• Title/Summary/Keyword: Clavicle

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Scapulothoracic Arthrodesis for Refractory Shoulder Dysfunction: A Retrospective Study of Indications and Functional Outcome

  • Chung, Soo-Tai;Warner, Jon J.P.
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2009.03a
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    • pp.208-208
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    • 2009
  • Eleven shoulders (9 patients) with refractory scapulothoracic dysfunction were treated with scapulothoracic arthrodesis between 2000 and 2006. Refractory shoulder dysfunction included facioscapulohumeral muscular dystrophy in five shoulders (3 patients), refractory scapular winging with long thoracic nerve palsy in one shoulder, scapular winging caused by serratus anterior palsy with trapezius dysfunction in one shoulder, post-surgical thoracic outlet syndrome due to medial clavicle resection in two shoulders, refractory scapular winging with spinal accessory nerve injury in one shoulder, and chronic trapezius rupture caused by cervical spine surgery in one shoulder. The mean active flexion was improved from 82 degrees preoperatively to 112 degrees postoperatively. The mean Constant score was improved from 27.2 points to 68.0 points. Two shoulders (1 patient) that had facioscapulohumeral muscular dystrophy had broken wires due to nonunion, and one patient had a reactive pulmonary effusion. In ten of the eleven shoulders, the patients were satisfied with their results. The scapulothoracic arthrodesis can cause significant pain relief and functional improvement in refractory scapulothoracic and/or shoulder dysfunction. By selecting patients that present with appropriate indications, and using experienced surgical technique through complete preoperative evaluation, we can diminish the complication rate and make good clinical outcomes.

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Clinical Evaluation of Chest Trauma - Analysis for 97 cases - (흉부외상의 임상적 고찰)

  • 정원상
    • Journal of Chest Surgery
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    • v.21 no.2
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    • pp.307-315
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    • 1988
  • A clinical analysis was performed on 97 cases of chest injuries experienced at Department of Thoracic and cardiovascular Surgery, Armed Forces Capital Hospital during 2 years period from 1986 to 1988. Of 97 patients of chest trauma, 39 cases were result from penetrating injuries whereas 58 cases were from non-penetrating injuries, and there were 77 cases of hemothorax and / or pneumothorax, 47 of rib fracture, 8 of foreign body, 6 scapular and clavicle fracture, 5 of diaphragmatic injuries, 4 of paraplegia. The majority of chest injuries were encounted in the age group between 21 and 30 years-old, mean age was 25.9 years-old and all cases were male except one. Gun-shot wound was the most common cause in the penetrating injuries and the majority of non-penetrating chest injury patients were traffic accident and fist or kick accounted for next. The principles of therapy for chest trauma were rapid expansion of the lung by closed thoracostomy[45 cases] and thoracentesis only[3 cases] but thoracotomy done at 27 cases because of massive bleeding or intrapleural hematoma, foreign body, cardiac injury, diaphragmatic injury and bronchial rupture. The over-all mortality was 2.07 percent[2 cases among all], a case was from penetrating injuries and another was from non-penetrating injuries.

Percutaneus Cerclage Wiring in Distal Clavicle Fracture Type 2a - One Case Report - (원위 쇄골 골절 2a 형에서의 경피적 환상 강선 고정술 -1례 보고-)

  • Kim, Jae-Hwa;Lee, Soon-Chul;Cho, Duck-Yun;Yoon, Hyung-Ku;Lee, Yoon-Seok
    • Clinics in Shoulder and Elbow
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    • v.9 no.1
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    • pp.124-129
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    • 2006
  • Distal clavicular fracture frequently requires operative treatment due to high rate of non-union. The operative technique includes the tension band wiring, K- wire fixation, and cerclage wiring etc. Each method has disadvantages somewhat like pin migration or acromioclavicular joint injury and so on. For the distal clavicular fracture type 2a, because of its oblique fracture line, the cerclage wiring is suitable. We performed the cerclage wiring percutaneously under minimal incision without injury to periosteum for the patient who had the distal clavicular fracture type 2a, and the result was favorable.

Reverse shoulder arthroplasty with os acromiale

  • Shin, Woo-Jin;Lee, Hyun-Ju;An, Ki-Yong
    • Clinics in Shoulder and Elbow
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    • v.23 no.2
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    • pp.100-104
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    • 2020
  • Function and strength of the deltoid muscle are important in reverse shoulder arthroplasty (RSA). Moreover, location and shape of the acromion, clavicle, and scapular spine, which are origins of the deltoid muscle, are also important. The frequency of os acromiale is 5% to 15%; however, it is rare in the Asian population, affecting approximately 0.7% of Koreans. RSA has rarely been reported in patients with os acromiale. We present a case series of two patients with cuff tear and arthropathy combined with os acromiale who underwent RSA. From 2016 to 2018, two patients with os acromiale who presented with pain and limited range of motion (ROM) underwent RSA with cuff tear arthropathy using the subscapularis-sparing deltopectoral approach. Their ROM, visual analog scale (VAS), and satisfaction were evaluated before and after surgery. In both patients, VAS decreased, ROM increased, and postoperative satisfaction increased. There were no specific complications due to os acromiale. The VAS, ROM, and satisfaction of patients improved after surgery compared with values before surgery. However, careful attention must be given during surgery to ensure optimal repair and recovery.

A Case Report of Traumatic Oculomotor Nerve Palsy Treated with Acupuncture and Herbal Medicine. (외상성 동안신경마비 치험 1례)

  • Kim, Hee-jeong;Lee, Gil-Young;Kim, Yoon-Bum
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.17 no.3
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    • pp.167-173
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    • 2004
  • Strabismus is a misalignment of the eyes. It is divided into paralytic strabismus and non-paralytic strabismus. There are so many causes in paralytic strabismus, and the oculomotor nerve palsy is one of them. Many studies reported the etiology and clinical features of oculomotor nerve palsy. Common causes of oculomotor nerve palsy are idiopathic, vascula.; disease, aneurysm, head trauma, neoplasm and miscellaneous. Recently the proportion of traumatic cause has been increased, but the treatment is difficult as it used to be. In this case report, one case of traumatic oculomotor nerve palsy with zygomatic arch Fx and clavicle Fx were treated by herbal medicine and acupuncture. After Treatment, symptoms- ptosis, deviation of Lt. eye to downward & outward in primary position, diplopia, limited adduction & elevation & depression, dilated pupil without pupil reflex- were improved. There are so many hypothesises but no definite guide lines are established about the oriental medical treatment of oculomotor nerve palsy, so we expect the establishment of definite guide lines by further clinical studies.

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ORAL MANIFESTATION AND TREATMENT IN CLEIDOCRANIAL DYSPLASIA PATIENT - A CASE REPORT - (쇄골 두개 이형성증 환자의 구강내 증상과 치료-증례 보고)

  • Jo, Hyung-Woo;Choi, So-Young;Kim, Jin-Wook;Byeon, Ki-Jeong;Kim, Chin-Soo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.5
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    • pp.440-443
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    • 2009
  • Cleidocranial dysplasia(CCD) is a rare syndrome usually caused by an autosomal dominant gene or no apparent genetic cause. The skull is large and short with marked bossing of the frontal bone. Closure on the fontanelles and sutures is delayed. The clavicle may be unilaterally or bilaterally aplastic. Oral manifestations include multiple impacted permanent teeth, prolonged retention of primary teeth and multiple supernumerary teeth. There are many difficulties in the early diagnosis of CCD because a majority of the craniofacial abnormalities becomes obvious only during adolescence. Late diagnosis produce occlusional & psychological problem. Therefore early detection and treatment of CCD can reduce the period and the extent of orthodontic and surgical interventions. We experienced CCD patient with multiple supernumerary teeth and will report it with the literature review.

Treatment of Rockwood Type III Acromioclavicular Joint Dislocation

  • Kim, Seong-Hun;Koh, Kyoung-Hwan
    • Clinics in Shoulder and Elbow
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    • v.21 no.1
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    • pp.48-55
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    • 2018
  • While non-operative treatment with structured rehabilitation tends to be the strategy of choice in the management of Rockwood type III acromioclavicular joint injury, some advocate surgical treatment to prevent persistent pain, disability, and prominence of the distal clavicle. There is no clear consensus regarding when the surgical treatment should be indicated, and successful clinical outcomes have been reported for non-operative treatment in more than 80% of type III acromioclavicular joint injuries. Furthermore, there is no gold standard procedure for operative treatment of type III acromioclavicular joint injury, and more than 60 different procedures have been used for this purpose in clinical practice. Among these surgical techniques, recently introduced arthroscopic-assisted procedures involving a coracoclavicular suspension device are minimally invasive and have been shown to achieve successful coracoclavicular reconstruction in 80% of patients with failed conservative treatment. Taken together, currently available data indicate that successful treatment can be expected with initial conservative treatment in more than 96% of type III acromioclavicular injuries, whereas minimally invasive surgical treatments can be considered for unstable type IIIB injuries, especially in young and active patients. Further studies are needed to clarify the optimal treatment approach in patients with higher functional needs, especially in high-level athletes.

A Case of Creation of Mediastinal Tracheostoma with Unilateral Manubrial Resection as Salvage Operation (구제수술에서 일측 복장뼈자루 절제를 통한 전종격동 기관절개술의 1례)

  • Jeon, Seok Won;Kim, Chang Hoi;Lee, Hae Young;Kim, Sung Won
    • Korean Journal of Head & Neck Oncology
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    • v.32 no.2
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    • pp.29-33
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    • 2016
  • A 65-year-old male visited hospital in the state of tracheostomal recurrence 1 year after total pharyngolaryngectomy. Extensive recurrence around stoma or paratracheal, superior mediastinal area is challenging in treatment, especially in securing airway. We performed mediastinal tracheotomy through resection of unilateral manubrium, some part of sternal side of clavicle and $1^{st}$ rib as the salvage operation for recurrent laryngeal cancer. This procedure could be risky, thus very careful patient selection is required because of a tortuous postoperative course. We would like to present the case that anterior mediastinal tracheostomy could be needed as appropriate palliative means of airway construction in the patients with recurrent laryngeal cancer with lower neck extension with literature review.

Changes in the Respiratory Function of Stroke Patients on the Ground and Immersed under Water (지상과 수중에서 뇌졸중 환자의 호흡기능 변화)

  • Kim, Ju-Seung;Park, Min-Chull
    • PNF and Movement
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    • v.16 no.3
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    • pp.389-395
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    • 2018
  • Purpose: The purpose of this study was to investigate whether the respiratory function of patients with stroke was different on the ground and under water. Methods: We recruited 14 adults who had experienced a stroke (12 male, 2 female) for our study. We measured forced vital capacity, forced expiratory volume at one second, maximum inspiratory pressure, and maximum expiratory pressure when the participants breathed on the ground and under water. On the ground, the participants were safely supported using a table and chair and were measured in a standing posture. For measuring under water, the participants were immersed in water in a standing position to clavicle height. The participants were measured while standing, and the assistant supported them when they needed help. The collected data were analyzed by a paired t-test. Results: Forced vital capacity and forced expiratory volume at one second were significantly lower in water than on the ground when breathing at maximum. Maximum inspiratory pressure was not significantly different when standing on the ground or in water, but maximum expiratory pressure was significantly higher in water than on the ground. Conclusion: It has been confirmed that the hydrostatic pressure affecting stroke patients immersed in water affects the forced expiratory volume at one second while reducing the forced vital capacity and increasing the maximum expiratory pressure.

Osteological Development of the Larvae and Juvenile in Sakhalin Sole Limanda sakhalinensis (사할린가자미(Limanda sakhalinensis) 자치어의 골격발달)

  • Han, Kyeong-Ho;Lee, Seong-Hoon;Baek, Jeong-Ik;Park, Jae-Min
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.52 no.4
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    • pp.389-399
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    • 2019
  • This study is designed to observe the development of skeleton of Sakhalin sole Limanda sakhalinensis in order to use the findings as the basic data for the taxonomic research. As for the development of skeleton, on 20 days of the hatch when its average total length was 5.86 mm, the clavicle and the paraspenoid in the cranium were ossified. As for the jaw bone, the premaxillary and the dentary were ossified. On 28 days of hatch when its total length was 7.05 mm, 25 neural spines and 22 hemal spines were ossified and 5 fin rays appeared. On 34 days of hatch when its average total length was 8.40 mm, the end of tail was twisted by $45^{\circ}$ and 3 hypural bones were ossified. On 48 days of hatch when its average total length was 10.1 mm, 2 actinosts below the postcleithrum were ossified. On 54 days of hatch, when the average total length was 10.4 mm, the ethmoid, prootic and exoccipital were ossified, thus completing the ossification of skeleton.