• Title/Summary/Keyword: Anterior shoulder dislocation

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Large Hill-Sachs Lesion Combined with a Rotator Cuff Tear in an Acute Traumatic Anterior Dislocation of the Shoulder in an Elderly Patient Treated with an Allogenic Iliac Tricortical Bone Graft (노인 환자의 급성 외상성 견관절 전방 탈구에서 회전근개 파열과 동반된 거대 Hill-Sachs 병변에 대해 간접 정복 및 지지대 목적의 동종 장골 삼중 피질골 이식을 통한 치료 1예)

  • Hyun, Yoonsuk;Lim, Jinkyu;Baek, Seung-Ha;Park, Jinho;Lee, Seung-Jin
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.2
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    • pp.188-192
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    • 2020
  • An indirect reduction through the bicipital groove and allogenic iliac tricortical bone graft was performed as a treatment for a large Hill-Sachs lesion with a rotator cuff tear in an acute traumatic shoulder joint dislocation in an elderly patient. Six months after surgery, the rotator cuff healing and bone union were confirmed. The patient also showed satisfactory clinical results with 95 points of the American Shoulder and Elbow Surgeons (ASES) shoulder score and active range of motion with 155° flexion, 120° abduction, and 70° external rotation and 30° internal rotation at 90° abduction. The surgical method can be considered for a large Hill-Sachs lesion with rotator cuff tear in an acute traumatic shoulder joint dislocation in elderly patients.

Humeral Avulsion of the Glenohumeral Joint Capsule - Case Report - (상완골 부착 부위에서 파열된 견관절 낭(증례 보고))

  • Lee Young-Soo;Baek Joon-Sik;Shin Dong-Rae
    • Clinics in Shoulder and Elbow
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    • v.2 no.2
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    • pp.199-203
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    • 1999
  • It is well known that the essential pathology in traumatic anterior dislocation of the shoulder is the avulsion of the glenohumeral ligament complex from the glenoid rim, However, there were some reports that the avulsion can occur from the humeral attachment site. We have experienced a 42-year-old man who had complained of persistent shoul­der pain after traffic accident and showed the instability on physical examination. The MR arthrogram and arthro­scopic surgery revealed the avulsion of glenohumeral ligament from the humeral attachment site. We repaired the lesion using the suture anchor through the anterior axillary approach and had a good result after 1 year.

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Bankart Suture Repair for Anterior Instability of the Shoulder- Results of Arthroscopic versus Open Repair - (견관절 전방 재발성 탈구의 치료-관절경 및 관혈적 Bankart병변 수복술의 비교 -)

  • Choi, Chang-Hyuk;Kwun, Koing-Woo;Kim, Shin-Kun;Lee, Sang-Wook;Shin, Dong-Kyu;Kim, Kyung-Min
    • Clinics in Shoulder and Elbow
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    • v.5 no.1
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    • pp.47-54
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    • 2002
  • Purpose : We evaluated clinical result of arthroscopic and open Bankart repair in anterior shoulder instability to identify factors iuluencing operative result and prognosis. Materials & Methods . We reviewed 24 patients of anterior shoulder instability treated with arthroscopic Bankart repair in 16 cases and open Bankart repair in 8 cases. Average age was 26 years old and involved in dominant arm in 15 cases. Patients were suffered instability for 3.1 years before operation and mean follow-up was 2 year 9 months ( 1 you 9 months -4year 10 months). Results : Post operative pain was subsided in 2 weeks in arthroscopic surgery and 3 weeks in open surgery. The final range of motion after arthroscopic repair were flekion in 168" , external rotation in 54" , and internal rotation in 79, and after open repair 168" ,49" , and 78 respectively. In arthroscopic surgery,2 cases (13%) were redislocated, and 4 cases(25%) showed mild instability. In open case,1 case (11%) showed mild instability. According to function- al result by Rowe grading scale, satisfactory results were 12case (76%) in arthroscopic repair and 7 cases (88%) in open cases. Conclusions Both arthroscopic or open Bankart could get good results in the treatment of anterior instability of shoulder. In arthroscopic repair, perioperative morbidity was lower than open repair, but it needs careful rehabilitation program to prevent redislocation and to return to sports activity.

Accompanying Lesions and Clinical Results in the Greater Tuberosity Fracture of the Humerus with Anterior Shoulder Dislocation Under the Age of Forty (40세 이하에서 견관절 전방 탈구가 동반된 상완골 대결절 골절에서 관절내 병변 및 임상 결과)

  • Kim, Doo-Sup;Yoon, Yeo-Seung;Lee, Dong-Kyu;Park, Hyeun-Kook;Park, Jang-Hee;Shin, John
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.20-26
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    • 2011
  • Purpose: The purpose of this study is to investigate the accompanying lesions of humerus greater tuberosity fracture with anterior shoulder dislocation and to analyze its clinical results. Materials and Methods: From May 2005 to November 2008, arthroscopy was performed on a total of 30 selected patients who were diagnosed with humerus greater tuberosity fracture with anterior shoulder dislocation and who were also under the age of 40. The preoperative and postoperative Constant and Rowe scores were compared. Results: There was a total of 21 cases of anteroinferior labral lesions: 2 Bankart lesions, 4 bony Bankart lesions, 4 Perthes lesions, 2 free ALPSA lesions, 3 GLAD lesions and 6 capsular tears. For other lesions, 5 rotator cuff partial tears, 3 SLAP lesions and 1 biceps tendon rupture were found. The constant scores were increased from 56.3 to 94.43 points (p=0.034), and the Rowe scores were increased from 52.56 to 91.76 points (p=0.026). Conclusion: For humerus greater tuberosity fracture with anterior shoulder dislocation, the accompanying lesion was identified and the fracture was treated using arthroscopy. Good clinical results and bone union were achieved. According to the secondary arthroscopic findings, all of the Perthes lesion, the free ALPSA lesion, the GLAD lesion and the capsular tear spontaneously healed or they did not progress to extended rupture although arthroscopic suture was not performed. Any postoperative secondary instability was not observed.

Arthroscopic Reconstrucion in Megafrequency of Recurrent Anterior Shoulder Dislocations (관절경을 이용한 고 빈도 재발성 전방 견관절 탈구의 재건술)

  • Ko, Sang-Hun;You, Chong-Il;Cho, Sung-Do;Choi, Chang-Hyuk;Cheon, In-Ho;Woo, Jong-Keun;Kwag, Chang-Yul;Yun, Dong-Jin;Choe, Seong-Won
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.194-200
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    • 2005
  • Purpose: To evaluate the short-term follow up outcome and the effectiveness of arthroscopic vertical shift of anteroinferior capsulolabral complex, plication of AIGHLC (anterior band of inferior glenohumeral ligament complex) and thermal capulorraphy, posteroinferior suture plication, rotator interval closure as an adjuncts in recurrent instability of megafrequency with night time dislocation. Materials & Methods: From March 1998 to February 2004, we have had 18 shoulders out of 156. All of the cases have been night time dislocation above more one time. The age were average 29.4$(21{\sim}37)$ year old. The average follow up were 21.1 $(12{\sim}45)$months We checked Rowe score and ROM at pre-operation, post-operation 6 months,1 year & last follow up period. Results: Above good results were 16 cases(88.9%). The excellent were 6 cases, good were 10, fair 1, poor 1. Conclusions: In recurrent anterior shoulder dislocation in greater than 50 frequency, arthroscopic stabilization can be an alternative technique for selected patients against open inferior capsular shift. But more long ter n follow up and large materials will be needed in the future study.

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Reverse shoulder arthroplasty for corticosteroid-induced deltoid myopathy in a patient with systemic lupus erythematosus: a case report

  • Bayram, Serkan;Ersen, Ali
    • Clinics in Shoulder and Elbow
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    • v.24 no.3
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    • pp.178-182
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    • 2021
  • A 50-year-old woman who had been previously diagnosed with systemic lupus erythematosus consulted our clinic for pain and weakness in her right shoulder. On examination, she had an atrophied deltoid muscle, a painful right shoulder on movement, and a tender mass in the deltoid area. The patient was diagnosed with corticosteroid-induced deltoid myopathy, shoulder pain, and loss of range of motion that did not resolve with conservative treatment. We decided to perform reverse shoulder arthroplasty. No complications were observed at the last follow-up visit at 3 years postoperative. Unlike deltoid insufficiency that results from axillary nerve injury, deltoid myopathy due to corticosteroid use contains intact fibers,. Therefore, we increased the effectivity of the remaining deltoid fibers by extending the moment arm of the anterior fibers using reverse shoulder arthroplasty and achieved reliable improvements in clinical symptoms and function without increasing the risk of dislocation.

Isolated Anterior Dislocation of the Radial Head in Adult - A Case Report - (성인에서 발생된 요골 두 급성 전방 탈구 - 증례 보고 -)

  • Heo, Youn-Moo;Kim, Woo-Sik;Kim, Sung-Hun;Jeon, Teak-Soo;Kim, Sang-Bum;Oh, Byung-Hak
    • Clinics in Shoulder and Elbow
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    • v.10 no.1
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    • pp.131-135
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    • 2007
  • We report an isolated anterior dislocation of the radial head in a 23-year-old man after a fall on the outstretched arm. At the time of the injury, the patient's elbow was in a position of mild flexion and pronation which was suddenly further pronated as he fell down. The radial head was incarcerated by the lateral portion of brachialis muscle, and annular ligament was interposed between capitellum and radial head. Open reduction was performed. During 12 months follow-up, reduction of radial head was well maintained without a limitation of range of motion.

Proposal of Modified Velpeau View as an Alternative Test Method of Velpeau View and the Visual Comparison (Velpeau view의 대체 검사법으로서 modified velpeau view의 제안 및 영상 비교평가)

  • Lee, Jae-Hyun;Kim, Sang-Tae
    • The Journal of the Korea Contents Association
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    • v.10 no.6
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    • pp.323-328
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    • 2010
  • If a patient wearing arm sliding due to shoulder dislocation or fracture is impossible with abduction, the velpeau view is performed instead of superior-inferior axial projection view. However, it aggravates the patient's pain because it is difficult for the patient with dislocation or fracture to pull back the shoulders. Therefore, I suggest a new method of the 'modified velpeau view' that allows patients to lower their heads at examination. In order to investigate the easiness of fixing posture at examination and clinical utility, I conducted a study comparing the bone structures at the velpeau view and those at the modified velpeau view depending on wall-bucky and the patients' leaning forward angle ($30^{\circ},\;45^{\circ},\;60^{\circ}\;and\;75^{\circ}$), with the subjects of 20 velpeau view-prescribed patients amongst who had come to my hospital suspected of dislocation of shoulder or fracture and 30 healthy people from October of 2009 to January of 2010. Department of radiologists and orthopedics specialists evaluated the pictures for scales 0 to 5(best grade) under the given criteria. As a result of comparison in bone structures depending on wall-bucky and the leaning-forward angle in the group of healthy people, the velpeau view and the modified velpeau showed a similar diagnostic utility at $45^{\circ}$ and $60^{\circ}$. The picture evaluation result for proving diagnostic value showed that the anterior and posterior of shoulder heads and the anterior and posterior of glenoid fossa could be observed in the velpeau view; on the other hand, besides these areas acromioclavicular joint and coracoid process could be viewed in the modified velpeau view. This result verified that the modified velpeau view could replace the velpeau view for its diagnostic value as an examination method. This result, moreover, suggests that the modified velpeau view needs to be studied and improved from a variety of perspectives not only for an alternative for patients having troubles with the velpeau view position but also for clinical application of new test method for diagnosis of shoulder disorders other than dislocation of shoulder or fracture.

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.