• Clinics in Shoulder and Elbow
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• v.2 no.1
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• pp.35-40
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• 1999

Impingement syndrome is caused by a conflictual status between rotator cuff, subacromial bursa and anatomic and functional coracoacromial arch. The purpose of this study was to assessment the coracoacromial arch by MRI and to determine major factors among five components of coracoacromial arch. We analyzed forty-two cases of clinical impingement sign and test positive and postoperative confirmed diagnosed from March, 1991 to January, 1999. We evaluated acromial end abnormality according to the Bigliani acromial type and formation of osteophyte. Clavicular end abnormality classified flat, outward protrusion, inward protrusion to coracoacromial arch. Acromioclavicular joint abnormalities were advanced osteoarthritis and positive signal change. Coracoacromial ligament thickening was above 2 mm in oblique sagittal image. Coracoid process abnormality was inward protrusion to coracoacromial arch. All consecutive patients abnormalities were as follows: clavicular end osteophyte formation and inward protrusion to coracoacrmial arch were 30%, acromial end osteophyte formation was 28%, advanced acromioclavicular joint arthritis and osteophyte formation were 56%, coracoacromial ligament thickening was 24% and no coracoid process inward protrusion to coracoacromial arch. Impingement syndrome combined with rotator cuff tear group abnormalities were clavicular end(40%), acromial end(40%), acromioclavicular joint(20%), coracoacromialligament(20%) and coracoid process abnormality(0%) respectively. Only impingement syndrome group abnormalities were clavicular end(25%), acromial end(31%), acromioclavicular joint(62%), coracoacromial ligament(25%) and coracoid process(0%) respectively. Acromial type I(flat) were 6 cases, type II(curved) were 26 cases and type III(hooked) were 10 cases. We concluded that the most important contributing factors for impingement syndrome was acromial type and second was acromioclavicular joint arthritis and bony spur formation.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2002.10a
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• pp.211-213
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• 2002

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2001.03a
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• pp.95-101
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• 2001

RTC repair When safely possible Partial repair Gives complete function ASD and debridement In functional RCT Preservation of the coracoacromial arch

• Clinics in Shoulder and Elbow
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• v.1 no.1
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• pp.19-25
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• 1998

Appropriate clinical examination and imaging may lead to early diagnosis and treatment of the shoulder impingement syndrome, thus preventing progressing to a complete tear of rotator cuff. The impingement syndrome was caused by repeated entrapment and compression of supraspinatus tendon between the proximal end of humerus inferiorly, particullary its greater tuberosity. and one or m <)re component of coracoacromial arch superiorly. The purpose of this study is to critically, evaluate the result of twenty-five consecutive subacromial decompression with impingement syndrome and to assess the diagnostic accuracy of MR imaging by using oblique coronal and oblique sagittal plan. These patients were treated by arthroscopic subacromial decompression after their pains failed to improve with conservative therapy over three month. The average follow up was 25 month(range, 12 to 50). The mean age was 43 year old. The results were rated based on subjective response and the UCLA shoulder rating scale of the result. Ten patients(40%) were rated as excellent, 11patients(44%) were good. while four patients(16%) were fair. Radiologic evaluation suggested that the oblique sagittal plan of MRI can be helpful in evaluation of bony and soft-tissue structure of the coracoacromial arch and determining depth of bony resection. There were no infection or neurovascular injury. In reviewing our result, it appears that the arthroscopic subacromial decompression can be successful sugery for shoulder impingement syndrome and diagnostic accuracy of supplimentary oblique sagittal view of MRI was relatively higher than oblique coronal view alone for apprqpriate surgical plan.

• Journal of radiological science and technology
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• v.35 no.2
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• pp.103-107
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• 2012

This study was performed to design a modified Y-View as an imaging method for the Y-View in supine position for patients who requires Y-View imaging for the diagnosis of shoulder impingement syndrome but having trouble for the positioning of patients complaining of shoulder pain. On the result of comparative analysis of the images obtained by changing the lateral-medio degree of X-ray tube into $35^{\circ}$, $40^{\circ}$, and $45^{\circ}$ while patient is in supine position, $40^{\circ}$ of X-ray tube in lateral-medio direction produced the most valuable image for the diagnosis by best describing the shapes of acromion, clavicle space, and coracoacromial arch. Therefore, patients who have difficulty in Y-View position to obtain Y-View image, modified Y-View can be applied as a useful alternative method. By this study, various applications not only in shoulder impingement syndrome but also in diverse omarthralgia diseases are expected.

• Journal of Korean Physical Therapy Science
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• v.3 no.4
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• pp.121-138
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• 1996

Impingement syndrome is mechanical impingement between the greater tubercle of the humerus and the under surface of the coracoacromial arch, is a common source of shoulder pain in the athletes as well as non-athletes. Several factors contribute to shoulder impingement syndrome, including rotator cuff weakness, capsular tightness, poor scapulohumeral rhythm, and muscle imbalance of the scapular upward rotation force couple. The purpose of this article is to review current concepts of anatomy and biomechanics and the underlying pathomechanics as it relates to evaluation and treatment of shoulder impingement syndrome.

• Journal of the Korean Arthroscopy Society
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• v.12 no.3
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• pp.217-221
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• 2008

Coracoid impingement syndrome results from abnormal contact between the anterosuperior humerus and the coracoacromial arch. The coracoid impingement may occur from traumatic, idiopathic, or iatrogenic causes. Traumatic causes of coracoid impingement include fractures of scapular neck, coracoid process or lesser tuberosity. Coracoid impingement due to lesser tuberosity malunion is a rare disease and most of them were treated by open procedures. The authors present a case of coracoid impingement caused by malunion after isolated lesser tuberosity fracture which was treated by arthroscopic coracoplasty with percutaneous screw fixation.

• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.132-140
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• 2010

Purpose: Surgical treatment of massive rotator cuff tear is challenging and there are various surgical options. The purpose of this article is to describe arthroplasty for the treatment of massive rotator cuff tear. Materials and Methods: We reviewed all publications that focused on and/or mentioned arthroplasty as a treatment option for massive rotator cuff tear. Results: Arthroplasty can be used as primary treatment and represents a salvage option for irreparable rotator cuff tear. Hemi-arthroplasty can provide satisfactory results by Neer's limited goals criteria in patients with intact coracoacromial arch. In addition, reverse total shoulder arthroplasty can be a salvage option for pain relief and restoration of active flexion in elderly patients with pseudoparalysis. Conclusion: In patients with massive rotator cuff tear, proper selection of arthroplasty can provide pain relief and restoration of functional range of motion in shoulder joints.

• Journal of the Korean Arthroscopy Society
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• v.14 no.3
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• pp.192-195
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• 2010

Subcoracoid impingement resulting from abnormal contact between the anterosuperior humerus and the anterior coracoacromial arch represents an uncommon source of anterior shoulder pain. Certain operative procedures can also alter the relationship between the coracoid and the lesser tuberosity, leading to impingement of the interventing soft tissue, including the subscapularis and the bursa. We describe an unique case of subcoracoid impingement with the tear of subscapularis tendon after the internal fixation of the fractured coracoid process with cannulated screw due to crowding of the coracohumeral space. Arthroscopic removal of the screw and repair of the subscapularis in our patient resulted in successful resolution of his symptoms. Although subcoracoid impingement is a rare cause of shoulder pain, failure to diagnose and treat this condition may represent a significant cause of failed shoulder surgery.