• Journal of the Korean Arthroscopy Society
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• v.14 no.3
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• pp.192-195
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• 2010

Subcoracoid impingement resulting from abnormal contact between the anterosuperior humerus and the anterior coracoacromial arch represents an uncommon source of anterior shoulder pain. Certain operative procedures can also alter the relationship between the coracoid and the lesser tuberosity, leading to impingement of the interventing soft tissue, including the subscapularis and the bursa. We describe an unique case of subcoracoid impingement with the tear of subscapularis tendon after the internal fixation of the fractured coracoid process with cannulated screw due to crowding of the coracohumeral space. Arthroscopic removal of the screw and repair of the subscapularis in our patient resulted in successful resolution of his symptoms. Although subcoracoid impingement is a rare cause of shoulder pain, failure to diagnose and treat this condition may represent a significant cause of failed shoulder surgery.

• 대한관절경학회:학술대회논문집
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• 2009.10a
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• pp.14-22
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• 2009

회전근 개 부분 파열은 노화의 과정 중 생기는 무증상의 병변 또는 견관절 기능 장애의 잠재적인 원인으로 생각되었다. 발병 원인은 해부학적인 원인에 의한 충돌 또는 반복적 미세 외상 등이 원인으로 이해되고 있으며 병리생태에 관한 이해가 깊어지고 진단 기구, 즉 초음파나 자기공명영상, 관절경 등의 발달로 발생률이 과거에 비해 증가하고 있다. 그러나 회전근 개부분 파열은 질환 자체보다 전층 파열로 진행하는 일종의 질환 스펙트럼(disease spectrum)의 개념으로 전층 파열에 비해 현재까지 발표된 연구 자료가 많지 않다. 즉 회전근 개 부종, 견봉과의 마찰로 생긴 염증성 건병증, 회전근 개 섬유화 및 부분 또는 전층 파열로 진행되는 회전근 개 병변의 스펙트럼의 일부로 간주되는 경우가 많다. 본 종설은 회전근 개 부분 파열의 진단, 파열 분류, 수술의 적응증 및 수술 방법과 그 결과에 대해 논하고자 한다.

• Journal of Korean Orthopaedic Sports Medicine
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• v.10 no.1
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• pp.4-7
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• 2011

Rotator cuff disease is one of the most common shoulder problems. When dealing with patients suffering from rotator cuff disease, whether to perform surgery or not is the most common difficulty faced by the outpatient clinic. Choosing the adequate operation time as well as the method of operation is important when deciding to perform surgery. Selecting the type of non-surgical treatment is an important issue when opting not to perform surgery. This review article will focus on the decision-making process involved in the treatment of rotator cuff disease.

• Clinics in Shoulder and Elbow
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• v.10 no.2
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• pp.183-189
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• 2007

Introduction: While uncommon, humeral head osteonecrosis is an indication for arthroplasty when the humeral head collapse is advanced. The current authors report the short-term clinical results of 7 hemiarthroplasties to treat humeral head osteonecrosis. Materials and Methods: This study focused on 7 reconstructed shoulders of 5 patients whose humeral head osteonecrosis was treated with hemiarthroplasty. The postulated causes were alcohol-induced (4 cases) and steroidinduced (3 cases). The minimum follow-up was 12 months. This study compared the preoperative and postoperative shoulder pain, range of motion, and ASES scores. The postoperative patient satisfaction was assessed. Results: The level of pain during exercise was reduced from a preoperative average of 7.6 to a postoperative average of 1.9. The range of motion, in terms of forward flexion, abduction, and external rotation, improved from preoperative averages of $105.7^{\circ}$, $80^{\circ}$, and $22.1^{\circ}$ to postoperative averages of $146.6^{\circ}$, $139.3^{\circ}$, and $44.3^{\circ}$, respectively. The ASES scores increased from a preoperative mean of 39.0 to a postoperative mean of 84.1. The patients' ratings of the outcomes were excellent (5 cases) and good (2 cases). Conclusions: These short-term results indicate that hemiarthroplasty is a reliable treatment method for humeral head osteonecrosis improving shoulder pain, range of motion, and patient satisfaction.

• Clinics in Shoulder and Elbow
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• v.15 no.1
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• pp.52-64
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• 2012

Acute traumatic shoulder injuries related to motor vehicle accidents and industrial accident has shown a steep increase recently. In regard to the causal relationship and the previous illness, the rotator cuff tear and SLAP lesion are the mostly debated among shoulder injuries related to trauma. Both the possibility of spontaneous occurrence related to their degenerative etiology and the discordance between the extent of injury and the symptom of the rotator cuff tear and SLAP lesion, make it difficult and obscure to estimate the extent of involvement of accident. Therefore, the Insurance Committee of Korean Shoulder and Elbow Society performed a questionnaire for the shoulder specialists to investigate their criteria about deciding the treatment modalities and SLAP lesion and reviewed literatures regarding the causal relationship between the accident and the rotator cuff tear and SLAP lesion. The committee recommended the diagnostic criteria to judge contribution of the accident on traumatic shoulder injuries, and to offer a guideline for disabilities.

• Journal of radiological science and technology
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• v.29 no.2
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• pp.57-62
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• 2006

Purpose : This study was to understand about the measurement of shoulder motion fraction and motion ratio. We proposed the radiological criterior of glenohumeral and scapulothoracic movement ratio. Materials and Methods : We measured the motion fraction of the glenohumeral and scapulothoracic movement using CR(computed radiological system) of arm elevation at neutral, 90 degree, full elevation. Central ray was $15^{\circ},\;19^{\circ},\;22^{\circ}$ to the cephald for the parallel scapular spine, and the tilting of torso was external oblique $40^{\circ},\;36^{\circ},\;22^{\circ}$ for perpendicular to glenohumeral surface. Healthful donor of 100 was divided 5 groups by age(20, 30, 40, 50, 60). The angle of glenohumeral motion and scapulothoracic motion could be taken from gross arm angle and radiological arm angle. We acquired 3 images at neutral, $90^{\circ}$ and full elevation position and measured radiographic angle of glenoheumeral, scapulothoracic movement respectively. Results : While the arm elevation was $90^{\circ}$, the shoulder motion fraction was 1.22(M), 1.70(W) in right arm and 1.31, 1.54 in left. In full elevation, Right arm fraction was 1.63, 1.84, and left was 1.57, 1.32. In right dominant arm(78%), $90^{\circ} and Full motion fraction was 1.58, 1.43, in left(22%) 1.82, 1.94. In generation 20, $90^{\circ} and Full motion fraction was 1.56, 1.52, 30' was 1.82, 1.43, 40' was 1.23, 1.16, 50' was 1.80, 1.28, 60' was 1.24, 1.75. There was not significantly by gender, dominant arm and age. Conclusion : The criterior of motion fraction was useful reference for clinical dignosis the shoulder instability.

• Journal of the Korean Arthroscopy Society
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• v.12 no.1
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• pp.69-73
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• 2008

Synovial chondromatosis is an uncommon condition, and the involvement of the shoulder joint is rare. A 15 year old female patient presented to author's institution for right shoulder pain. We checked the plain radiographs and MRI. And they showed that a diagnosis of synovial chondromatosis in the shoulder, and they also demonstrated that the disease involved the bicipital tendon sheath as well as glenohumeral joint. We removed all loose bodies with total synovectomy by arthroscopic procedure, and a miniopen procedure for the lesions of biceps tendon sheath. Arthroscopic treatment affords excellent visualization of the shoulder joint with less morbidity. However, with current arthroscopic techniques, it is difficult to manage the synovial chondromatosis of biceps tendon in bicipital groove. The authors suggest that the complete elimination of synovial chondromatosis involving shoulder requires a mini-open procedure for the lesions of biceps tendon sheath in addition to the arthroscopic resection of the affected synovium and loose body removal in the glenohumeral joint.

• 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.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.7 no.2
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• pp.120-126
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• 2014

Acromioclavicular (AC) joint cyst is an uncommon presentation around the shoulder joint that is usually associated with chronic rotator cuff pathology and degenerative AC joint arthritis. Understanding the underlying pathophysiology of the shoulder joint is essential for appropriate interpretation of the AC joint cyst, assistance in determining the therapeutic strategy, and prevention of complications after treatment. We present a case of AC joint cyst with an aseptic fistula which was complicated by simple excision for recurred AC joint cyst after multiple aspirations. This case revealed a massive rotator cuff tear involving supraspinatus, infraspinatus, and subscapularis tendon on ultrasonography. We also reviewed the clinical approach and treatment options to be considered for its pathogenesis in the literature.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2007.11a
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• pp.88-94
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• 2007

회전근개의 치료의 방침은 거의 전층 파열인 부분파열과 전층파열이고 봉합이 불가능하거나 봉합의 비적응증을 제외하고는 모두 수술로 봉합하여주는 것이 좋으며 그 방법으로는 관절경과 관절경하 miniopen 술식이 적절한 봉합방법으로 생각된다. 봉합의 기본적인 원칙은 최대한 파열된 건의 anatomic footprint reconstruction과 force couple의 balancing (견갑하근과 극하근건의 복원)이 중요하며 적절한 재활과 함께 동반 시 좋은 결과를 얻을 수 있을 것으로 사료된다.