• The Academic Congress of Korean Shoulder and Elbow Society
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• 2008.03a
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• pp.164-164
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• 2008

The beach-chair traction position is designed to allow the use of traction while allowing the surgeon to orient the shoulder in an upright position and convert to an open procedure, if necessary. The patient is placed in the beach-chair position under general anesthesia. A three-point shoulder holder (Arthrex, Naples, Florida) is attached to the rail of the operating table on the same side as the surgeon, whereas it is placed on the side opposite the surgeon in the lateral decubitus position. A shoulder traction and rotation sleeve (Arthrex) are affixed to the arm following the manufacturer's instructions. Positioning the thumb toward the closed side of the sleeve ensures a field for the anterior portion of the rotator cuff and prevents the tendency of the suspension apparatus to place the arm in internal rotation. The arm is maintained in 30 to 40 degree abduction and 30 to 40 degree flexion by controlling the length and height of the bar and the location of the universal clamp. The universal clamp allows multiple planes of adjustment to control abduction and forward movement of the arm. The sleeve is attached to the longitudinal traction cable using a sterile hook, and a lateral strap is secured around the proximal portion of the sleeve to the overhead traction cable to ensure a field for glenohumeral reconstruction. The use of a lateral strap permits ideal shoulder positioning for improved access to the anterior and inferior glenohumeral joint. The lateral strap can be released or removed to widen the subacromial space during subacromial decompression or rotator cuff repair. A 10-lb weight is attached to the longitudinal traction cable for an average-sized person.

• The Journal of the Korea Contents Association
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• v.13 no.10
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• pp.523-532
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• 2013

When the golf club hits the ground prior to making contact with the golf ball, we define it as 'fat shot'. The aim of this research was to investigate the difference between normal shot and fat shot in golf. Five candidates playing as recreational golfer participated in this research and they were all right-handed people. Time phase between each event, wrist cocking angle, elbow extension-flexion angle, backswing height, pelvis angle, thorax angle, L-GRF, R-GRF, pelvis linear velocity, pelvis angular velocity and COG path were calculated. For statistical analysis the paired T-test was used. An early un-cocking, an early right elbow extension and impact with leaving their weight behind foot were not reasons of fat shot. Backswing height, X-Factor, pelvis angle and thorax rotation angle were not different between normal shot and fat shot. But we could find a pattern of abrupt pelvic movement and weight shift to target direction just before impact in case of fat shot. In addition fat shot showed time-delayed and small value of pelvis linear velocity pattern to upward during downswing phase as against normal shot.

• Journal of the Korean Society for Precision Engineering
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• v.26 no.7
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• pp.134-141
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• 2009

Recently, many researchers have tried to develop wearable robots for various fields such as medical and military purposes. We have been studying robotic exoskeletons to assist the motion of persons who have problems with their muscle function in daily activities and rehabilitation. The upper-limb motions (shoulder, elbow and wrist motion) are especially important for such persons to perform daily activities. Generally for shoulder motion 300F is needed to describe its motion(extension/flexion, abduction/adduction, internal/external rotation) but we have used a redundant actuator thus making a 4 DOF system. In this paper, we proposed the mechanism design of the exoskeleton which consists of 4-DOF for shoulder and 1-DOF for elbow robotic exoskeleton to assist upper-limb motion. Then we compared the new mechanism design and prototype mechanism design. Here we also analyze the proposed system kinematically to find out and to avoid the singular point. This research will ensure that the proposed wearable robot system make human's motion more powerfully and more easily.

• Journal of Korean Physical Therapy Science
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• v.2 no.3
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• pp.587-598
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• 1995

The purpose of this study was to test the microcurrent electrical neuromuscular stimulation on muscle soreness, serum creatine kinase levels and force deficits evident following a high-intensity eccentric exercise bout. 10 volunteer male subjects were randomly assigned to a treatment group or to a control group. Exercise consisted of high-intensity eccentric contractions of the elbow flexors. Resistance was reduced as subjects fatigued, until they reached exhaustion. Muscle soreness rating was determined using a visual analog scale. Serum creatine kinase levels were analyzed using a blood sample. Force deficits were determined by measures of maximal voluntary isometric contraction at $90^{\circ}$ of elbow flexion on a Orthotron II dynamometer. Muscle soreness rating, serum creatine kinase levels and maximal voluntary isometric contraction were determined at the before exercise and again at 24 and 48 hours postexericse. Treatments were applied immediately following exercise. The control group subjects rested following their exercise bout. Statistical analysis showed significant increases in muscle soreness rating and significant decreases in maximal voluntary isometric contraction when the before exercise was compared with 24 and 48 hour measures(p<0.01). No significant effects were observed between groups in muscle soreness rating and maximal voluntary isometric contraction(p>0.05). Highly significants differences in serum creatine kinase levels were found using on Analysis of variance(ANOVA) repeated measures between groups for each time cycles(p<0.001). This modality may have benefits when used early stage in the muscle damage.

• 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.

• Clinics in Shoulder and Elbow
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• v.20 no.2
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• pp.59-67
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• 2017

Background: The purpose of this study was to examine the clinical and radiological results of the all-arthroscopic, suture-button fixation technique to treat acute acromioclavicular (AC) joint separations. Methods: All patients with acute AC joint separations received all-arthroscopic, single suture-button (TightRope) procedure without a special guide. Postoperative Constant score (CS), pain level according to visual analogue scale, and range of motion (ROM) were evaluated. For radiological evaluation, coracoclavicular distances were measured bilaterally. Results: Between December 2010 and June 2012, 18 consecutive patients (4 women and 14 men; mean age, 29.3 years) with acute AC joint separations underwent surgical treatment after 6.4 days (range, 2-20 days) following the initial trauma. The average postoperative follow-up was 16.9 months. The mean CS was 92.4 (range, 84-96). The mean external rotation, forward flexion, and abduction were $75.8^{\circ}$ (range, $50^{\circ}-90^{\circ}$), $170^{\circ}$ (range, $150^{\circ}-180^{\circ}$), and $163.8^{\circ}$ (range, $140^{\circ}-180^{\circ}$), respectively. Five patients exhibited coracoclavicular ossifications. In two patients, superficial wound infections were successfully treated with antibiotic therapy. In one patient, a coracoid fracture was observed. No significant differences were found regarding pain, ROM, or strength parameters between both sides. The coracoclavicular distance was discovered to be approximately 2.8 mm greater on the affected side; however, this minimal reduction loss did not affect the functional results. Conclusions: The findings of this study suggests that all-arthroscopic treatment of AC joint separations using the single suture-button technique without a drill guide is safe, yielding good to excellent clinical results.

• Clinics in Shoulder and Elbow
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• v.21 no.3
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• pp.145-150
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• 2018

Background: This study evaluated the shoulder girdle muscle characteristics of elite archery athletes and provides suggestions for archery training programs. Methods: This study enrolled 15 cases of high level archery athletes (7 males, 8 females) and 30 cases of (15 males, 15 females) sex, age-matched, healthy, non-athletic individuals. We measured peak torques of flexion (FL), extension (EX), abduction (ABD), adduction (ADD), external rotation (ER) and internal rotation (IR) of both shoulders at an angular velocity of $30^{\circ}/sec$, $60^{\circ}/sec$, and $180^{\circ}/sec$. The peak torques and peak torque ratios of FL/EX, ABD/ADD, and ER/IR of the two groups were compared. Results: The archer group had a greater peak torque of IR and ADD, but only in the left shoulder (p<0.05). In the same group, both shoulders had greater peak torque of EX and lower peak torque of FL. The peak torque ratios of FL/EX of both shoulders were significantly lower in the archer group at all three angular velocities (p<0.05). The peak torque ratios of ABD/ADD were significantly greater in only the left shoulder of the archer group (p<0.05). Conclusions: The prominent characteristics of the shoulder girdle muscles of an elite archer are stronger adductor muscles of the bow shoulder and stronger extensors of both shoulders, as compared to healthy, non-athletic individuals. These muscle groups of the shoulder probably contribute a major role in maintaining the accuracy and stability during archery shooting. Hence, a training program that selectively enhances the adductor and extensor muscles could prove helpful in enhancing the archery skills of the athlete.

• Clinics in Shoulder and Elbow
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• v.1 no.2
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• pp.160-166
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• 1998

The purpose of this study was to assess the results of arthroscopic subacromial decompression in patients with chronic impingement and to evaluate the results according to the rotator cuff pathology. We evaluated the clinical results of treatment for chronic impingement syndrome in 28 patients from Feb 1996 to Feb 1997. There were twenty men and eight women in age from 24 to 72 years (mean age 51) with dominant arm involvement in sixteen patients. Follow up evaluations averaged 15(range 12-24)months. The average duration of symptoms were 15(range 6­60)months. The final diagnoses which were based on the physical examination, plain radiographs and arthroscopic findings, were stage II impingement in 16 patients and stage ill impingement in 12 patients. We excluded the patients with acromioclavicular arthritis or glenohumeral instability in this study. All patients were managed non-operatively a minimum of six months. During the operation we performed contouring and smoothing the acromial undersurface and only resecting of the anterolateral band of the coracoacromial ligament. The clinical results were quantitated using UCLA shoulder rating score. Satisfactory results were obtained in 23(80%) patients. Unsatisfactory results were obtained in 5(18%) patients with posterior cuff tear. The average UCLA pain score showed significant improvement from 2.8(constant pain) to 7.2(present during heavy activities) at final follow up. The function and active forward flexion scores also increased from their preoperative value. There was no significant differences according to the surface and severity of tear and NeeI' stage (P>0.05). These results compared favorably with those reported following open acromioplasty. While arthroscopic subacromial decompression is a demanding technique with a learning curve, it is a reliable treatment for chronic impingement syndrome. A less aggressive approach to subacromial decompression and preserving the posteromedial band of the coracoacromialligament does not appear to compromise results.

• Clinics in Shoulder and Elbow
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• v.13 no.2
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• pp.280-285
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• 2010

Purpose: Coracoid impingement syndrome refers to subscapularis impingement between the coracoid process and lesser tuberosity of the humerus, and pain may occur when the arm is positioned in forward flexion, internal rotation and adduction. This position is common for archers. Material and methods: A female archer with coracoid impingement syndrome that was uncontrolled by conservative therapy underwent arthroscopic subcoracoid decompression. At the 20th postoperative month of follow up, she complained of painful rotator interval widening and so she underwent arthroscopic rotator interval plication. Results: At the postoperative 6th month of follow up after the second operation, she showed no pain and good functional results, and she returned to competing as an archer. Conclusion: We have reported here on a case of successful treatment of painful rotator widening after subcoracoid decompression in an elite archer.

• Clinics in Shoulder and Elbow
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• v.9 no.1
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• pp.105-110
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• 2006

Purpose: This study reports the clinical results of the arthroscopic Bankart repair in traumatic anterior instability of the shoulder with bio-knotless anchor. Materials and Methods: 21 cases of 21 patients (20 male and 1 female) were included in this study. The average age was 24.8 years old and the period from the first injury to operation was average 37.2 months. All cases had Bankart lesion and 12 cases had Hill-Sachs' lesion. The SLAP lesion was associated in 6 cases. Preoperative Rowe score was average 29.1. Arthroscopic Bankart repair with bio-knotless anchor were performed in all cases; 3 anchors at 3, 4, 5 O'clock position of the glenoid were used in 11 cases and 2 anchors at 4, 5 O'clock position were used in 10 cases. All the associated SLAP lesions were repaired arthroscopically with bio-knotless anchor. Thermal capsular shrinkage at the anterior and inferior shoulder capsule after the Bankart repair was performed in 3 cases. The average follow up period was 20.2 months. Results: The Rowe score improved to 92.8, excellent in 17 cases and good in 4 cases, at last follow up period and 20 cases had full range of motion of the shoulder. 1 case had mild limited range of motion of the shoulder (150 degrees in flexion, 60 degrees in external rotation and T12 level in internal rotation) without any problem in normal activity. The arthroscopic revision surgery of the shoulder was performed in 1 case because of multiple traumatic injuries of the shoulder with pain postoperatively. Conclusion: Arthroscopic Bankart repair with bio-knotless anchor in traumatic anterior shoulder instability is one of the good methods because of the good clinical results.