• Title/Summary/Keyword: 회전근 개 손상

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Recurrent Shoulder Dislocation with Rotator Cuff Tears and Bankart Lesion (중장년층에서의 회전근 개 파열과 Bankart 병변을 동반한 재발성 견관절 탈구)

  • Lee Kwang Won;Yang Dong Hyun;Ahn Jae Hoon;Kim Ha Yong;Choy Won Sik;Ha Kwon-Ick
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.3 no.1
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    • pp.81-86
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    • 2004
  • Objectives: To assess the functional outcome of Bankart repair and rotator cuff repair using miniopen technique in patients with recurrent shoulder dislocation(8 cases) with rotator cuff tears and Bankart lesion of over 40 years. Materials and Methods: From May 1991 to January 2002, twenty two patients were available to participate in the study. Mean age was 52 years old(41-67), Follow-up evaluations averaged 50.5months(10-147). Results: The patients(22 cases) were divided into two groups. Group 1: with recurrent shoulder dislocation(8 cases) with rotator cuff tears and Bankart lesion in patients over 40 years old. Group 2: without Bankart lesion(14 cases). In Group 1, mean average of forward flexion and abduction improved from 122 degrees to 154 degrees at the final follow-up and from 115 degrees to 161 degrees respectively. In terms of University of Pennsylvania patient self-assessment of pain score and VAS, scores improved from 11.0 to 5.5 and from 5.4 to 2.5 respectively. In terms of UCLA score & Constant score, scores also improved from 20.2 to 29.6 and from 48.6 to 69.0 respectively. Functional outcome of Group 1: two patients with excellent, four patients with good, and two patients with fair. Functional outcome of Group 2: two patients with excellent, six patients with good, five patients with fair, and one patient with poor. But they had no statistical significance between the two groups. All cases were improved shoulder pain at the final follow up. And six patients were satisfied with the outcome of shoulder function. Conclusions: This study demonstrates the effectiveness of Bankart repair and rotator cuff repair using miniopen technique in patients with recurrent shoulder dislocation(8 cases) with tears of rotator cuff and Bankart lesion older than 40 years. We recommend Bankart repair and rotator cuff repair at the same time.

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Clinical and Radiographic Outcome of Shoulder Function after Unreamed Antegrade Intramedullary Nailing for Humerus Fracture: Ultrasonographic Evaluation for Rotator Cuff Integrity (비확공성 전향적 상완골 금속정 고정술후 견관절 기능에 대한 임상적 및 방사선학적 평가: 초음파를 이용한 회전근 개 추시관찰)

  • Baek, Seung-Hoon;Choi, Chang-Hyuk
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.6 no.1
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    • pp.1-9
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    • 2013
  • Purpose: The purpose is to perform objective evaluation for rotator cuff using ultrasonography and validate factors influencing cuff integrity as well as efficacy of follow-up ultrasonography after unreamed antegrade intramedullary nailing for humerus fracture. Materials and Methods: Seventeen patients with an average age of $55.7{\pm}18.6$ years underwent antegrade intramedullary nailing for humerus fracture and follow-up ultrasonography of shoulder joint. Mean follow-up period was $43.5{\pm}32.2$ months. Intraoperative evaluation for preoperative cuff tear was performed, of which four cuffs were repaired by single row repair technique. Clinical evaluation included visual analogue scale (VAS), range of motion, Korean Shoulder Scoring System (KSS) and American Shoulder and Elbow Society (ASES) score. Ultrasonographic evaluation was performed on cuff integrity and protrusion of proximal nail tip as well. Radiographic evaluation included time to union, protrusion of proximal nail tip and migration of proximal interlocking screw which could affect shoulder joint function. Results: Mean VAS at last follow-up was $1.65{\pm}1.84$ points. Range of motion showed forward flexion of $137.0{\pm}33.5^{\circ}$, external rotation of $43.5{\pm}12.7^{\circ}$ and internal rotation of $16.4{\pm}2.0^{\circ}$ while KSS score and ASES score were $79.6{\pm}20.7$ and $83.7{\pm}17.0$ points, respectively. Bone union was demonstrated in all cases and average time to union was $3.4{\pm}1.3$ months. Migration of proximal interlocking screw was shown in 6 cases (35%). On ultrasonographic evaluation, there were normal in 8 (47%), weaving in 4 (24%), partial tear in 5 cases (29%), but no complete tear. Protrusion of proximal nail tip was demonstrated in 8 cases (47%) on plain radiographs whereas in 11 cases (65%) on ultrasonography and was associated with increasing age (p=0.038). Ultrasonographic weaving and partial tear was associated with protrusion of proximal nail tip (p=006), but not with repair of preoperative tear (p>0.05). Conclusion: Because weaving and partial tear on ultrasonography originated from protrusion of proximal nail tip, careful insertion of nail and meticulous repair of cuff during operation lead to stable fixation with satisfactory recovery of shoulder function follow-up ultrasonography can be a useful tool for evaluating protrusion of nail tip and rotator cuff tear, of which diagnosis is difficult on plain X-ray after antegrade intramedullary nailing for humerus fracture.

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Arthroscopic Treatment with Suture Anchor for the Isolated Subscapularis Tear (견갑하근 단독 손상 시 시행한 관절경하 봉합 나사를 이용한 봉합술)

  • Moon, Young-Lae;An, Ki-Yong
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.137-141
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    • 2009
  • Purpose: We wanted to evaluate the results of arthroscopic management of an isolated rupture of the subscapularis tendon using suture anchors. Materials and Methods: Twenty nine patients with unilateral ruptures of the subscapularis tendon and who underwent arthroscopic repair between February 2001 and October 2007 were reviewed prospectively. All the cases were isolated tears of the subscapularis without the involvement of any other rotator cuff tendon. In 19 patients the tear was localized to the superior one third, in 7 cases the tear was localized to the upper two thirds and the entire tendon was involved in 3 cases. The mean follow up period was 12.2 months (range: 6-26 months). The results of the treatment were assessed by evaluating the constant shoulder score and the pain score before surgery and after surgery. Results: The constant shoulder score improved from $49.9\pm7.3$ to $73.8\pm3.0$ points compared to before surgery and the pain score improved from $4.3\pm3.2$ to $11.2\pm3.0$ points postoperatively. Conclusion: Arthroscopic repair of isolated ruptures of the subscapularis tendon using suture anchors is a good option for effectively managing these tears.

The Effectiveness of Prolotherapy Postoperative Rotator Cuff Tear (회전근 개 봉합 수술 후 증식 요법의 유용성)

  • Moon, Young Lae;You, Jae Won;An, Ki Yong;Cho, Sung Won
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.3 no.1
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    • pp.21-25
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    • 2010
  • Purpose: To evaluate efficacy of ultrasound guided prolotherapy in patients with persistant symptoms after rotator cuff repair. Materials and Methods: Between January and December of 2008, 90 patients who had persistant pain and shoulder adhesion 4 weeks after rotator cuff repair were treated with ultrasound guided prolotherapy. The mean age was 55.2 years. Visual analogue scale (VAS) and range of motion (ROM) before and after the procedure, complications related to the procedure were analyzed. Results: The average VAS score at 4 weeks follow up decreased to $2.5{\pm}2.304$ from $6.3{\pm}1.25$ before prolotherapy and forward flexion range at 4 weeks follow up increased to $143{\pm}26.63$ from $106{\pm}21.64.$ Four weeks after the ultrasound guided prolotherapy, 74 cases(82%) reported of improved pain and ROM, 13 cases(14%) reported of improvement after 2~5 days of the procedure and 3 cases(4%) had no improved in pain and ROM. No complications were encountered. Conclusion: The authors believe that ultrasound guided prolotherapy in repaired rotator cuff tear patients theoretically increased possibilities of healing and with relieving the pain of the patients results in increased possibility of rehabilitation effect.

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Mini open repair of the rotator cuff tear (회전근개 파열에 대한 소절개를 이용한 봉합술)

  • 이용걸
    • 대한정형외과스포츠의학회:학술대회논문집
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    • 2004.12a
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    • pp.31-33
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    • 2004
  • 소절개 봉합술은 관혈적 봉합술에 비해 동반된 상완관절와 관절(glenohumeral joint)내의 병변을 확인하고 이에 대한 처치를 시행할 수 있으며, 견봉하 감압술과 함께 동반된 견봉 쇄골 관절의 병변을 치료할 수 있다. 또한 삼각근 기시부에 대한 손상을 최소화하기 때문에 마른 재활과 조기 퇴원을 시행할 수 있는 둥의 장점이 있다. 관절경적 봉합술에 비해서는 수술 술기가 어렵지 않기 때문에 항상 좋은 결과를 기대할 수 있다. 회전근개 파열에 대한 수술을 시행할 때 관절경적 봉합술이 모든 경우에서 관혈적 또는 소절개 봉합술에 비해 좋은 결과를 나타내는 것은 아니다. 환자가 심한 골다공증이 있는 경우, 기술적 문제가 있는 경우, 봉합후 회전근개에 지나친 긴장이 염려될 때는 항상 소절개 봉합술로의 전환을 시도하여야 한다. 소절개 봉합술을 시행한 경우에도 관절경적 봉합술시와 비슷한 좋은 결과를 얻을 수 있고, 치료의 결과는 수술의 종류보다는 정확한 술기 및 술전 환자의 상태에 좌우된다고 하겠다.

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The Tire Damage Classification by Pulse Interval Time Density Function of Ultrasonic Wave Envelope on Driving (주행 중 타이어 손상에 의해 발생하는 초음파 포락선 신호의 펄스 간격 시간밀도함수에 의한 손상 분별)

  • Shin, Seong-Geun;Kang, Dae-Soo
    • The Journal of the Institute of Internet, Broadcasting and Communication
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    • v.11 no.3
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    • pp.41-46
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    • 2011
  • The tire damage classification method is researched by periodicity detection of ultrasonic envelope signals to occur at the driving vehicle tire. Because periodic signals is generated by rotations of the damaged tire, it should convert to pulse for using the density function. After time intervals of pulses are represented by the density function, the dominant periodicity is detected. The threshold to make a pulse is calculated by moving average of envelope signals. The result of time density function in case of one damage material, the first peak's time is equals to tire's rotation period, 162ms and 102ms, about the speed of 50km/h and 80km/h. In case of more than one damage material, the sum of each peak's time is equals to tire's rotation period about the speed.

Arthroscopic Evaluation on Intra-Articular Pathology in Recurrent Shoulder Dislocation Aged Over 40 Years (40세 이상 재발성 견관절 탈구 환자에서 관절내 병변에 대한 관절경적 연구)

  • Min, Woo-Kie;Kim, Ju-Eun;Cho, Hwan-Seong;Kim, Poong-Taek;Jeon, In-Ho
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.215-220
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    • 2009
  • Purpose: This study is to analyze the prevalence of various intra-articular lesions in patients with traumatic recurrent anterior dislocation of shoulder over 40 years and suggest clinical implications for treatment. Materials and Methods: We retrospectively studied 16 cases that underwent surgical treatment for recurrent anterior dislocation of shoulder from January 2001 to May 2009. There were 9 males and 7 females, and the mean age was 52.7years. We carried out arthroscopic exam for all patients based on standard protocol, which included labrum, capular lesion, cuff, bony lesions. Results: All 16 cases showed Hill-Sachs lesion, 3 patients (19%) had bony Bankart lesion, 6 patients (38%) had labral tear. Capsular tear were found 15 patients (94%). Twelve (75%) had ruptured supraspinatus and 5 (31%) had subscapularis tear. Only one (6%) had SLAP lesion. Conclusion: There was relatively higher incidence of capsular and rotator cuff tears in patients over age 40 years. Preoperative planning to address these lesions is highly recommended.

Ultrasonography for Diagnosing Sports-Related Shoulder Pain (스포츠 관련 견관절 통증에서 초음파 영상 검사)

  • Song, Hyun Seok
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.5
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    • pp.384-392
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    • 2019
  • Ultrasonography is used for making the diagnosis and treatment decisions for those patients who complain of shoulder pain related with sports activity. Ultrasonography is especially helpful for diagnosing issues with the rotator cuff, the long head of biceps tendon and the acromio-clavicular joint. The medical decisions about shoulder pain can be promptly made when portable ultrasonography is used in the field of sports.

Management of Biceps and Labral Disorders (이두 근 및 관절순 손상의 치료)

  • Choi, Chang-Hyuk
    • 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.

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