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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 7, Issue 2 - Dec 2004
Volume 7, Issue 1 - Jun 2004
Selecting the target year
What Should We Treat For Recurrent Dislocation?
Tae Suk-Kee ;
Clinics in Shoulder and Elbow, volume 7, issue 1, 2004, Pages 1~4
DOI : 10.5397/CiSE.2004.7.1.001
As the multidirection and posterior instabilities of the shoulder are not only uncommon but responds well to conservative treatment, the shoulder instabilities which requires surgical treatment are traumatic anterior type in most cases, Although various surgical procedures had been used in the past, Bankart procedure is the standard surgical method as a primary procedure in traumatic anterior instability, Nevertheless there has been changes in the techniques of Bankart procedure in order to minimize decrease of external rotation and effectively address capsular laxilty, Capsular shift might be needed if there remains excessive capsular laxity of the inferior capsule after repair of the Bankart lesion, Large bony Bankart lesion should be fixed if possible and severe glenoid rim erosion requires extracapsular bone block after repair of the capsule. Although a few surgical procedures are described for the management of Hill-Sachs lesion in special circumstances, Hill-Sachs lesion does not usually need to be addressed.
Associated Changes During Arthroscopic Evaluation of the Glenohumeral Joint in Rotator Cuff Tear - Comparison According to Tear Size -
Choi Chang-Hyuk ; Kwun Koing-Woo ; Kim Shin-Kun ; Lee Sang-Wook ; Cho Myung-Rae ; Ko Sang-Bong ; Kim Tae-Hoon ;
Clinics in Shoulder and Elbow, volume 7, issue 1, 2004, Pages 5~9
DOI : 10.5397/CiSE.2004.7.1.005
Purpose: To identify associated findings in glenohumeral joint in rotator cuff tear and evaluate its clinical significance, we examined minor and major changes during arthroscopic or mini open repair. Materials & Methods: We reviewed 66 patients of rotator cuff tear treated from March, 2001 to January, 2004. Of 38 cases of small to medium tear, average age was 53 years old and involved in dominant arm in 27 cases. Of 28 cases of large to massive tear, average age was 58 years old and involved in dominant arm in 26 cases. Minor and major associated changes of the glenohumeral joint were evaluated in the tendon of biceps long head, biceps pulley, cartilage of the glenoid and humeral head, labrum and synovium. Results: Minor changes in biceps tendon were in 35% of cases, biceps pulley in 18%, cartilage of humeral head in 27%, cartilage of glenoid in 18%, labrum in 38%, and synovium in 42%. Major changes in biceps tendon were in 6% of cases, biceps pulley in 35%, arthritis of humeral head in 3%, arthritis of glenoid in 2%, labrum in 6%, and synovium in 21 %. Major changes in biceps tendon were 5% in Group I and 7% in Group Ⅱ(p>0.05) and in biceps pulley, 18% and 57% in each (P<0.05). Minor changes of arthritis were prevalent in glenoid cartilage and major changes were more prevalent in humeral head. There were no differences in minor changes of labrum and synovium, but major changes were more prevalent in Group Ⅱ. Conclusion: The prevalence of intraarticular associated changes of rotator cuff tear were 63% in synovium, 54% in labrum, 53% in biceps pulley, 41% in biceps tendon, 30% in humeral head and 20% in glenoid cartilage in order. Major changes of biceps pulley, humeral head, labrum and synovium were more prevalent in Group Ⅱ.
Possible Development of Modified SLAP Ⅱ and Bankart Lesion After Shoulder Avulsion injury -A Case Report-
Yoo Jae Chul ; Kwak Ho-Yoon ; Hwang Seung-Keun ;
Clinics in Shoulder and Elbow, volume 7, issue 1, 2004, Pages 10~13
DOI : 10.5397/CiSE.2004.7.1.010
Superior labrum anterior to posterior (SLAP) lesions of the shoulder has recently been a popular issue to shoulder surgeons. Now we are correlating many shoulder symptoms to this SLAP lesion. A 45 year-old female patient injured her shoulder when her arm sleeve was entrapped in moving automobile door. A forceful pull of the arm in external and abduction position was suspected. She complained continuous shoulder pain with limited range of motion for 2 months. Magnetic resonance image showed possible SLAP lesion but no definite diagnosis were made prior to the operation. Arthroscopic evaluation revealed SLAP type Ⅱ lesion with concomitant avulsion of the superior glenoid cartilage. In addition anterior labrocapsular tear was seen from 7 to 9 o`clock of anterior glenoid. The SLAP lesion and the anterior capsulolabral lesion were repaired properly to the glenoid. We report a case of glenoid-cartilage avulsion type of SLAP Ⅱwith anterior labrocapsular lesion.
Simple Radiographic Analysis of Chronic Shoulder Pain in Patients 50 Years and Older
Yoo Chong II ; Kim Hui Taek ; Eun II Soo ;
Clinics in Shoulder and Elbow, volume 7, issue 1, 2004, Pages 14~22
DOI : 10.5397/CiSE.2004.7.1.014
Purpose: To evaluate a usefulness of the simple radiograph in the patients with chronic shoulder pain 50 years and older. Material and method: 1152 patients with chronic shoulder pain and 100 asymptomatic individuals were involved in this study. All patients were 50 years and older. We excluded patients who had a history of fracture or dislocation. Radiographic interpretation was performed on a shoulder AP view, an axillary view and a supraspinatus outlet view. For statistical analysis, a chi-square test was performed. A p value of <0.05 was considered statistically significant. Results: Abnormal radiologic findings were identified in 369(32%) out of 1152 patients with a shoulder pain: greater tuberosity sclerosis, acromial sclerosis, subacromial osteophytes are common abnormal radiologic findings. A rotator cuff tear or impingement syndrome was identified on a final diagnosis in 61(85.2%) out of the 76 patients with radiologic abnormalities in both greater tuberosity and acromion (p<0.05). Abnormal radiologic findings were identified in 18% of the asymptomatic individuals. Conclusion: Simple radiographic analysis is an important primary diagnostic tool in patients (50 years and old) with chronic shoulder pain.
Treatment of Anterosuperior Rotator Cuff Tear
Moon Gi Hyuk ; Ahn Gil Young ; Lee Jae Wook ; Yoo Yon Sik ;
Clinics in Shoulder and Elbow, volume 7, issue 1, 2004, Pages 23~29
DOI : 10.5397/CiSE.2004.7.1.023
It has been reported that rotator cuff tear have good response to arthroscopic or open repair even if the range being so wide. However, the majority of this literature regarding the diagnosis and treatment of tear focused on lesion of the supraspinatus and infraspinatus tendons. But involvement of the subscapularis tendon with rotator cuff tear should be thought to be less common and poorer to open operative repair. Furthermore, some europian author have stated that the rotator cuff tear including the subscapularis tendon are sufficiently distinct in their clinical presentation and prognosis as to merit separate consideration of their diagnosis and treatment. The purpose of this study is to evaluate result of arthroscopic or open repair in patient with rotator cuff tear that include the subscapularis tendon. Of the 128 rotator cuff repairs performed from 1998 through 2003, 12 had a tear that include the subscapularis tendon in combination with the supraspinatus (8 cases) and infraspinatus (4 cases). Mean duration of symptoms before surgical treatment was 6 months (range 3 to 12 months). All 12 patient demonstrated a positive lift off sign. Shoulder function was assessed using the Constant- Murley score, which ranges from 30 to 58. Pain was assessed using a linear visual analogue scale range from 0 to 10. Postoperative Constant score range from 40 to 64 (average 47.8). Pain score improved from 5.5 to 8.5, but there are postoperative pain improvement on nothing in 5 patient. The overall result for 12 patient were satisfy in 2, fair in 5 and dissatisfy in 5: Therefore satisfactory result were noted only in 16 % of this overall group. In conclusion, we have failed to make good result in patient with rotator cuff tear that included the subscapularis tendon. At the result, outcome after surgical repair of this type of rotator tear is comparatively inferior to the result of operative repair of rotator cuff not involved the subscapularis tendon.
Arthroscopic Assisted Mini-open Repair of Rotator Cuff Tear - 5∼8 Years Follow-up Results -
Kim Young-Mo ; Rhee Kwang-Jin ; Shin Hyun-Dae ; Byun Ki-Yong ; Kim Kyung-Cheon ; Hong Ui-Pyo ;
Clinics in Shoulder and Elbow, volume 7, issue 1, 2004, Pages 30~34
DOI : 10.5397/CiSE.2004.7.1.030
Purpose: To report our experience of treatment of rotator cuff tear and evaluate the mid-term outcome. Materials and Methods: We have performed 50 cases of mini-open rotator cuff repair from March 1996 to March 1999. Male to female ratio was 34：16, the average age 46.5(23∼57) years old, mean follow-up period was 78(62∼93) months. All-arthroscopic repair and open repair cases were excluded. Mean symptomatic period was 12.5(6∼38) months, operation was indicated in cases of no improvement by 6 months of conservative management. Preoperative simple radiographs and Magnetic resonance arthrography were obtained in all cases. We also observed the inflammation, synovitis, thickness of tear and associated pathology intraoperatively. We evaluated pain, function, and range of motion by UCLA score. Results: Overall UCLA score was mean 29.5 points. Excellent 25, good 18, poor 7 cases. Mean pain score was improved 2.6 to 7.5, 44 cases(88%) were improved and 6 cases(12%) were not improved. Mean functional score was improved 3.4 to 8.5, and activity at follow up, 25 cases(50%) were same, 8 cases(14%) were above, 17 cases(34%) were below compared with preoperative level. Mean active forward flexion was preoperative 112° to postoperative 160°, forward flexion strength was improved 3.8 to 4.7. 43 cases(86%) of patients were satisfied at the result, 7 cases(14%) were not satisfied or aggravated. Results: Mini-open rotator cuff repair was effective method in treating rotator cuff tear.
Effects of Calcific lesion on Shockwave Therapy of the Tennis Elbow
Lee Seok-Beom ; Kwon Duck-Joo ; Song Young-Joon ; Lee Kee-Byung ;
Clinics in Shoulder and Elbow, volume 7, issue 1, 2004, Pages 35~40
DOI : 10.5397/CiSE.2004.7.1.035
Purpose: The aim of this study was to investigate effects of calcific lesion on shockwave therapy of the tennis elbow. Materials and Methods: twenty-four patients with refractory tennis elbow were treated with shock waves. The patients were evaluated by assessment of pain using visual analog scale (VAS) and simple elbow test (SET). Comparision of clinical outcomes for the patients with and without calcification in the extensor tendon and/or cortical irregularity of lateral condyle was tried to determine if this could be a possible prognostic factor in clinical settings. Overall clinical outcomes were evaluated by Roles and Maudsley score at 12 months after ESWT. Results: Significant improvement of symptoms were observed in 20 (83 %) patients at 12 months follow up according to Roles and Maudesley scores. The patients with calcification and/or cortical irregularity improved significantly better, when compared to the patients without calcification and/or cortical irregularity at follow up. Conclusion: This study suggests that shock waves therapy could be considered as effective and noninvasive treatment modality for refractory tennis elbow. Also calcific deposit in extensor tendon and/or cortical irregularity of the lateral epicondyle was seem to be good prognostic factor for shock wave therapy for tennis elbow
Arthroscopic Treatment of Post-traumatic Stiff Shoulder by Rotator Interval Bridging Scar Adhesion - Case Report -
Kim Young-Mo ; Rhee Kwang-Jin ; Kim Kyung-Cheon ; Byun Byung-Nam ;
Clinics in Shoulder and Elbow, volume 7, issue 1, 2004, Pages 41~45
DOI : 10.5397/CiSE.2004.7.1.041
In adhesive capsulitis of the shoulder of no response to nonoperative treatment, an arthroscopic capsular release and manipulation improves range of motion and pain relief. We performed an arthroscopic examination in the stiff shoulder, of which she had no response to nonoperative treatment, after the conservative treatment of a clavicular shaft fracture by motorcycle-driver traffic accident. We found the intra-articular `rotator interval bridging scar adhesion` between subscapularis tendon and antero-superior glenoid fossa under the rotator interval which was no adhesion and contracture itself. We performed the scar adhesion removal and synovectomy, maintaining the rotator interval. We recommended nonsteroidal anti-inflammatory drug for postoperative pain relief and continuous active and passive range of motion (ROM) exercise to gain motions. Preoperatively, active and passive range of motion were 70° for forward elevation, 60° for abduction and especially 0° for external rotation. After postoperative 2 months, active ROM were 150° for forward elevation, 130° for abduction and 80° for external rotation. After postoperative 6 months, passive and active ROM were full. UCLA score improved from preoperative 9 points to postoperative 29 points.
Snapping Scapula with Congenital Bilateral Elbow Fusion
Choi Chang-Hyuk ; Koh Sang-Bong ; Kim Tae-Hoon ;
Clinics in Shoulder and Elbow, volume 7, issue 1, 2004, Pages 46~50
DOI : 10.5397/CiSE.2004.7.1.046
The snapping scapula is a relatively uncommon phenomenon occuring as a consequence of some anomalous conditioin existing between the thoracic wall and the undersurface of the scapula. It may present in several ways like crepitus, pain during scapular movement and limitation of scapular motion. The causes of snapping scapula are changes in the intervening soft tissues, the muscles, or the bursae between the scapula and the chest wall; and changes in the congruence between the anterior scapular surface and the underlying chest wall. The congenital elbow fusion or humeroradioulnar synostosis is an extremely rare inheritable disorder that previously described just a few reports. Recently we experienced a case of snapping scapular with congenital bilateral elbow fusion treated by arthroscopic scapulothoracic bursectomy and consequent open superomedial scapulectomy. We would describe the clinical feature of a snapping scapula and result of treatment with literature review.
Isolated Unilateral Hypoglossal Nerve Palsy after Shoulder Surgery in Beach-Chair Position - Case Report -
Lee Yong Girl ; Lee Dong-hun ;
Clinics in Shoulder and Elbow, volume 7, issue 1, 2004, Pages 51~55
DOI : 10.5397/CiSE.2004.7.1.051
Arthroscopic surgery of the shoulder is regarded as a convenient and safe approach, but there is a possibility of complication during procedure. We report an isolated unilateral hypoglossal neurapraxia following combined arthroscopic and open Bankart reconstruction performed in beach-chair position under general anesthesia with orotracheal intubation.