark, Ji Yong ; Koh, Jin-Sin ; Park, Hyung Bin ;
Clinics in Shoulder and Elbow, volume 17, issue 1, 2014, Pages 31~35
DOI : 10.5397/cise.2014.17.1.31
Pulmonary embolism (PE) is a serious complication that can occur after orthopedic surgery. Most instances of PE in the orthopedic field have occurred after hip or knee arthroplasties or after fracture surgeries. The occurrence of PE related to arthroscopic shoulder surgery is very rare. We report a case of PE that developed after arthroscopic rotator cuff repair, in which the patient did not show preoperatively any remarkable risk factors for PE. We also review the current literature related to this topic.
Spontaneous Healing of Acromial Stress Fracture Caused by Clavicle Hook Plate in Acromioclavicular Joint Dislocation - A Case Report
Kim, Gang-Un ; Kim, Seong-Hwan ; Lee, Jae-Sung ; Kim, Jae Yoon ;
Clinics in Shoulder and Elbow, volume 17, issue 1, 2014, Pages 36~39
DOI : 10.5397/cise.2014.17.1.36
Clavicular hook plate is known to be an effective treatment on acromioclavicular (AC) joint injury, but there have been some reports of complications, like osteolysis and bony erosion of the undersurface of acromion. Fifty-five year old male underwent open reduction and hook plate insertion on Rockwood type 5 acromioclavicular joint dislocation. He complained of protrusion of posterior acromion at 1 month after the surgery, and acromial fracture was noted in simple radiographs. The hook plate was removed and any other treatment for osteosynthesis was refused by the patient. At the 18 months after the surgery, the patient had no pain and a full range of motion with no tenderness around the shoulder joint. After two years, plain radiographs revealed complete bony union of the acromion fracture.
Osteochondritis Dissecans in Medial Trochlea of the Humerus in a Pitcher - A Case Report
Lee, Jin-Ho ; Kim, Myung-Sun ;
Clinics in Shoulder and Elbow, volume 17, issue 1, 2014, Pages 40~43
DOI : 10.5397/cise.2014.17.1.40
Osteochondritis dissecans (OCD) is an idiopathic condition affecting the articular epiphysis. Initially described in the knee, this entity affects several other parts of the body such as the talar dome, tarsal navicular, and femoral capital epiphysis. Osteochondritis dissecans (OCD) of the elbow is typically located in the capitellum of the humerus in young teenagers. OCD of humeral trochlea is very rare, but can be occurred among young athletes. OCD developed medial trochlea was extremely rare, especially, without any other trauma. We present a patient, pitcher with OCD in the medial trochlea of the humerus who underwent arthroscopic debridement and microfracture.
Arthroscopic Partial Repair of Massive Contracted Rotator Cuff Tears
Kim, Sung-Jae ; Kim, Young-Hwan ; Chun, Yong-Min ;
Clinics in Shoulder and Elbow, volume 17, issue 1, 2014, Pages 44~47
DOI : 10.5397/cise.2014.17.1.44
Typically, massive rotator cuff tears have stiff and retracted tendon with poor muscle quality, in such cases orthopaedic surgeons are confronted with big challenging to restore the cuff to its native footprint. Furthermore, even with some restoration of the footprint, it is related with a high re-tear rate due to less tension free repair and less tendon coverage. In this tough circumstance, the partial repair has yielded satisfactory outcomes at relatively short follow-up by re-creating the transverse force couple of the rotator cuff. Through this partial repair, the massive rotator cuff tear can be converted to the "functional rotator cuff tear" and provide improvement in pain and functional outcomes in patient's shoulder.