• The Journal of Korean Orthopaedic Ultrasound Society
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• v.7 no.2
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• pp.89-97
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• 2014

Purpose: To evaluate the ultrasonographic findings of the elbows on group screening of middle school baseball players. Materials and Methods: Ninety-three players (age: 12-15, mean 13.5 years) of four middle school baseball team were evaluated with bilateral elbow ultrasonographies in the field regardless of elbow pain. Medial and anterolateral ultrasound examination of the both elbow were performed in the field to detect any abnormalities including medial epicondylar separation or fragmentation and capitellar osteochondritis dissecans respectively. We analyzed the relationship among elbow pain, physical findings and sonographic abnormalities and the differences of sonographic abnormalities between pitchers and fielders. Results: Thirty-six of 93 (39%) players had sonographic abnormalities of elbow in dominant arm, 30 with medial epicondylar apophyseal separation or fragmentation, 2 with osteochondritis dissecans, 4 with both lesions. Twenty-nine of 37 (78%) players with elbow pain had sonographic abnormalities. On physical examination, players with medial epicondylar abnormalities had medial epicondylar tenderness (59%) and pain on valgus stress test (52%), and 5 of 6 (83%) players with osteochondritis dissecans showed flexion contracture more than $5^{\circ}$. The incidence of medial epicondylar abnormalities between pitchers and fielders was statistically not significant but osteochondritis dissecans was more prevalent in pitchers (p<0.05). Conclusion: Elbow sonography is a simple and useful screening tool in the field and also effective for early detection of medial epicondylar abnormalities or osteochondritis dissecans that could be the main causes of elbow pain in adolescent baseball players.

• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.1
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• pp.97-101
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• 2002

Purpose : To describe clinical results and improvement of range of motion and pain after arthroscopic treatment for the athletic elbow lesion. Materials and Methods : We reviewed 13 cases of functional restriction of the elbow motion, who all patients were treated by conservative treatment during than 6 months but failed. We performed arthroscopic osteophytectomy, capsular release, spur excision. The interval from injury to operation was average of 13 months (range, eight to sixteen months). We used the Broberg and Morrey functional rating score system in evaluating result. The follow-up period averaged 6 months. Results : Arthroscopic finding that moderative to severe synovitis in all cases, intraarticular loose body in 9 cases, olecranon bony spur in 2 cases, was observed. All cases were successfully improved in range of motion and pain without in any further operation. Preoperative average score was 65 and postoperative average score was 89.4 in Broberg and Morrey functional rating score. Conclusions : Arthroscopic treatment appear to be satisfactory management modality due to diagnose the casative factor and reduce the injury around the elbow joint in painful elbow lesion. Elbow arthroscopy appears to be a safe and effective treatment for athletes, allowing easy return to participation in sports.

• Clinics in Shoulder and Elbow
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• v.15 no.2
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• pp.109-116
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• 2012

Purpose: The aim of this study was to evaluate preoperative ultrasonographic findings and usefulness in ulnar neuropathy around elbow. Materials and Methods: Twenty-two patients with ulnar neuropathy were performed preoperative ultrasonogram. The route, location, thickness of the ulnar nerve and space occupying lesion through longitudinal scan were evaluated. Cross-sectional areas of the ulnar nerve were measured at the level of medial epicondyle and 3 cm proximal and distal to the medial epicondyle through axial scan. Correlations between swelling ratio of ulnar nerve and eletrophysiologic study and preoperative Dellon's assessment were checked. Results: In 21 cases (95.6%) of total 22 cases, diffuse swelling of the ulnar nerve around elbow were identified. 4 cases had space occupying lesions including 3 ganglionic cysts and 1 heterotopic ossification. Cross sectional areas at the level of medial epicondyle were significantly larger than at the level of 3 cm proximal and distal to the medial epicondyle (p<0.05). There were no statistically significant correlations between swelling ratio of ulnar nerve and eletrophysiologic study and preoperative clinical assessment (p>0.05). Conclusion: This study showed that ultrasonography was helpful to detect etiology of ulnar neuropathy around elbow such as space occupying lesion, morphological change or dislocation of ulnar nerve. It could be useful tool for diagnosis and treatment in patients with ulnar neuropathy at elbow.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2007.11a
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• pp.104-109
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• 2007

외상성 전방탈구의 경우 일차성 탈구이거나 일상생활에 큰 불편을 호소하지 않는 불안정성이 있을 경우 및 비외상성 다방향 불안정성의 경우 보존적 치료가 바람직하며, 10대 및 20대의 재탈구로 인한 불안정성이 유발될 경우 관절경적 혹은 개방성 Bankart 술식을 통하여 관절순의 해부학적 정복 및 술 후 잘 조절된 재활치료를 시행할 경우, 좋은 결과를 얻을 수 있다. 치료 방법의 선택 시 가장 중요한 요소는 환자의 원하는 결과를 만족 시켜줄 수 있는 치료 방법을 선택하는 것이며, 이는 불안정성의 원인, 정도, 탈구의 횟수, 환자의 활동도 및 재활 의지등을 종합적으로 감안하여 결정되어야 한다.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2007.11a
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• pp.88-94
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• 2007

회전근개의 치료의 방침은 거의 전층 파열인 부분파열과 전층파열이고 봉합이 불가능하거나 봉합의 비적응증을 제외하고는 모두 수술로 봉합하여주는 것이 좋으며 그 방법으로는 관절경과 관절경하 miniopen 술식이 적절한 봉합방법으로 생각된다. 봉합의 기본적인 원칙은 최대한 파열된 건의 anatomic footprint reconstruction과 force couple의 balancing (견갑하근과 극하근건의 복원)이 중요하며 적절한 재활과 함께 동반 시 좋은 결과를 얻을 수 있을 것으로 사료된다.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2006.11a
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• pp.147-151
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• 2006

외측 및 내측 상과염은 흔히 관찰되며 지속적인 치료 과정의 관찰이 요구되는 건의 질병이지만 현실적으로는 전체적인 질병의 발생과 치료의 과정에 대한 이해가 부족한 상태에서 모든 의사들이 치료 할 수 있는 질병처럼 취급되면서 초기 치료에서 수술적 치료까지의 결정이 전문적인 정형외과 전문의에 의하여 시행되지 못하여 적절한 시기에 적합한 치료가 선택되지 못하고, 각 치료 과정의 정보가 공유되지 않아 환자에게 꼭 필요한 치료 방법을 선택하는데 어려움이 발생하고 있는 실정이며, 치료 과정중의 불편함이 환자에게 전가되고 있는 상황이다. 따라서 전문적인 지식을 갖춘 정형외과 전문의의 지속적인 관심과 적절한 치료 방법의 선택으로 환자의 유병 기간을 최대한 단축 할 수 있다고 생각한다.

• Clinics in Shoulder and Elbow
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• v.10 no.2
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• pp.190-198
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• 2007

Purpose: The current study reports the clinical results of total elbow arthroplasties (TEA) which were Performed on patients with poor clinical and radiological results after initial surgeries for elbow fractures or dislocations. Materials and Methods: The clinical outcomes of twelve consecutive patients who underwent TEA after failed surgeries for elbow fractures or dislocations from january, 1995 to December, 2005 were evaluated. The initial diagnoses were distal humeral fractures in 8 cases and fracture-dislocations in 4 cases. The Mean period from the initial operations to the TEAs was 12 months. The mean folloow up period after TEA was 43 months. Results: The mean range of motion, in terms of active extension, activeflexion, supination, and pronation, improved from $14.2^{\circ}$, $96.7^{\circ}$, $50.8^{\circ}$ and $53.3^{\circ}$ to $5.4^{\circ}$, $122.1^{\circ}$, $63.3^{\circ}$ and $67.5^{\circ}$, respectively (p<0.05). RAdiolucent lines were found in 3 cases, which were 1 case of type 3, and 2 cases of type 4. All three loosening cases underwent revision TEAs. The mean postoperative Mayo elvow performance score was 79 point. There were 6 cases of excellent, 2 cases of good, and 4 cases in poor. Conclusion: Good clinical results were obtained after TEA performed in failed surgeries for elbow fractures of dislocations.

• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.99-104
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• 2011

Purpose: Total elbow arthroplasty (TEA) is still in its infancy as compared with other forms of arthroplasty. TEA designs have evolved with experience, but comparatively little long-term outcome data is available. This article provides an overview of the current states of linked, unlinked, and convertible total elbow arthroplasty. Material and Method: The designs of total elbow prostheses can be subdivided into three categories: unlinked, linked, and convertible. This article provides an overview of the current states of linked, unlinked, and convertible total elbow arthroplasty. Results and Conclusion: By proper patient selection and by utilizing implant design advances, improvements in cementation techniques, a meticulous surgical technique, and appropriate postoperative rehabilitation, total elbow arthroplasty can provide a high level of patient satisfaction and pain relief.

• Clinics in Shoulder and Elbow
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• v.8 no.2
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• pp.63-67
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• 2005

Osteochondritis dissecans is a common cause of lateral elbow pain in throwing athletes and gymnasts between the age of 10 and 15 years. The pain frequently is insidious and progressive in nature and is relieved with rest in most cases. Compressive forces at the radiocapitellar joint along with a tenuous blood supply to the region may play a role in the etiology of this condition. Treatment is directed according to presenting symptoms, radiographic findings and status of the involved segment. Surgical management involves either an excision of a loose lesion and removal of loose bodies or reattachment of an osteochondral fragment. The role of subchondral penetration of debridement of the defect after fragment excision is unclear. Whether to excise and debride or to fix an unstale fragment is a highly controversial topic. The clinician should recognize osteochondritis dissecans of the elbow as a potentially disabling condition where the prognosis for return to sport is guarded

• Clinics in Shoulder and Elbow
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• v.12 no.1
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• pp.53-60
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• 2009

Purpose: Primary osteoarthritis on the elbow is the result of the growth of osteophytes and contracture of the capsule. It often causes disability on joint motion and pain while exercising. As arthroscopy has developed, the arthroscopic diagnosis and treatment of the elbow have recently become more generalized as well. Therefore, we like to report on arthroscopy for treating elbow arthritis and its results. Materials and Methods: This study includes 23 cases of elbow arthritis that were seen between 2005 June to 2007 June and these patients didn't response to conservative treatment. From this we excluded 18 cases that underwent arthroscopic surgery and among these 18 cases, 6 cases underwent ulnar nerve transfer. The average observation time was 21.3 months and the average age was 48.4 years (range: 22-66 years). The pre and post operative pain was evaluated with using the Visual Analogue Scale (VAS) and functional evaluation was done with using the Mayo elbow Performance Score (MEPS) with the range of joint motion. Results: The VAS score at the last follow up was significantly decreased from 3.4 to 1.9 compare to the preoperative score. The range of joint motion was improved by 25 (0-40) to 8.5 (0-20) in extension and 101.7 (80-140) to 125.2 (85-140) in flexion (p<0.05). The MEPS always showed significant improvement by showing an increase from 65.4 (40-85) to 87.9 (55-100). However, 3 cases showed a decreased range of motion after the operation. One case showed ulnar nerve symptoms after surgery. Conclusion: An arthroscopic procedure can treat the pathologic processes associated with arthritis of the elbow and it was safe and effective in this series.