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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 17, Issue 4 - Dec 2014
Volume 17, Issue 3 - Sep 2014
Volume 17, Issue 2 - Jun 2014
Volume 17, Issue 1 - Mar 2014
Selecting the target year
The Internal Rotation Deficit in Reverse Shoulder Arthroplasty: Can Humeral Rotation Make Difference?
Kim, Young-Kyu ;
Clinics in Shoulder and Elbow, volume 17, issue 4, 2014, Pages 151~151
DOI : 10.5397/cise.2014.17.4.151
Short-term of Reverse Total Shoulder Arthroplasty for the Treatment of Irreparable Massive Rotator Cuff Tear
Park, Jong-Hyuk ; Wang, Seong-Il ; Lee, Byung-Chang ;
Clinics in Shoulder and Elbow, volume 17, issue 4, 2014, Pages 152~158
DOI : 10.5397/cise.2014.17.4.152
Background: To investigate the effectiveness of reverse total shoulder arthroplasty (RTSA) in treating irreparable massive rotator cuff tears (RCTs). Methods: Twenty-nine patients who underwent RTSA for the treatment of irreparable massive RCTs and completed follow-up for at least 1 year were selected. Their mean age was 69.7 years (range, 59-80 years). The mean follow-up was 17.7 months (range, 12-42 months). The shoulder range of motion was measured preoperatively and at final follow-up. The functional result was evaluated using visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeon (ASES) score, and Korean Shoulder Society (KSS) score. Additionally, the shoulders were categorized into two groups depending on prior history of surgery and the clinical outcomes were analyzed between two groups. Results: Mean pain VAS improved, from
(p=0.001), and the mean functional VAS from
(p=0.006). The mean ASES score improved from
(p=0.012). The mean KSS improved from
(p=0.009), the mean forward elevation from
(p=0.0001), and the mean abduction from
(p=0.0001). Internal rotation differed significantly from the first sacral to the third lumbar vertebrae (p=0.036). External rotation did not change significantly (p=0.076). There was also no statistically significant difference between groups (no previous operation versus none). Four complications occurred: one superficial infection, one with anterior dislocation, one acromial fracture, and one clavicle fracture. Conclusions: RTSA provides reliable pain relief and recovery of shoulder function in patients with massive irreparable RCTs in short-term follow-up.
Clinical and Radiologic Outcomes of Acute Acromioclavicular Joint Dislocation: Comparison of Kirschner's Wire Transfixation and Locking Hook Plate Fixation
Rhee, Yong Girl ; Park, Jung Gwan ; Cho, Nam Su ; Song, Wook Jae ;
Clinics in Shoulder and Elbow, volume 17, issue 4, 2014, Pages 159~165
DOI : 10.5397/cise.2014.17.4.159
Background: Kirschner's wire (K-wire) transfixation and locking hook plate fixation techniques are widely used in the treatment of acute acromioclavicular joint (ACJ) dislocation. The purpose of this study was to compare the clinical and radiologic outcomes between K-wires transfixation and a locking hook plate fixation technique. Methods: Seventy-seven patients with acute ACJ dislocation managed with K-wire (56 shoulders) and locking hook plate (21 shoulders) were enrolled for this study. The mean follow-up period was 61 months. Results: At the last follow-up, the shoulder rating scale of the University of California at Los Angeles (UCLA) was higher in patients treated with locking hook plate than with K-wires (
, p=0.009). In radiologic assessments, coracoclavicular distance (CCD) (7.9 mm vs. 7.7 mm, p=0.269) and acromioclavicular distance (ACD) (3.0 mm vs. 1.9 mm, p=0.082) were not statistically different from contralateral unaffected shoulder in locking hook plate fixation group, but acromioclavicular interval (ACI) was significant difference. However, there were significant differences in ACI, CCD, and ACD in K-wire fixation group (p<0.001). Eleven complications (20%) occurred in K-wire transfixation group and 2 subacromial erosions on computed tomography scan occurred in locking hook plate fixation group. Conclusions: ACJ stabilization was achieved in acute ACJ dislocations treated with K-wires or locking hook plates. Locking hook plate can provide higher UCLA shoulder score than K-wire and maintain CCD, and ACD without ligament reconstruction. K-wire transfixation technique resulted in a higher complication rate than locking hook plate.
Isokinetic Muscle Strength and Muscle Endurance by the Types and Size of Rotator Cuff Tear in Men
Kim, In Bo ; Kim, Do Keun ;
Clinics in Shoulder and Elbow, volume 17, issue 4, 2014, Pages 166~174
DOI : 10.5397/cise.2014.17.4.166
Background: Our study was to determine the effect on shoulder isokinetic muscle strength and muscle endurance in isolated full-thickness supraspinatus tendon tear and combined other rotator cuff tear. Methods: Total of 81 male patients (mean age
years) who were diagnosed as a full-thickness supraspinatus tendon tear were included. They were classified into isolated or combined tear. The isokinetic muscle strength and muscle endurance were measured using the Biodex multi-joint system
(Biodex Medical Systems, Shirley, NY, USA) in following movements: shoulder abduction, adduction, flexion, extension, external rotation, and internal rotation. Then, the difference in muscle function according to the type of tears were assessed. Fifty-seven patients had isolated supraspinatus tendon (mean age
years). They were classified into either anteroposterior tear or modified mediolateral tear. The size were measured using T2-weighted magnetic resonance imaging scans in sagittal plane. Results: Between subjects categorized into the type of tear, we found significant inter-categorical differences in isokinetic muscle strength during abduction, adduction, flexion, extension, and internal rotation, and in muscle endurance during flexion, extension, and internal rotation. Anteroposterior diameter tear, we did not show significant differences in either isokinetic muscle strength or muscle endurance during any movements. However, with modified mediolateral diameter, we found significant differences with isokinetic muscle strength during adduction, and in muscle endurance the external rotation and internal rotation. Conclusions: We found that a supraspinatus tendon tear associated with more numbers of rotator cuff tears has lower isokinetic muscle strength and muscle endurance than a tear found alone.
Coracoclavicular Ligament Suture Augmentation with Anatomical Locking Plate Fixation for Distal Clavicle Fracture
Lim, Tae Kang ; Shon, Min Soo ; Ryu, Hyung Gon ; Seo, Jae Sung ; Park, Jae Hyun ; Ko, Young ; Koh, Kyoung-Hwan ;
Clinics in Shoulder and Elbow, volume 17, issue 4, 2014, Pages 175~180
DOI : 10.5397/cise.2014.17.4.175
Background: For Neer type IIB fracture of distal clavicle with coracoclavicular ligament injury, various surgical treatments have been used in literatures. However, there was no consensus on the optimal treatment. The aim of this study is to report the clinical and radiological results of open reduction and internal fixation of unstable distal clavicle fracture and suture augmentation of disrupted coracoclavicular ligament. Methods: A prospective study was performed in 23 patients with Neer type IIB distal clavicle fracture in Seoul Medical Center, Eulji Hospital, and National Medical Center. Firstly, suture anchors are inserted in the base of coracoid process and preliminary reduction was achieved by tie-off of three suture limbs around the clavicle. Then, the final fixation was completed with anatomical locking plate. Bony union and the distance between coracoclavicular ligaments were evaluated. Clinical results and complications including stiffness and secondary procedures were evaluated. Results: Bony union was achieved in all cases except one (22 of 23). At mean 14.9 months, no significant difference in the mean coracoclavicular distance was observed compared to uninjured shoulder (
, p=0.14). Pain visual analogue scale, American Shoulder and Elbow Surgeons score, Constant score, and Disabilities of the Arm, Shoulder and Hand score were 0.5, 83.4, 78.5, and 6.2, respectively. Revision surgery was performed in one case of nonunion. Four patients who complained of skin irritation underwent implant removal. Conclusions: In cases of an unstable distal clavicle fracture with coracoclavicular ligament disruption, satisfactory clinical results were obtained by locking plate fixation and coracoclavicular ligament suture augmentation concurrently.
Schwannoma of the Ulnar Nerve in the Elbow: A Case Report
Kim, Doo-Sup ; Rah, Jung-Ho ; Chung, Hoe-Jeong ; Shin, John Junghun ; Hong, Kyung-Jin ;
Clinics in Shoulder and Elbow, volume 17, issue 4, 2014, Pages 181~184
DOI : 10.5397/cise.2014.17.4.181
Schwannomas are soft tissue sarcomas arising from neurilemma of Schwann cells in peripheral nerves, and is the most frequent type of benign tumor found in these nerves. We report a case of a Schwannoma of the ulnar nerve in the elbow joint, and along this report, give a review of the literature. A 46-year-old male patient was hospitalized with complaints of swelling and pain in the left elbow and a tingling sensation and hypoesthesia of the fourth and fifth fingers. Physical examination of the patient showed he was positive for Tinel's sign, and magnetic resonance imaging results demonstrated the presence of a Schwannoma. Subsequent biopsy and excision of the Schwannoma was carried out. The suspected mass, which had a clear margin separating it from the healthy nerve of the medial left elbow, was removed along with its
capsule after a histological diagnosis of a Schwannoma was made. Pathophysiological results confirmed the excised mass as a Schwannoma. Schwannoma of the ulnar nerve within the elbow joint is rare and differential diagnosis is difficult. Therefore, treatment can only proceed after the presence of Schwannoma has been confirmed by physical and radiological examinations.
Large Cavernous Hemangioma of the Subscapularis Muscle - A Case Report
Lee, Ki-Won ; Lee, Hyun Il ; Kim, Chung-Hwan ; Kim, Tae-Kyung ;
Clinics in Shoulder and Elbow, volume 17, issue 4, 2014, Pages 185~189
DOI : 10.5397/cise.2014.17.4.185
We report a case of intramuscular hemangioma in the subscapularis muscle and the resulting impairment of shoulder function in an adult patient. A nineteen-year-old female complained of shoulder pain and the development of a mass in the absence of previous trauma. Physical examinations, including lift-off and belly-press tests, showed abnormality. X-ray showed multiple calcifications in the front of the scapula. Magnetic resonance imaging showed a soft-tissue mass occupying almost the entire intramuscular portion of the subscapularis muscle. An arthroscopic examination excluded the possibility of a joint invasion, after which the entire mass was successfully removed by open excision. The displacement of the subscapularis by the mass was relieved after the surgery. Pathological diagnosis of the tissue confirmed a cavernous hemangioma. Both shoulder pain and function was improved after operation. There was no evidence of recurrence even at the 2-year follow-up. Rare forms of hemangioma adjacent to the shoulder joint could be successfully managed with surgical excision. Differential diagnosis, such as synovial chondromatosis, pigmented villo-nodular synovitis, and malignant sarcoma, should also be considered.
Iliac Bone Graft for Recurrent Posterior Shoulder Instability with Glenoid Bone Defect
Ko, Sang-Hun ; Cho, Yun-Jae ;
Clinics in Shoulder and Elbow, volume 17, issue 4, 2014, Pages 190~193
DOI : 10.5397/cise.2014.17.4.190
Recurrent posterior shoulder instability is a debilitating condition that is relatively uncommon, but its diagnosis in young adults is increasing in frequency. Several predisposing factors for this condition have been identified, such as the presence of an abnormal joint surface orientation, an osteochondral fracture of the humeral head or glenoid cavity, and a postero-inferior capsuloligamentary deficit, but their relative importance remains poorly understood. Whilst, conservative treatment is effective in cases of hyperlaxity or in the absence of bone abnormality, failure of conservative treatment means that open or arthroscopic surgery is required. In general, soft-tissue reconstructions are carried out in cases of capsulolabral lesions in which bone anatomy is normal, whereas bone grafts have been required in cases where posterior bony Bankart lesions, glenoid defects, or posterior glenoid dysplasia are present. However, a consensus on the exact management of posterior shoulder instability is yet to be reached, and published studies are few with weak evidence. In our study, we report the reconstruction of the glenoid using iliac bone graft in a patient suffering recurrent posterior shoulder instability with severe glenoid bone defect.
Arthroscopic Treatment of the Intratendinous Ganglion of the Long Head of Biceps Brachii - A Case Report
Wang, Jin-Man ; Yi, Woojin ; Son, Jin-Hyoung ; Im, Jung-Ju ;
Clinics in Shoulder and Elbow, volume 17, issue 4, 2014, Pages 194~196
DOI : 10.5397/cise.2014.17.4.194
A ganglion is a benign cystic mass, commonly found around a joint or tendon sheath. It frequently occurs at the wrist, foot, ankle, and knee. Intratendinous ganglion has been rarely reported, and intratendinous ganglion of the long head of biceps brachii is extremely rare. According to our literature review, this is the third case of intratendinous ganglion of the long head of biceps brachii, and the first case of arthroscopic treatment. Therefore we report a case of an arthroscopic treatement for an intratendinous ganglion of the long head of biceps brachii.
Acute Osteomyelitis in the Proximal Humerus Caused by Pyogenic Glenohumeral Arthritis in an Elderly Patient - A Case Report
Hyun, Yoon-Suk ; Kwon, Jae-Woo ; Hong, Sung-Yup ; Han, Kyeol ;
Clinics in Shoulder and Elbow, volume 17, issue 4, 2014, Pages 197~200
DOI : 10.5397/cise.2014.17.4.197
Reports of osteomyelitis in the proximal humerus with pyogenic glenohumeral arthritis of adjacent joints mostly involve pediatric patients. Nowadays, osteomyelitis that is secondary to adjacent pyogenic glenohumeral arthritis is extremely rare, even more so in adults than in pediatrics. We report a rare case of the pyogenic glenohumeral arthritis followed by osteomyelitis of the proximal humerus in an elderly patient. Initially, we diagnosed a case of pyogenic glenohumeral arthritis only, which, despite arthroscopic synovectomy, did not resolve and severe pain continued. Subsequent radiological imaging, performed after our suspicion of a secondary involvement, allowed us to diagnose osteomyelitis combined with the pyogenic glenohumeral arthritis, which we had overlooked because of the extreme rarity of the condition in adults since the antibiotic era began.
Pulmonary Embolism after Screw Fixation for a Greater Tubercle Fracture of Humerus
Kang, Suk ; Chung, Phil Hyun ; Kim, Jong Pil ; Kim, Young Sung ; Lee, Ho Min ; Jang, Han Gil ;
Clinics in Shoulder and Elbow, volume 17, issue 4, 2014, Pages 201~204
DOI : 10.5397/cise.2014.17.4.201
Pulmonary embolism is a serious complication, which is well known in patients undergoing total hip or total knee arthroplasty or lower extremity fracture surgery. But, there are few literatures concerning pulmonary embolism after upper extremity surgery. Pulmonary embolism after minor upper extremity fracture surgery is extremely rare. We report a case of 66-year-old female patient that developed pulmonary embolism after percutaneous cannulated screw fixation for a greater tubercle fracture of the proximal humerus with literature review.
Ultrasonography in Sternoclavicular Joint Posterior Dislocation in an Adolescent - A Case Report
Noh, Young Min ; Jeon, Seung Hyub ; Yoon, Hyung Moon ;
Clinics in Shoulder and Elbow, volume 17, issue 4, 2014, Pages 205~208
DOI : 10.5397/cise.2014.17.4.205
Sternoclavicular joint posterior dislocations are considered a very uncommon, and type of injury where if esophagus or airway injury occurs behind the clavicle, it poses a high risk to the patient. In addition, if epiphyseal fracture occurs as a result of the sternoclavicular joint posterior dislocation, surgical treatment is often required. However, in the absence of a complete ossification of the clavicle, it is difficult to differentiate between a simple dislocation and epiphyseal fracture-dislocation solely based on simple radiographs or computed tomography scans. In this case report, the authors present a case in which a sternoclavicular joint posterior dislocation was diagnosed in a 14-year-old male athlete. The case report discusses how the posterior dislocation without epiphyseal fracture was diagnosed using an ultrasound and subsequently treated with successful outcomes using manual reduction. The case report presents our findings along with discussion that includes a literature review of relevant research.
Current Concept of Management of Partial-thickness Rotator Cuff Tear
Lim, Tae Kang ; Park, Jae Hyun ;
Clinics in Shoulder and Elbow, volume 17, issue 4, 2014, Pages 209~217
DOI : 10.5397/cise.2014.17.4.209
Most studies on the pathophysiology, natural history, diagnosis by imaging and outcomes after operative or nonoperative treatment of rotator cuff tear have focused on those of full-thickness tears, resulting in limited knowledge of partial-thickness rotator cuff tears. However, a partial-thickness tear of the rotator cuff is a common disorder and can be the cause of persistent pain and dysfunction of the shoulder joint in the affected patients. Recent updates in the literatures shows that the partial-thickness tears are not merely mild form of full-thickness tears. Over the last decades, an improved knowledge of pathophysiology and surgical techniques of partial-thickness tears has led to more understanding of the significance of this tear and better outcomes. In this review, we discuss the current concept of management for partial-thickness tears in terms of the pathogenesis, natural history, nonoperative treatment, and surgical outcomes associated with the commonly used repair techniques.