• Clinics in Shoulder and Elbow
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• 제1권2호
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• pp.266-277
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• 1998

Forty-nine partial thickness rotator cuff tears underwent arthroscopic debridement or repair, and were followed up for a minimum of two years. Follow-up evaluations of the results were completed using a detailed functional questionnaire which was comprised of a rating of the UCLA shoulder scale and return to the previous sports activity and job. The average age of the 49 study patients was 46.5 years(range, 14 to 67 years). The patients were divided into four groups on the basis of the onset of the patient's symptoms. Thirty-five patients(72%) had partial tearing only on the articular surface, six(12%) on the bursal surface, and eight(16%) on both surfaces. Group I consisted of 21 patients with an average age of 56.7. Partial tearing in group I was attributed to the impingement syndrome. In group II, partial tearing of the rotator cuff was related to the anterior instability of the shoulder. This group included 9 patients with an average age of 27.9. In group III, all of the 8 patients were overhead athletes with an average age of 21.8. In this group, no isolated instances of significant trauma were related to the development of the shoulder pain. In group IV, 11 patients noted that a significant traumatic event preceded the onset of their pain. The average age of the patients was 34.9. Overall, 82% of the patients demonstrated satisfactory results and 18% revealed unsatisfactory results. The worst UCLA score and rate of return to the prior activity was noted in group III. In conclusion, partial thickness rotator cuff tear can be caused by subacromial impingement, instability, repetitive microtrauma, and macrotrauma. Arthroscopic debridement of partial tear of the rotator cuff provides a favorable outcome except in overhead athletes.

• Clinics in Shoulder and Elbow
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• 제2권2호
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• pp.115-119
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• 1999

Purpose: We reviewed the SLAP lesions and associated injuries, also evaluated a hypothesis that the type II posterior SLAP lesion is related with posterior rotator cuff tear and gives rise to the postero-superior instability. Materials and Methods: The patient recording papers, MRI, video and operation sheets were reviewed with the 28 SLAP lesions confirmed by the arthroscopy among 242 cases. Among these SLAP lesions, type II was 22 cases and classified to the anterior, posterior(16 cases), combined subtype(6 cases) based on the main anatomic location. There were 14 cases of the type II accompanying rotator cuff tear. The average follow-up(13 months) results were evaluated with the ASES and Rowe rating score after repair or debridement of the SLAP lesions. Results: In the type II lesions accompanying the rotator cuff tears(14 cases), the posterior(l0 cases) and combined type(4 cases), cuff lesions were all existed posteriorly. Also We could confirm the drive-through sign in the eleven cases, though did not check the disappearance of this sign after repair because of retrospective study. We could followed up the 22 cases, 18 cases(77%) were excellent or good, fair 3 cases(14%) and poor 1 case(4%). Also, type II lesions with the rotator cuff tear(14 cases) were showed better results in the repair(8 cases) than the debridement(6 cases) of the unstable type II with the cuff repair. Conclusion: The type II lesions were frequently associated with the cuff tear in the specific location. We could presume the possibility of postero-superior instability in the SLAP lesion with the cuff injuries. Also, satisfactory results could be experienced when the unstable SLAP lesions with the cuff tear were repaired at the same time.

• 산업경영시스템학회지
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• 제41권2호
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• pp.16-23
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• 2018

Postural instability can increase the likelihood of hazardous slip and fall accidents in workplaces. The present study intended to extend understanding of the effect of abnormal neck posture on postural control during quiet standing. The effect of body fatigue on the postural control was also of primary concern. Twelve healthy undergraduate students volunteered to participate in the experiment. Standing on a force platform with the neck neutral, flexed, extended, or rotated, subjects' center of pressures (COP) were measured under the two levels of body fatigue. For the fatigue condition, Subjects exercised in a treadmill to meet the predetermined level of body fatigue. Analyzing the position coordinates of COPs, the length of postural sway path was assessed in both medio-lateral (ML) axis and anterior-posterior (AP) axis. Results showed that, in AP direction, neck extension or rotation significantly increased the sway length as compared with neck neutral. Neck extension led to greater sway length compared to neck rotation. Neck flexion did not differ from neck neutral. The sway length in the AP direction also became significantly larger as the body fatigue accumulated after treadmill exercise. In ML direction, as compared to neutral posture, the neck extension, flexion, or rotation did not significantly affect the length of postural sway path. However, the sway length seemed to increase marginally with the neck extended during the fatigued condition. This study demonstrates that abnormal neck posture may interfere with postural control during standing. The ability to maintain postural stability decreases significantly with the neck extended or rotated. Body fatigue leads to postural instability further.

• 대한물리의학회지
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• 제13권3호
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• pp.75-80
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• 2018

PURPOSE: Scapular stability is very important to arm function during activities of daily living. The push-up plus exercise is commonly used to stabilize the shoulder muscles. In the present study, we designed an elastic shoulder band (ESB) that could be used with the push-up plus exercise and studied muscle activities of the serratus anterior (SA) and the lower and the upper trapezius (LT and UT) on stable and unstable support. METHODS: Fifteen healthy people participated in this study. Three muscles were investigated using surface EMG with and without the ESB on stable and unstable support. All subjects performed each trial three times for 7 seconds per set and rested for 30 seconds. Repeated one-way ANOVA was used for statistical analyses. RESULTS: The EMG activity of the SA was significantly different during the push-up plus exercise on stable support with the ESB compared with that on unstable support without the ESB (p<.05). However, there were no differences in the activities of UT and LT on stable and unstable support (p>.05). CONCLUSION: The ESB was effective for the activity of SA during the push-up plus exercise on stable support; therefore, it has the potential for use by people during push-up plus exercises. However, further studies are required to investigate the rehabilitation tools for patients with shoulder instability.

• Journal of Korean Neurosurgical Society
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• 제60권6호
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• pp.755-762
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• 2017

Objective : The purpose of this study is to describe the detailed surgical technique and short-term clinical and radiological outcomes of lateral lumbar interbody fusion (LLIF) and in situ lateral screw fixation using a conventional minimally invasive screw fixation system (MISF) for revision surgery to treat rostral lumbar adjacent segment disease. Methods : The medical and radiological records were retrospectively reviewed. The surgery was indicated in 10 consecutive patients with rostral adjacent segment stenosis and instability. After the insertion of the interbody cage, lateral screws were inserted into the cranial and caudal vertebra using the MISF through the same LLIF trajectory. The radiological and clinical outcomes were assessed preoperatively and at 1, 3, 6, and 12 months postoperatively. Results : The median follow-up period was 13 months (range, 3-48 months). Transient sensory changes in the left anterior thigh occurred in 3 patients, and 1 patient experienced subjective weakness; however, these symptoms normalized within 1 week. Back and leg pain were significantly improved (p<0.05). In the radiological analysis, both the segmental angle at the operated segment and anterior disc height were significantly increased. At 6 months postoperatively, solid bony fusion was confirmed in 7 patients. Subsidence and mechanical failure did not occur in any patients. Conclusion : This study demonstrates that LLIF and in situ lateral screw fixation may be an alternative surgical option for rostral lumbar adjacent segment disease.

• 대한관절경학회지
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• 제15권2호
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• pp.121-124
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• 2011

Hill-Sachs 병변은 견관절 탈구 환자에서 가장 흔히 보이는 병변으로 상완골두의 후외방 골결손으로 지칭된다. 처음 탈구되는 환자에서도 관찰될 수 있으며, 탈구가 진행될 될수록 진행하여 탈구의 수와 Hill-Sachs 병변의 관찰정도는 비례관계가 있는 것으로 알려져 있다. Hill-Sachs 병변의 위치와 유무는 견관절 불안정성에 중요한 의미를 띄는 것으로 이해되고 있다. 저자들은 재발성 전방 견관절 탈구 환자에서 동반된 이중 Hill-Sachs 병변1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Clinics in Shoulder and Elbow
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• 제12권2호
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• pp.236-239
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• 2009

목적: 저자들은 장흉 신경 손상에 의한 전거근 마비로 발생한 진구성 익상 견갑에서 대흉근 이전 술 시행 시 유용성과 임상적 결과를 평가하고자 하였다. 대상 및 방법: 외상 성 탈구로 야기된 견관절 불안정성에 대해 관절경 수술을 시행 후 발생한 진구성 익상 견갑 환자1예를 대상으로 Modified Eden-Lange 술식을 이용한 대흉근 이전술을 시행하였고, 술 전 전방 거상 90도, 외전 70 도에 비해 술 후 전방 거상 170도, 외전 150 도로 술후 향상된 관절운동 범위와 합병증 및 익상 견갑의 재발은 보이지 않았으며, 환자의 술 후 심리적 만족도 또한 높게 나타났다. 결과 및 결론: 장흉 신경에 의한 전거근 마비로 발생한 익상 견갑의 경우 다른 견갑대의 근육, 신경의 이상이 동반되지 않았을 때 대흉근 근육 이전술은 정상적인 견갑흉곽 운동을 제공할 수 있는 만족스러운 치료법 중 하나로 생각된다.

• Clinics in Shoulder and Elbow
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• 제21권1호
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• pp.42-47
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• 2018

A 25-year-old woman presented to the emergency room with a painful and swollen right forearm. She had just sustained an injury from an accident during which her arm was tightly wound by a rope as she was lowering a net from a fishing boat. Before being released, her arm was rigidly trapped in the rope for approximately ten minutes. Radiographs revealed anterior dislocation of the radial head that was accompanied by plastic deformation of the proximal ulna, manifested as a reversal of the proximal dorsal angulation of the ulna (PUDA); suggested a Monteggia equivalent fracture. With the patient under general anesthesia, we reduced the radial head by posterior compression at $90^{\circ}$ of elbow flexion and at neutral rotation of the forearm. However, the reduction was easily lost and the elbow re-dislocated with even slight supination or extension of the arm. After the osteotomy of the ulnar deformity to restore the PUDA to normal, the reduction remained stable even with manipulation of the arm. We found that the patient could exercise a full range of motion without pain at the 3-month follow-up, and neither residual instability nor degenerative changes were observed at the final 3-year follow-up.

• Journal of Chest Surgery
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• 제49권5호
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• pp.361-365
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• 2016

Background: Sternal fractures are relatively rare, and caused mainly by blunt anterior chest wall trauma. In most cases, sternal fractures are treated conservatively. However, if the patient exhibits problematic symptoms such as intractable chest wall pain or bony crepitus due to sternal instability, surgical correction is indicated. But no consensus exists regarding the most appropriate surgical method. We analyzed the results of surgical fixation in cases of sternal fracture in order to identify which surgical method led to the best outcomes. Methods: We retrospectively reviewed the medical records of patients with sternal fractures from December 2008 to December 2011, and found 19 patients who underwent open reduction and internal fixation of the sternum with a longitudinal plate (L-group) or a T-shaped plate (T-group). We investigated patients' characteristics, clinical details regarding each case of chest trauma, the presence of other associated injuries, the type of open reduction and fixation, whether a combined operation was performed, and postoperative complications. Results: Of the 19 patients, 10 patients (52.6%) were male, and their average age was 56.8 years (range, 32 to 82 years). Seven patients (36.8%) had isolated sternal fractures, while 12 (63.2%) had other associated injuries. Seven patients (36.8%) were in the L-group and 12 patients (63.2%) were in the T-group. Three patients in the L-group (42.9%) showed a loosening of the fixation. In all patients in the T-group, the fracture exhibited stable alignment. Conclusion: Open reduction and internal fixation with a T-shaped plate in sternal fractures is a safer and more efficient treatment method than treatment with a longitudinal plate, especially in patients with a severely displaced sternum or anterior flail chest, than a longitudinal plate.

• 한국운동역학회지
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• 제31권3호
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• pp.155-161
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• 2021

Objective: There is a lack of studies using the 3D-2D image registration techniques on the mechanism of a shoulder injury for ice hockey players. This study aimed to analyze in vivo 3D glenohumeral joint arthrokinematics in collegiate ice hockey athletes and compare shoulder scaption with or without a hockey stick using the 3D-2D image registration technique. Method: We recruited 12 male elite ice hockey players (age, 19.88 ± 0.65 years). For arthrokinematic analysis of the common shoulder abduction movements of the injury pathogenesis of ice hockey players, participants abducted their dominant arm along the scapular plane and then grabbed a stick using the same motion under C-arm fluoroscopy with 16 frames per second. Computed tomography (CT) scans of the shoulder complex were obtained with a 0.6-mm slice pitch. Data from the humerus translation distances, scapula upward rotation, anterior-posterior tilt, internal to external rotation angles, and scapulohumeral rhythm (SHR) ratio on glenohumeral (GH) joint kinematics were outputted using a MATLAB customized code. Results: The humeral translation in the stick hand compared to the bare hand moved more anterior and more superior until the abduction angle reached 40°. When the GH joint in the stick hand was at the maximal abduction of the scapula, the scapula was externally rotated 2~5° relative to 0°. The SHR ratio relative to the abduction along the scapular plane at 40° indicated a statistically significant difference between the two groups (p < 0.05). Conclusion: With arm loading with the stick, the humeral and scapular kinematics showed a significant correlation in the initial section of the SHR. Although these correlations might be difficult in clinical settings, ice hockey athletes can lead to the movement difference of the scapulohumeral joints with inherent instability.