• Clinics in Shoulder and Elbow
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• v.2 no.2
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• pp.157-169
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• 1999

Eighty-nine shoulders in eighty-eight patients with traumatic unilateral anterior shoulder instability were evaluated for Rowe and UCLA scores, recurrence, return to activity, and range of motion by an independent examiner at an average of 39 months after either arthroscopic or open Bankart repair using suture anchors. The arthroscopic technique included a minimum of 3 anchors, and a routine incorporation of capsular plication and proximal shift. Twenty­six shoulders(86.6%) out of thirty in the open Bankart repair group had excellent or good results while fifty­four(91.5%) of the fifty-nine shoulders with arthroscopic Bankart repair had excellent or good results. The arthroscopic group revealed significantly better results in the Rowe(p=.041) and UCLA scores(p=.026). Two shoulders in each group developed redislocation. There were no significant differences in the loss of external rotation and return to prior activity between the two groups(p>.05). The residual instability occurred more frequently in the group of patients with lesser anchors. Arthroscopic suture anchor capsulorraphy has results equal to or better than the open Bankart procedure.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2007.11a
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• pp.153-161
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• 2007

견관절의 ABER position에서 posterosuperior rotator cuff 가 posterior glenoid에 contact 하여 internal impingement가 일어나는 현상은 운동선수가 아닌 일반인에게도 발생하는 physiologic phenomenon이며 과도한 반복 동작으로 인하여 증상이 발현한다. Internal impingement는 증상이 모호할 뿐만 아니라 견관절 내 여러 병소가 함께 존재하기 때문에 각각의 pathology에 대한 자세하고 정확한 evaluation이 필수적이다. 아직 controversy가 있지만 internal impingement의 pathologic factors로서는 anterior capsular laxity (true anterior laxity), posteroinferior capsular tightness (pseudo anterior laxity)와 이로 인한 glenohumeral internal rotation deficit (GIRD), 그리고 SICK scapula syndrome (scapular dyskinesis) 등으로 요약할 수 있다. 진단은 주로 병력 청취와 신체 검사로 내려지며 ultrasonogram, MRA등으로 확진한다. Sleeper stretching exercise 등과 같은 보존적 치료에 반응이 좋지만 6개월간의 재활 치료에도 호전이 없다면 증상과 직접 관련된 주 병소(appropriate pathology)를 찾아 이에 대한 적절한 수술이 이루어져야 한다.

• The Journal of the Korea Contents Association
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• v.9 no.11
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• pp.271-279
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• 2009

Frozen shoulder is clinically characterized by pain and reduced ROM. The therapeutic goal of frozen shoulder can be reducing pain and increasing ROM in shoulder joint, resulting in improvement of joint movement. Therefore, this study was conducted to know the effect of mobilization in parallel with conservative physical therapy(H/P, TENS, U/S) in patients with frozen shoulder on subjective pain scale and ROM. 26 patients diagnosed with frozen shoulder were included for study. Among them, 13 patients(experiment group) were managed by mobilization as well as conservative physical therapy, another 13 patients(control group) were only treated by conservative physical therapy alone. All the patients were treated three times a week for 4 weeks, and after each treatment subjective pain scale and ROM were measured. In experimental group, pain has decreased and ROM has increased in abduction, external rotation and internal rotation. In control group, pain has also decreased but ROM has not changed in abduction, external rotation and internal rotation. There were no significant difference in subjective pain scale between two groups but some difference in ROM (external rotation, internal rotation). According to the results, we concluded that both conservative physical therapy and joint mobilization technique are more effective for increasing ROM especially external rotation, internal rotation than conservative physical therapy alone.

• Journal of the Korean Orthopaedic Association
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• v.54 no.2
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• pp.110-119
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• 2019

Proximal humerus fracture can be defined as a fracture that occurs in the surgical neck or proximal part of the humerus. Despite the appropriate treatment, however, various complications and sequelae can occur, and the treatment is quite difficult often requiring surgical treatment, such as a shoulder replacement. The classification of sequelae after a proximal humerus fracture is most commonly used by Boileau and can be divided into two categories and four types. Category I is an intracapsular impacted fracture that is not accompanied by important distortions between the tuberosities and humeral head. An anatomic prosthesis can be used without greater tuberosity osteotomy. In category I, there are type 1 with cephalic collapse or necrosis with minimal tuberosity malunion and type 2 related to locked dislocation or fracture-dislocation. Category II is an extracapsular dis-impacted fracture with gross distortion between the tuberosities and the humeral head. To perform an anatomic prosthesis, a tuberosity osteotomy should be performed. In category II, there are type 3 with nonunion of the surgical neck and type 4 with severe tuberosity malunion. In type 1, non-constrained arthroplasty (NCA) without a tuberosity osteotomy should be considered as a treatment. On the other hand, reverse shoulder arthroplasty (RSA) should be considered if types 1C or 1D accompanied by valgus or varus deformity or severe fatty degeneration of the rotator cuff. In general, the results are satisfactory when NCA is performed in type 2 sequelae. On the other hand, RSA can be considered as an option when there is no bony defect of the glenoid and a defect of the rotator cuff is accompanied. In type 3, it would be effective to perform internal fixation with a bone wedge graft rather than shoulder replacement arthroplasty. Recent reports on the results of RSA are also increasing. On the other hand, recent reports suggest that good results are obtained with RSA in type 3. In type 4, RSA should be considered as a first option.

• Journal of the Korean Arthroscopy Society
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• v.17 no.1
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• pp.95-99
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• 2013

We introduce arthroscopic Bankart repair technique using antegrade suture passer that can effectively restore detached anteroinferior capsulolabral complex for shoulder anterior instability. After diagnostic arthroscopy is performed using posterior, anteroinferior and anterosuperior portals, we confirm Bankart lesion and perform debridement and decortications of anteroinferior glenoid edge and neck. Suture anchor is inserted through anteroinferior portal at 2 mm medial side of glenoid edge (4:30 direction). Scorpion$^{TM}$ loaded suture is directly advanced to detached and retracted anteroinferior capsulolabral complex and the suture is passed at 10~15 mm medial side of detached anteroinferior capsulolabral complex (5:30 direction). The suture is retrieved by Scorpion's hook and then is tied using samsung medical center (SMC) sliding knot technique. Then suture anchors are serially inserted (2:30, 3:30) and capsulolabral complex repair is performed using suture hook and suttle-relay technique. This technique that can obtain anatomical restoration of anteroinferior glenohumeral ligament with proper tension is useful technique to reduce postoperative recurrence and makes it possible for less experienced surgeons.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.1
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• pp.105-110
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• 2010

Purpose: Three phase bone scan was considered sensitive in Patients with Reflex Symphathetic Dystrophy Syndrome (RSDS). Generally, three phase bone scan in the RSDS patients shows increased uptake of one side extremity joint. But three phase bone scan has been performed with flow, blood pool and delayed scan. We performed blood pool half body scan in order to investigate its usefulness. Materials and Methods: From October 2007 to September 2009, three phase bone scan (flow, blood pool, half body blood pool, delayed) was performed after injection of 750 MBq of $^{99m}Tc$-DPD in diagnosed patients with RSDS (M:F=8:7, R:L=9:6). For quantitative analysis, we obtained the count ratios of bilateral hands by drawing a region of interest (ROI) in the three phase images and compared with the count ratios of shoulders in half body blood pool and delayed images. Results: In flow images, right/left ratios were $1.09{\pm}0.53$. In blood pool images, right/left ratios were $1.13{\pm}0.47$ (hand), $1.08{\pm}0.26$ (shoulder). In delayed images, right/left ratios were $1.24{\pm}0.75$ (hand), $1.11{\pm}0.31$ (shoulder). As a result, Log of right/left counts of the others and that of shoulder blood pool image were correlated well with statistical significance (Spearman's R, p<0.005 SPSS for windows ver.12.0). Conclusion: Half body blood pool scan may be helpful in the diagnosis of patients with RSDS. Moreover, Half body blood pool scan reduced false negative and false positive rates. In order to improve agreement on interpretation of RSDS, Blood pool half body scan should be established as common criteria.

• Journal of Korean Orthopaedic Sports Medicine
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• v.5 no.2
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• pp.110-116
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• 2006

Lesion of the superior glenoid labrum and the insertion of the biceps tendon are a common cause for shoulder pain in patients performing overhead sports. Medial shearing stress during overhead throwing may cause biceps instability and associated rotator cuff problem aggravates the symptoms. Careful attention to the history and physical examination and may arouse suspicion of injury to the biceps tendon and the superior labral complex. Progress in shoulder arthroscopy has led to the identification of the lesion and normal variation. Treatment should be directed according to the type of lesion and related symptoms.

• Clinics in Shoulder and Elbow
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• v.11 no.2
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• pp.150-157
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• 2008

Purpose: We wanted to evaluate the results of surgical treatment for fracture of the scapular body. Materials and methods: The subjects of this study were seven patients with fracture of the scapular body and all these patients were managed surgically. We considered the operative indications as being 100% translation of the lateral border, or $25^{\circ}$ of angular deformity of the glenoid, or 1cm medialization or the variant of the double disruption of the superior scapular suspensory complex. There were five males and two females, and their ages ranged between 40 and 58 years (mean age: 49) with average follow up of 11 months (6~24 months). Two patients sustained multiple fractures of the ribs and spines. The surgical results were evaluated according to the subjective satisfaction, the UCLA score and the Korean shoulder score. Results: The mean UCLA score was 29 (17~33) and the mean Korean shoulder score was 86 (63~94). The self assessment for subjective satisfaction was 7.7 (4~9). There were two complications; one case of screw pull-out without the loss of the fracture fixation and the other case with screw penetration of the glenoid cavity. Conclusion: Surgical treatment may be effective for the management of severely displaced fracture of the scapular body in order to prevent the impairment of the shoulder function caused by the altered glenohumeral and scapulothoracic kinematics.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.2 no.2
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• pp.74-78
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• 2009

Purpose: To evaluate the effectiveness of ultrasonography-guided multiple needling for calcific tendinitis of the shoulder. Materials and Methods: We included 18 symptomatic calcific tendinitis patients who underwent ultrasonography-guided multiple needling and followed for average 17 weeks. The procedures were multiple needling or aspiration of the calcific deposit and injection of local anesthetics and steroid into the subacromial bursa under the ultrasound control. Clinical improvements were evaluated using pain VAS, UCLA score and KSS score. The size and status of calcific deposits were compared. Results: A significant improvement was seen in pain VAS, UCLA score and KSS score (p<0.05). At the final follow up, the calcific deposits had resolved completely of nearly completely in 39%, and the size was decreased in 61%. Conclusion: Ultrasound-guided multiple needling is considered as a useful method which could provide prompt pain relief and reduce calcific deposit for calcific tendinitis of the shoulder.

• Clinics in Shoulder and Elbow
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• v.10 no.2
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• pp.212-219
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• 2007

Purpose: To determine the causes of the surgical treatment results in glenoid fracture by a retrospective analysis. Materials and methods: From March 1999 to February 2004, 9 patients who underwent an open reduction due to a glenoid fracture were reviewed. The modified Ideberg classification was used. There were 1, 3, 2, 1 and 2 cases of modified Ideberg type I, II, III, V, and VI, respectively. The internal fixators were a reconstruction plate, a small plate, a one-third tubular plate, a small screw, and a cannulated screw in 6, 1, 3, 3 and 1 case, respectively. The constant score and Adam's functional assessment method were used to evaluate the postoperative shoulder function. Results: The average time for fracture union was 7 weeks. The functional assessment was excellent in 4 cases, good in 3 cases, and fair in 2 cases. There were two complications related to surgery; articular screw encroachment, and inferior glenoid bone resorption without instability. Conclusion: A glenoid fracture with glenohumeral instability or displaced that was treated by open surgery showed good clinical results. Moreover, the more comminuted fracture had a lower functional score.