• Korean Journal of Veterinary Service
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• v.46 no.2
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• pp.175-179
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• 2023

This study was conducted to find out the compensation strategy through kinetic gait analysis by comparing dog with congenital luxation of the shoulder joint and normal dog. Ground reaction forces were recorded for all limbs while normal poodle dog and poodle dog with shoulder joint luxation was allowed to walk on an instrumented platform. The dogs were evaluated for maximal vertical force (MVF), body load distribution (BLD), and symmetry index (SI). The MVF was increased in the contralateral forelimb of luxated shoulder joint. The SI was also increased in a dog with dislocated shoulder joints in the forelimbs. For BLD, the maximum load distribution increased centrally, but the total load distribution decreased in the ipsilateral forelimb paw. In contrast, total load distribution was increased in the contralateral forelimb paw. During forelimb lameness, changes in weight-bearing load showed compensatory load redistribution. These biomechanical changes may lead to changes in the musculoskeletal system in a dog with luxated shoulder.

• Clinics in Shoulder and Elbow
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• v.1 no.2
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• pp.167-174
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• 1998

Since the first description by Cotton, there have been sporadic reports about the inferior subluxation of the shoulder. Nevertheless there is still a lack of consensus regarding the mechanism of occurrence, evolution and treatment. We have experienced six cases of inferior sublusation(five cases after trauma and one case after surgery) which resolved over time. Analysis of the clinical informations including serial radiographs, data from clinical examination and electromyography(EMG) revealed the following results. All the five post-traumatic inferior subluxations were noted in women with an average age of 59 years after direct trauma resulting in fracture of the proxiaml hrnerus(4) or clavicle(1), of which nerve injury was proven by EMG in three. One case occurred after Bankart repair by stretch injury to the axillary nerve. The presenting symptom was unusually severe pain on passive motion. Absence of anterior or posterior displacement wasl confirmed by radiographs. All the cases seemed to have delayed onset of subluxation except one. The subluxed hu.meral head was concentrically reduced at an average 11 weeks(range 3-23 weeks) from the supposed time of occurrence and the acromiohumeral interval measUred on the standing anteroposterior radiographs decreased to 9.4 mm ftom 23 mm. Improvement of pain paralled the reduction. In conclusion, the most common cause of transient inferior subluxation was nerve injury in ou~ series and the prognosis was excellent, however protraction of recovery or leaving permanent subluxation would be possible if .the injured nerve is unrecoverable.

• Journal of the Korean Society of Physical Medicine
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• v.2 no.2
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• pp.243-250
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• 2007

Purpose : Shoulder subluxation is a very common problem in patients with hemiplegia with stroke. Prevention of the low tone subluxed shoulder has been an issue for physical therapists working with neurological patients for many years. Methods : This study reviewed the literature to definite the management and a cause of shoulder subluxation with hemiplegia patients after stroke. Various modalities have been suggested for realigning the glenohumeral joint, but their use is controversial. The purpose of this paper is to review critically the evidence base in order to inform the clinical decision-making process for physiotherapists working in neurology. Results : Literature has identified supports, strapping and functional electrical stimulation(FES) in the management of low tone shoulders. Following review of this evidence it is suggested that there is a lack of reliable and valid research evidence on which to base conclusions. The modalities with the best supporting evidence for realigning the low tone subluxed glenohumeral joint are the triangular sling, Harris hemi sling and the Rolyan humeral cuff used in a standing position and the lap board and arm trough while the patient is sitting. However, due to soft tissue adaptation with associated lack of movement, over-correction and the need for careful patient positioning these supports need to be evaluated for each patient and should be used only in appropriate situations. Conclusion : Similarly, there is a lack of evidence on the effects of long-term use to this equipment. Electrical stimulation is also thought to have potential in the treatment to subluxed low tone shoulders but additional research is required to clarify the parameters for use and the long-term effects of these forms of management.

• Clinics in Shoulder and Elbow
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• v.9 no.1
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• pp.60-67
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• 2006

Purpose: The purpose of this study was to compare the method of using coraco-clavicular (C-C) sling with modified Phemister operation by postoperative clinical results, radiologic analysis and complications. Materials and Methods: 33 patients of acromioclavicular joint dislocation were included in this study. Thirteen patients were treated with simple C-C sling method and twenty patients were treated with modified Phemister operation. The assesment of clinical and radiological evaluation were performed and the final results were examined by using the Weitzman's classification. Results: In the final result of C-C sling method group, forward elevation $161^{\circ}$, external rotation $70^{\circ}$, internal rotation T8 level, Visual Analogue Scale (VAS) 83.3 points were checked. In modified Phemister operation group, forward elevation $155^{\circ}$, external rotation $67^{\circ}$, internal rotation T6 level, VAS 83.8 points were checked. In coracoclavicular distance of C-C sling method group, pre-operation 12.82 mm and last follow up 8.37 mm were checked. In modified Phemister operation group, pre-operation 12.8 mm and last follow up 7.7 mm were checked. In functional evaluation by the Weitzman criteria, C-C sling group had excellent 8, good 1, fair 1 and modified Phemister group had excellent 13, good 4, fair 3. Conclusion: C-C sling method would be the better than the Modified Phemister operation because of short operation time and smaller skin incision.

• Journal of Korean Medical classics
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• v.19 no.3
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• pp.47-64
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• 2006

籬위제고화가심대청대정골추나요법적인식화이해(爲提高和加深對淸代正骨推拿寮法的認識和理解), 특선어차방면의의교심차유의사문환가치적(特選於此方面意義較深且有醫史文歡價値的) ${\ulcorner}$의종금감(醫宗金鑑) 정골심법요지(正骨心法要旨)${\lrcorner}$ 중적(中的) ${\ulcorner}$외치법(外治法)${\lrcorner}$ 진행료연구(進行了硏究), 획득여하연구결과(獲得如下硏究結果). 기수법총론부분(其手法總論部分), 파요지규정료정골수법적정의급기중요성(擺要地規定了正骨手法的定義及其重要性), 후유증적예방(後遺症的預防), 안환자원기강약이수요주의적사항(按患者元氣强弱而需要注意的事項), 정골의생적기본공화심이소질등문제(正骨醫生的基本功和心理素質等問題). 기정골수법부분(其正骨手法部分), 포괄모(包括模) 접(接) 단(端) 제(提) 접(按) 나(摩) 추(推) 나등팔법(拿等八法), 각법지적응증용현대용어해석여하(各法之適應症用現代用語解釋如下): 모법용어촉진(模法用於觸診), 접법용어골절치료(接法用於骨折治療), 단법용어탈위치료(端法用於脫位治療), 제법용어견인법(提法用於牽引法), 안마법용어연조직손상화골착건적치료(按摩法用於軟組織損傷和骨錯鍵的治療), 추나법용어절적운동(推拿法用於節的運動) 부리화관절적부완전결합적치료(不利和關節的不完全結合的治療). 기기구총론부분(其器具總論部分), 개소료십종정골치료용기구(介紹了十種正骨治療用器具), 각종기구적적응증급기효능용현대용어해석여하(各種器具的適應症及其效能用現代用語解釋如下): 이렴구유보호환부적효과(裏簾具有保護患部的效果), 진정용어동통(振挺用於疼痛) 부종(浮鍾) 경결적치료(硬結的治療), 피견용어견관절탈구적고정료법(被肩用於肩關節脫臼的固定療法), 격색속어리용자아체중적견인료법(擊索屬於利用自我體重的牽引療法), 루관속어분부동계단이용자아체중진행견인적료법(壘觀屬於分不同階段利用自我體重進行牽引的療法), 통목속어포추지압축성골절적래목치료용구(通木屬於胞推之壓縮性骨折的來木治療用具), 요주구유대요추골급기근육이상적부가보호대효과(腰柱具有對腰推骨及其筋肉異常的附加保護帶效果), 죽렴용어골절적고정치료(竹簾用於骨折的固定治療), 삼리구유대골절적쌍중고정효과(杉籬具有對骨折的雙重固定效果), 포슬구유대슬관절적고정효과(抱膝具有對膝關節的固定效果).

• Clinics in Shoulder and Elbow
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• v.8 no.2
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• pp.88-96
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• 2005

Purpose: To compare and analyze the outcome of primary clavicular lateral end resection method and conventional acromioclavicular (AC) joint reduction method in type III AC dislocation patients over 45 years. Materials and Methods: This study was performed on selected 24 cases of type III AC dislocation patients, over 45 years of age, operated at our hospital from 1998 to 2002. Group I consist of 12 patients who underwent primary clavicular lateral end resection methods (average age: 54.3 years$(45{\sim}72)$). Group II consist of 7 patients using Bosworth methods and 5 patients using Phemister methods (average age: 54.4 years$(45{\sim}71)$). Clinical outcome was evaluated by Weaver and Dunn method. Radiological results were compared by measuring coracoclavicular distance between normal and injured side. Results: As clinical outcome, good was 10 cases(83%); fair 2(17%) in Group I, and good 6(50%); fair 3(25%); poor 3(25%) in Group II. In contrast, the difference of coracoclavicular distance was not statistically significant between two groups before or after surgery, and last follow up. At the last follow up, there was no special correlation between the difference of coracoclavicular distance and clinical outcome. Conclusion: We considered that primary clavicular lateral end resection may be effective for prevention of arthrosis in AC joint in type III AC dislocation patients over 45 years.

• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.1
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• pp.79-88
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• 2002

Purpose: In this prospective, randomized study, we compared the results of early motion versus conventional immobilization after the arthroscopic Bankart repair. Materilal and Methods : We performed an arthroscopic Bankart repair using suture anchors in 62 patients with traumatic anterior shoulder instability and randomized them into two groups; Group 1 (n=28; mean age, 28 years) underwent three-week of immobilization and conventional rehabilitation program, while Group 2 (n=34; mean age, 29 years) underwent an accelerated rehabilitation program with staged range of motion and strengthening exercises starting from the immediate postoperative day. Selected patients were non-athletes with a classic Bankart lesion and a robust labrum. Analysis of outcome included pain scores (6-week and follow-up: 31(9 months), range of motion, return to activity, recurrence, patients’ satisfaction with each program, and shoulder scores (ASES, UCLA, and Rowe). Results : The recurrent rate was not different between the two groups (2 anterior apprehension from each group) (p=0.842). Patients with accelerated rehabilitation resumed functional range-of-motion faster and returned earlier to the functional level of activity (p<0.05). Accelerated rehabilitation decreased postoperative pain and more patients were satisfied with this program (p<0.05). No differences were found between the two groups at the follow-up with regards to the shoulder scores, return to activity, pain score, and the range-of-motion. Conclusions : Early mobilization after arthroscopic Bankart repair does not increase the recurrence rate in selected patients. Although the final outcomes are similar in both groups, the accelerated rehabilitation program promotes functional recovery and reduces postoperative pain, which enables patients an early institution of desired activities.

• Clinics in Shoulder and Elbow
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• v.11 no.1
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• pp.41-45
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• 2008

Purpose: To review the clinical and radiological results after an open reduction and internal fixation with a T-shaped LCP for unstable distal clavicle fractures. Materials and Methods: From February 2005 to June 2006, ten patients with distal clavicle Neer type II fractures were treated with an open reduction and internal fixation with a T-shaped LCP. Bony union was identified by plain radiography. The clinical results were analyzed according to the UCLA scoring system. Results: The mean time to fracture union was 9weeks and union was achieved in all cases. The mean UCLA score was 33.4 (30-35); excellent in 8 cases and good in 2 cases. In one case, loosening of one distal screw was occured and mild AC joint subluxation was observed in another case. Conclusion: 3.5 mm T-shaped LCP fixation is a useful technique for treating unstable distal clavicle fractures. This procedure provide stable fixation with no further AC joint injury.

• Clinics in Shoulder and Elbow
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• v.3 no.2
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• pp.75-78
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• 2000

Purpose: The purpose of this study was to review primary traumatic anterior shoulder dislocation in the 40 years and older to determine the incidence of recurrence, rotator cuff injury and associated fractures. Materials and Methods: From May, 1991 to October, 1998, seventeen patients were available to participate in the study. The average age was 55 years(range, 40 to 75 years). Follow-up averaged 27 months(range, 12 to 48 months). There were 12 men and 5 women. 10 right and 7 left shoulders were involved. Any participant with a history of shoulder pain and limitation of motion was excluded from the study. Each shoulder was evaluated with UCLA shoulder functional assessment. Results: The overall results were excellent in 9 patients(52.9%), good in 3 patients(17 .6%), fair in 3 patients(17.6%), and poor in 2 patients(11.7%). Surgical treatment of the associated rotator cuff and greater tuberosity fracture injuries resulted in 5 patients with excellent(55.6%), 3 patients with good(33.3%) and I patient with poor(11.1 %) and Nonsurgical treatment of the associated injuries resulted in 2 patients with excellent(33.3%), 3 patients with fair(50%), 1 patient with poor(16.7%)(P=0.025). Conclusion : Our findings on small number of patients suggest that the diagnosis of a rotator cuff and other pathologies should be approached aggressively by an MRI, CT arthrogram if significant pain and weakness are still present and early surgical repair of rotator cuff and greater tuberosity can lead to restoration of shoulder function and better outcomes in selected patients.

• Clinics in Shoulder and Elbow
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• v.2 no.1
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• pp.1-7
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• 1999

Purpose : There has been considerable controversy as to the method of the treatment of acute acromioclavicular joint dislocation classified to type III injury. The purpose of this study is to compare the conservative and operative treatment of the type III acute acromioclavicular joint dislocation in terms of clinical and radiological results. Materials and Methods: We treated 31 cases of acute, type III acromioclavicular joint dislocation, 17 cases were treated by operative methods and 14 patients by conservative treatment, and 1 year minimum follow-up was done from January 1990 to January 1996. We used UCLA Shoulder Rating Scale for clinical results. And for the radiological results coracoclaviclar distance were measured. We used Fisher's exact test for statistical analysis of results between the two treatment methods. Results: Fifteen(88.2%) of seventeen patients in operative treatment and eleven(78.6%) of fourteen patients in nonoperative treatment were rated excellent or good on the UCLA rating scale. In radiographic evaluation, the average coracoclavicular distances of preoperative state, immediate postoperation(or postreduction) and last follow-up were as follows. In operative cases, it was 1.75±0.21mm, 1.14±0.24mm and 1.33± 0.22mm respectively. In nonoperative cases, it was 1.65±0.14mm, 1.26±0.26mm, and 1.42±0.27mm respectively. Conclusion : This study demonstrated that there was no significant difference in clinical and radiological results between the operative and nonoperative treatment groups. So, nonoperative treatment is recommended for acute type III acromioclavicular dislocation as general rule.