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REFERENCE LINKING PLATFORM OF KOREA S&T JOURNALS
> Journal Vol & Issue
Clinics in Shoulder and Elbow
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Korean Shoulder and Elbow Society
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Volume & Issues
Volume 4, Issue 2 - Dec 2001
Volume 4, Issue 1 - Jun 2001
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Surgical Treatment of Rotator Cuff Tear in Patients Younger than 40 Years
Lee Kwang-Won ; Lee Seung-Hun ; Ryu Chang-Soo ; Oh Jae-Uk ; Kim Ha-Yong ; Kim Byung-Sung ; Choy Won-Sik ;
Clinics in Shoulder and Elbow, volume 4, issue 2, 2001, Pages 161~165
Purpose: The purpose of this study was to analyze the possible contributing factors and surgical results of rotator cuff tears in patients younger than 40 years of age. Materials and Methods: From July, 1996 to February, 2000, twelve patients were available to participate in the study. The average age was 35 years (range, 17 to 40 years) old. Follow-up averaged eighteen months (range, 12 to 55 months). There were eleven men and one women. Each shoulder was evaluated with UCLA shoulder functional assessment, return-to-work status, return-to-sport status, and overall postoperative satisfaction. Results: After operation, eleven patients (92%) reported diminished pain relative to their preoperative level, and ten patients (83%) were improved in shoulder function. eleven patients (92%) exhibited improved strength after operation. nine patients (75%) returned to employment, and six patients (50%) returned to sports activities. Preoperative UCLA score averaged 12 and postoperative score averaged 31. Ten patients (83%) were satisfied with the outcome of their treatment. Conclusion: A traumatic event was the etiology of the rotator cuff tears in patients younger than 40 years. Results of surgical treatment in this younger group were satisfactory.
Treatment of Frozen Shoulder under the Arthroscopic Capsular Release Combined with Manipulation
You Yeun-Sik ; Lee Young-Hyun ; Lee Sang-Soo ; Nam I1-Hyun ;
Clinics in Shoulder and Elbow, volume 4, issue 2, 2001, Pages 166~172
Purpose: To evaluate effectiveness of arthroscopic capsular release combined with manipulation in frozen shoulder. Material and Method: 15 patient who had failed to respond to physical therapy were evaluated, which were treated with arthroscopic capsular release combined with manipulation, from July 1998 to March 2000. Result: At a mean of fifteen months(range, six to twenty four) after the combined procedure, the improvement in the score of Constant and Murley averaged 45 points. The mean improvement in motion was 76 degrees for abduction; 40 degrees and 65 degrees for external rotation in adduction and abduction. Conclusion : Arthroscopic capsular release with manipulation is useful method to treatment the frozen shoulder which was not respond to conservative treatment.
A Comparative Study of the Shoulder Scoring Systems
Tae Suk-Kee ; Cho Sung Koo ; Jung Young Bok ; Jin Hui Jae ; Kim Jong Won ;
Clinics in Shoulder and Elbow, volume 4, issue 2, 2001, Pages 173~180
Aim: To evaluate validity and responsiveness of four shoulder scoring systems. Material and Method: Twenty-five cases of shoulder instability(22 traumatic, 3 non-traumatic) and twenty-three cases of rotator cuff tear(12 small or medium, 10 large or massive) treated surgically were evaluated with the Shoulder Function Score of the University of Pennsylvania(Penn FS), Constant Score, UCLA Shoulder Rating Scale and Simple Shouler Test(SST), preoperatively and at final follow-up. The average follow-up was 16.0 months in instability group and 17.5 months in rotator cuff tear group. Using the SPSS program, Pearson linear correlation coefficiency(PLCC) between the scores were calculated. And to assess the construct validity, PLCC between patients' satisfaction and the scores were also calculated. Responsiveness was measured by the standardized response mean(SRM). Result: In instability group, correlation between the scoring systems was low preoperatively except between Constant and SST, but high after operation. Patients' satisfaction with the scores showed low PLCC preoperativley, but high PLCC postoperatively. SRM was high in PENN and UCLA, but when the satisfaction segment of the score was eliminated from UCLA, the SRM was the lowest. In rotator cuff tear group, there was high correlation between the scores not only preoperatively but postoperatively. And the patients' satisfaction matched well with the scores. SRM was particularly high in UCLA and SST. Even when satisfaction segment was eliminated from UCLA, the SRM was still the highest. Conclusion : Evaluation by the 4 scoring systems investigated in the study showed less consistency in instability than rotator cuff tear in terms of correlation and validity. Responsiveness was generally higher in rotator cuff tear group than in instability group except for Pennsylvania Shoulder Function Score. Therefore it is construed that use of any among the four scoring systems doesn't make difference in evaluation of rotator cuff lesions. However in instability group, care is needed because different result may be obtained according to the selection of a scoring system.
Bilateral Anterior Shoulder Instability
Rhee Yong Girl ; Cho Nam Su ;
Clinics in Shoulder and Elbow, volume 4, issue 2, 2001, Pages 181~185
Purpose: We reviewed the bilateral anterior shoulder instability to evaluate the final outcomes and influencing factors that had effect on the final outcomes. Materials and Methods: Sixteen patients of the bilateral shoulder instability underwent the operative treatment and 15 patients could be followed up average 29 months. There were Bankart lesions in 28 cases and 46% retracted markedly onto the medial side of the glenoid neck. Capsular redundancy could be seen in 50%, but the generalized ligamentous laxity in only two patients. We performed open Bankart repair in 21 cases and arthroscopic repair in 9 cases. Inferior capsular shift was performed in 12 cases of 15 cases in patients who was shown the capular redundancy. Results: The average increment of the forward flexion was 4° postoperatively but the average decrement of the external rotation was 6° postoperatively. After the inferior capsular shift surgery, there were significantly the decrement in external rotation by 13° even though the forward flexion was at the same level comparing with preoperative motion. There were 13 cases(43%) in excellent result, 14 cases(47%) in good and 3 case(l0%) in poor. Rowe score improved from 53 to 87.3 postoperatively. Conclusion : Re-establishing a proper capsular tensioning in a bilateral anterior shoulder instability is critical to ultimate success because there was a redundant laxity in a half and majority of them had marked retraction of an anteroinferior glenohumeral ligament complex. Especially, it should be considered that an unexpected limitation of external rotation could be occurred in the inferior capsular shift surgery.
Diagnostic Accuracy of Physical Examinations in Impingement Syndrome and Rotator Cuff Tear
Lee Young Soo ; Kim Jin Yong ; Cho Duck Yun ; Kim Young Ho ; Kim Se Hyen ;
Clinics in Shoulder and Elbow, volume 4, issue 2, 2001, Pages 186~190
Purpose: The aim of this study was to investigate the diagnostic accuracy of Neer, Hawkins provocative tests and supraspinatus manual muscle test for the assessment of impingement syndrome, partial tear and small complete tear of De rotator cuff. Materials and Methods: Seventy-one female and 115 male patients were included in the study. Patients were divided into four groups of no impingement, impingement without tear, partial tear and small complete tear of the rotator cuff, which were confirmed by sonogram, magnetic resonance imaging and surgery. Neer and Hawkins provocative tests and supraspinatus manual muscle test were performed respectively. SAS 6.12 version was used in statistical analysis. Results: We found that Neer test had 94% sensitivity, 54% specificity for impingement without tear and 89% sensitivity, 78% specificity for partial tear and 96% sensitivity, 23% specificity for small tear. Hawkins test revealed 95% sensitivity, 54% specificity for impingement without tear and 93% sensitivity, 78% specificity for partial tear and 100% sensitivity, 23% specificity for small tear. Supraspinatus manual muscle test revealed 27% sensitivity, 94% specificity for impingement without tear and 29% sensitivity, 82% specificity for partial tear and 48% sensitivity, 82% specificity for small tear. Conclusion: Neer and Hawkins tests have high sensitivity, low specificity for impingement syndrome, partial and small tear. Supraspinatus manual muscle test had low sensitivity and high specificity. However this test was not effective to differentiate the partial and small rotator cuff tear. We thought that more effective provocative test should be designed to detect the partial and small rotator cuff tear.
Reconstruction of Recurrent Posterolateral Rotatory Instability of the Elbow - A Case Report -
Jeon In Ho ; Kyung Hee Soo ; Kim Poong Taek ; Ihn Joo Chul ;
Clinics in Shoulder and Elbow, volume 4, issue 2, 2001, Pages 191~195
Posterolateral rotatory instability is the most common pattern of elbow instability especially which is recurrent, and is usually post-traumatic because of inadequate soft tissue healing. The lateral ulnar collateral ligament was reconstructed by using ipsilateral palmaris longus tendon. Functionally good result was obtained. This is a case report illustrating the posterolateral rotatory instability of the elbow and its reconstruction with palmaris longus.
Synovial Chondromatosis of the Subscapular Recess - A Case Report -
Nha Koung Wook ; Choo Suk Kyu ; Jung Byung Hyun ; Suk Seung Yeub ; Kim Han Sung ;
Clinics in Shoulder and Elbow, volume 4, issue 2, 2001, Pages 196~198
Synovial chondromatosis is the chondroid metaplasia of the synovial membrane, Large joints such as the knee and hip are commonly involved. Synovial chondromatosis very rarely develops within the shoulder joints. We have experienced the synovial chondromatosis developed in the right subscapular recess communicating the shoulder joint of a 30 year-old-female who was diagnosed by plain radiograph, MRI and microscopic findings, and then treated by arthroscopic synovectomy and removal of loose bodies.
Bilateral Elastofibroma - A Case Report -
Lee Young-Soo ; Kim Jin-Yong ; Kim Hee-Sang ; Cho Duck- Yun ;
Clinics in Shoulder and Elbow, volume 4, issue 2, 2001, Pages 199~202
Elastofibroma is a very rare lesion and one of the most unusual pathologic condition which a surgeon or pathologist can encounter. The elastofibroma is a completely benign lesion that is characteristically localized in the subscapular lesion. The lesion is characterized by abundant benign fibrous tissue and sparse accumulation of elastic fibers. It may occur in the old age and was not found in the adolescence or infant. Most of the elastofibroma involve unilaterally and bilateral involvement is less common. A case of bilateral elastofibroma located in the subscapular region that was treated with marginal excision is reported.