• Title/Summary/Keyword: 견관절 질환

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Recurrent Shoulder Dislocation and Proximal Humerus Fracture in Neurofibromatosis Type I - A Case Report - (제 1형 신경 섬유종증 환자에서 발생한 재발성 견관절 탈구 및 근위 상완골 골절 - 1예 보고 -)

  • Hwang, Tae Hyok;Cho, Hyung Lae;Wang, Tae Hyun;Yang, Hui Sun
    • Clinics in Shoulder and Elbow
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    • v.16 no.2
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    • pp.135-140
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    • 2013
  • We report a case of recurrent shoulder dislocation and combined proximal humerus fracture in neurofibromatosis type I. A twenty-year-old male patient with known neurofibromatosis type I presented with right shoulder dislocation and proximal humerus fracture following a minor trauma. His injured arm also had large plexiform neurofibromas on the elbow, and the dislocation of the shoulder joint was proven to be recurrent. Bony deformation of the humerus and scapula were revealed on X-ray and computed tomography, as well as multiple neurofibromatic changes of the deltoid and periscapular muscles were noted on magnetic resonance imaging. Open reduction and capsular reconstruction were performed and humeral fracture was stabilized with a reconstruction plate. Satisfactory union and functional result were achieved and the dislocation did not recur until the 7-month followup after the procedure. Recurrent shoulder dislocation and combined proximal humerus fracture in neurofibromatosis type I are rare complications. However, it should still be considered in the orthopaedic evaluation process of the diseases.

Acromial Morphology in Different MR Oblique Sagittal Slices: Correlation with Rotator Cuff Disorder (자기 공명 영상의 사 시상면에서의 견봉 형태의 변화: 회전근 개 질환과의 임상적 연관성 분석)

  • Jo, Chris H.;Kim, Ji-Beom;Choi, Hye-Yeon;Ko, Young-Whan;Yoon, Kang-Sup;Lee, Ji-Ho;Kang, Seung-Baik;Lee, Jae-Hyup;Han, Hyuk-Soo;Rhee, Seung-Whan
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.173-179
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    • 2009
  • Purpose: On the hypothesis that the acromion morphology is changed according to the its site, we identified the morphology of the acromion on the oblique slices of MRI and we investigated the association of the acromial shape with the clinical stages of rotator cuff disorder on the magnetic resonance (MR) images. In addition, we compared the acromion morphology on MRI and simple X-rays. Material and Methods: The MR images of seventy one patients with rotator cuff disorder and who underwent arthroscopic surgery were compared with that of a control group of sixteen patients who didn't have rotator cuff disorder on MRI. On three subsequent oblique sagittal slices from the lateral edge of the acromion (S1, S2 and S3), each acromion morphology on the MRI slices was classified according to Epstein et al: flat, curved or hooked. We investigated the changing parttern of the acromion shape and we compared the acromion shape on MRI and that on simple X-rays. We classified the rotator cuff tear by the severity: bursitis, partial thickness tear or full thickness tear. We investigated which acromial type on the MRI oblique slice was associated with the severity of rotator cuff disease. Results: Changes of the acromial shape occurred in 54 patients (76.1%). The most frequent pattern was that the types are same on S1 and S2 and different on S3 (22 cases, 31.0%). The acromial type on S1 and S2 was significantly associated with the severity of rotator cuff disorder (p=0.001 and 0.022), respectively. There was no reliability of the acromial shape on MRI and roentgenography (p>0.05) Conclusion: The type of acromion changed from lateral to medial. Among the three positions, the shape of the acromion on S1 and S2 had meaningful correlation with the clinical stage of rotator cuff disorder. There was no statistical correlation of the acromial shape between MRI and simple X-ray.

Hemarthrosis Occurred after Arthroscopic Rotator Cuff Repair in a Chronic Renal Failure Patient with a Stenosis in an Ipsilateral Arteriovenous Fistula (동측의 동정맥루를 가진 만성 신부전증 환자의 회전근개 파열에 대한 관절경적 수술 이후 발생한 혈관절증)

  • Huh, Soon Ho;Kim, Se Jin;Park, Jin Yeong;Kang, Kyung Rok
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.4
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    • pp.366-371
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    • 2019
  • Hemarthrosis occurring after arthroscopic surgery for lesions of the shoulder joint is a very rare complication that can develop due to an injury to the blood vessels when an anterior portal is formed. This is a complication that rarely develops in patients who are taking antithrombotic drugs or who do not have associated diseases, such as thrombocytopenia. We report a case of hemarthrosis that occurred after performing arthroscopic surgery to repair a rotator cuff tear in a patient with a stenosis in an arteriovenous fistula for hemodialysis in the ipsilateral upper arm.

Inferior Capsular Shift Procedure using Splitting Subscapularis and Capsule for Instability of the Shoulder (견관절 불안정성의 견갑하근 및 관절 낭 수평 분할을 이용한 하방 관절 낭 이동술)

  • Park Jin-Young;Lim Soo-Taek;Yoo Moon-Jib;Lyu Suk-Joo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.1
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    • pp.102-107
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    • 2002
  • Purpose: The aim of this retrospective study were to report the short-term results of inferior capsular shift procedure using splitting subscapularis and capsule for the patients who had shoulder instability and were apt to recur after arthroscopic stabilization procedure. Materials & Methods : Fifteen cases of instability of the shoulder were included with an average follow-up of 2 years (range: 1$\~$3 years). There were 13 men and 2 women with an average age of 27years. Multidirectional instability was found in 4 cases, voluntary instability in 3 cases, bony Bankarte lesion in 2 cases and 6 cases were contact sportmen. Thirteen shoulders underwent the inferior capsular shifts and Bankart repairs and 2 shoulders without Bankart lesion underwent the inferior capsular shift only. Average 19 mm of shift (range: 10$\~$25 mm) was done. Results : Fourteen patients showed good and excellent results with one subluxation and one positive apprehension test. Postoperative ranges of motions did not change in forward elevation, external rotation at side and external rotation at 90$^{\circ}$ abduction (p>0.05). Conclusion : Inferior capsular shift procedure using splitting subscapularis and capsule can be helpful in shoulder instability patients who were high-risk group of recurrence with arthroscopic procedure.

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Phase-dependent Progress of Recalcitrant Calcific Tendinitis of the Shoulder after Removal (불응성 견관절 석회성 건염의 제거술 후 시기별 경과)

  • Moon, Young-Lae;Noh, Kyung-Hwan;Chang, Ji-Hoon
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.2
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    • pp.98-101
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    • 2008
  • Purpose: To evaluate the results of arthroscopic removal of calcific deposit depending on the phase-dependent progress of recalcitrant calcific tendinitis of the shoulder. Materials and Methods: From January, 2003 to September, 2007, arthroscopic treatment of calcific tendinitis of the shoulder joint, especially supraspinatus was performed in 27 consecutive patients who had had typical symptoms and failed with the conservative treatment and all patients could be followed up at least 6 months. We evaluated the visual analogue scale at preoperative, postoperative 2 weeks and 6 months. The results were compared according to the arthroscopic findings. Results: 11 cases were chalky calcium deposit of arthroscopic finding and 16 cases were toothpaste-like appearance. The VAS was 8.0 of the group with chalky deposit and 8.3 with toothpaste-like deposit preoperatively, which was not significantly different. However, at postoperative 2 weeks, it was 6.7 with chalky deposit and 2.7 with toothpaste-like, which is significantly different. At postoperative 6 months, the symptoms of all patients were resolved. Conclusion: Resorptive phase is well respond to surgical excision at early postoperative evaluation. The phase of calcific tendinitis is one of important factors for rapid resolution of the shoulder pain and functional improvement after arthroscopic treatment.

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Ultrasonographic Findings of the Shoulder in Asymptomatic High School Baseball Players (무증상 고교 야구 선수의 견관절 초음파 소견)

  • Hwang, Tae Hyok;Cho, Hyung Lae;Wang, Tae Hyun;Yang, Hee Soon
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.11 no.2
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    • pp.75-81
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    • 2012
  • Purpose: To evaluate the ultrasonographic (US) findings in both shoulders of asymptomatic high school baseball players and compare with healthy control. Materials and Methods: 42 individuals (age: $7.6{\pm}1.2$ years) participated in this study. We recruited two groups of high school male baseball players, 14 pitchers and 18 fielders without shoulder pain for recent 6 months as well as one control group of 10 untrained healthy high school students who were age-matched. Ultrasound measurements of thickness of the biceps and supraspinatus tendon and acromio-humral distance (AHD) at $0^{\circ}$ abduction were taken in dominant and nondominant shoulders. Results: On US examination, subacromial bursa effusion was observed in 7 of the dominant shoulders and in 2 of the nondominant shoulder of 32 baseball players and in none of the asymptomatic controls. The thickness of the biceps and supraspinatus tendons and AHD in both shoulders were significantly greater in the baseball players than in the controls (p<0.05). We also found that the biceps and supraspinatus tendon thickness and AHD of the dominant shoulder were significantly greater than the non-dominant shoulder in baseball players (p<0.05), but there were no differences between pitchers and fielders and between healthy controls. Conclusion: Subacromial effusion could be found even in the asymptomatic stage and the thickness of the biceps and supraspinatus tendons and AHD were significantly greater in the baseball players than in the healthy controls. Our data is useful reference guide for the ultrasonographic diagnosis of shoulder pathologies occurring in high school baseball players.

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Ultrasonographic Findings of the Shoulder in Asymptomatic High School Overhead Athletes (무증상 고교 상지 거상 운동 선수의 견관절 초음파 소견)

  • Cho, Su Hyun;Cho, Hyung Lae;Lee, Jung Su;Kim, Jung Woo
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.5 no.2
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    • pp.81-88
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    • 2012
  • Purpose: To evaluate the ultrasonographic (US) findings in both shoulders of asymptomatic high school overhead athletes and compare with healthy control. Materials and Methods: 33 individuals (age: $17.5{\pm}1.4$ years) participated in this study. We recruited two groups of high school male athletes, 13 baseball and 10 volleyball players without shoulder pain for recent 6 months as well as one control group of 10 untrained healthy high school students who were age-matched. Ultrasound measurements of thickness of biceps and supraspinatus tendon and acromio-humral distance (AHD) at 0o abduction were taken in dominant and nondominant shoulders. Results: On US examination, subacromial bursa effusion was observed in 5 of the dominant shoulders and in 1 of the nondominant shoulder of 23 overhead athletes and in none of the asymptomatic controls. The thickness of the biceps and supraspinatus tendons and AHD in both shoulders were significantly greater in the athletes than in the controls (P<0.05). We also found that the thickness of the biceps and supraspinatus tendon and AHD of the dominant shoulder were significantly greater than the non-dominant shoulder in overhead athletes (P<0.05), but there were no differences between baseball and volleyball players. Conclusion: Subacromial effusion could be found even in the asymptomatic stage overhead athlete and the thickness of the biceps and supraspinatus tendons and AHD were significantly greater in the overhead athletes than in the healthy controls. Our data is useful reference guide for the ultrasonographic diagnosis of shoulder pathologies occurring in overhead athletes.

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Multiple Rice Bodies in Subacromial Space - A Case Report - (견봉하 공간의 다발성 미립체 - 증례 보고 -)

  • Min, Kyoung-Dae;Ryu, Ki-Hoon;Lee, Jae-Sang;Lee, Byung-Ill
    • Clinics in Shoulder and Elbow
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    • v.10 no.2
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    • pp.232-235
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    • 2007
  • Multiple rice bodies are a rare disorder that is most commonly observed in chronic rheumatoid arthritis patients and as a complication of chronic inflammation in the bursa. However, it can occur in the absence of an underlying systemic disorder. Although it resembles synovial chondromatosis clinically and on imaging, the condition can be discriminated by an analysis of the radiographic and MR appearances. We encountered a case of multiple rice body formation with subacromial bursitis on the shoulder of a 37-year old man suffering from pain and motion limitation. The patient was treated by arthroscopic removal of the multiple rice bodies and a subacromial bursectomy. We present this case with a review of the relevant literature.