• Clinics in Shoulder and Elbow
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• v.17 no.1
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• pp.18-24
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• 2014

Background: To evaluate the efficacy of the subclavian portal approach for the arthroscopic repair of isolated subscapularis tendon tear. Methods: We used the subclavian portal to carry out arthroscopic repair of the isolated subscapularis tendon tear. The surgery was carried out in 18 cases (average age of 53) from May 2006 to December 2009 with a mean follow-up period of 35 months. Of these cases, 13 patients had the tear in their dominant arms, 16 were male, and 12 were from traumatic ruptures with on average 7.6 months of symptom period to operation. Additional surgery, acromioplasty and subacromial debridement, were carried out on 4 cases each during the subscapularis repair. The integrity of cuff status was assessed by ultrasonographic examination at 6 months and at 1 year after operation. Results: The initial average range of motion in forward flexion, external rotation, and internal rotation were $160^{\circ}$, $50^{\circ}$ and L4, respectively. At the 1 year follow-up period, these improved to $160^{\circ}$, $52^{\circ}$ and T12, respectively. The initial average functional scores were assessed by KSS, ASES, UCLA, and Constant scoring systems, which were 67, 60, 26, and 65, respectively. These scores improved progressively with time. At 3 months after operation, the scores were 74, 67, 27, and 74; at 6 months, 83, 77, 31, and 75; at 1 year, 88, 86, 32, and 79; and at the final follow-up of 35 months, 84, 92, 34, and 84. Conclusions: In the repair of isolated subscapularis tendon tear, the subclavian portal approach provided a good angle for anchor insertion and sufficient space to manage the upper portion of the tendon tear. In turn, these provisions resulted in satisfactory clinical results.

• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.236-239
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• 2009

Purpose: We wanted to evalulate the clinical results of pectoris major tendon transfer for a neglected winged scapula that was caused by paralysis of the serratus anterior due to injury to the long thoracic nerve. Materials and Methods: A patient had neglected winged scapula that followed an arthroscopic operation for multi-directional instability of the shoulder joint, which was caused by traumatic dislocation. The patient was treated with pectoralis major tendon transfer using the modified Eden-Lange procedure. The range of a motion was improved from forward flexion $90^{\circ}$ and external rotation $70^{\circ}$ to $170^{\circ}$ and $150^{\circ}$ respectively. Results and Conclusion: There were no complications or recurrence and the patient's psychological satisfaction was also high. If the shoulder girdle muscles are intact, except for the serratus anterior, then pectoralis tendon transfer is a satisfactory method that can provide normal scapulo-thoracic motion.

• Clinics in Shoulder and Elbow
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• v.20 no.3
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• pp.126-132
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• 2017

Background: The aim of the present study was to determine the correlation between the amount of pain reduction after local anesthetic injection into the subacromial space preoperatively and clinical outcome after arthroscopic rotator cuff repair. Methods: A total of 127 patients who underwent arthroscopic rotator cuff repair and followed up at least 1 year were analyzed retrospectively. Preoperatively, a visual analogue scale (VAS) for pain was measured in all patients before and after the ultrasound guided impingement test. The participants were divied into four groups according to pain reduntion ater impingement test (Group A: >75%, Group B: 50%-75%, Group C: 25%-50%, Group D: <25%). VAS for pain, shoulder range of motion, shoulder isometric strength, ASES score were evaluated preoperatively and at 3, 6, 9, and 12 months postoperatively. Results: After surgery, the amount of pain reduction shows significantly at 3, 6 months in Groups A, B as compared to Groups C, D (p<0.05). Among the range of motion of shoulder joint, forward flexion was significantly improved in Group A at 3 months (p<0.05). The ASES score significantly improved at 3, 6 months in Groups A, B as compared to Group C, D (p<0.05). Conclusions: Preoperative degree of pain reduction after impingement test correlates with the improvement of pain after arthroscopic rotator cuff repair, especially in the early phase. Therefore, the impingement test could be effectively used.

• Clinics in Shoulder and Elbow
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• v.22 no.1
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• pp.29-36
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• 2019

Background: The execution of fibular allograft augmentation in unstable proximal humerus fractures (PHFs) was technically demanding. In this study, the authors evaluated the clinical and radiographic outcomes after tricortical iliac allograft (TIA) augmentation in PHFs. Methods: We retrospectively assessed 38 PHF patients treated with locking-plate fixation and TIA augmentation. Insertion of a TIA was indicated when an unstable PHF showed a large cavitary defect and poor medial column support after open reduction, regardless of the presence of medial cortical comminution in preoperative images. Radiographic imaging parameters (humeral head height, HHH; humeral neck-shaft angle, HNSA; head mediolateral offset, HMLO; and status of the union), Constant score, and range of motion were evaluated. Patients were grouped according to whether the medial column support after open reduction was poor or not (groups A and B, respectively); clinical outcomes were compared for all parameters. Results: All fractures healed radiologically (average duration to complete union, 5.8 months). At final evaluation, the average Constant score was 73 points and the mean active forward flexion was $148^{\circ}$. Based on the Paavolainen assessment method, 33 patients had good results and 5 patients showed fair results. The mean loss of reduction was 1.32 mm in HHH and 5.02% in HMLO. None of the parameters evaluated showed a statistically significant difference between the two groups (poor and not poor medial column support). Conclusions: In unstable PHFs, TIA augmentation can provide good clinical and radiological results when there are poor medial column support and a large cavitary defect after open reduction.

• Journal of the Korean Society of Clothing and Textiles
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• v.47 no.3
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• pp.577-592
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• 2023

In this study, nanofiber-based textile sensors were developed for motion detection and monitoring. Poly(vinylidene fluoride) (PVDF) nanofibers containing zinc oxide (ZnO) nanoparticles and silver nanowires (AgNW) were fabricated using electrospinning. PVDF was chosen as a piezoelectric polymer, zinc oxide as a piezoelectric ceramic, and AgNW as a metal to improve electric conductivity. The PVDF/ZnO/AgNW nanocomposite fibers were used to develop a textile sensor, which was then incorporated into an elbow band to develop a wearable smart band. Changes in the output voltage and peak-to-peak voltage (V_p-p) generated by the joint's flexion and extension were investigated using a dummy elbow. The β-phase crystallinity of pure PVDF nanofibers was 58% when analyzed using Fourier transform infrared spectroscopy; however, the β-phase crystallinity increased to 70% in PVDF nanofibers containing ZnO and to 78% in PVDF nanocomposite fibers containing both ZnO and AgNW. The textile sensor's output voltage values varied with joint-bending angle; upon increasing the joint angle from 45° to 90° to 150°, the V_p-p value increased from 0.321 V_p-p to 0.542 V_p-p to 0.660 V_p-p respectively. This suggests that the textile sensor can be used to detect and monitor body movements.

• Clinics in Shoulder and Elbow
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• v.26 no.3
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• pp.267-275
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• 2023

Background: Physical therapy (PT) plays an important role in the recovery of function following anatomic total shoulder arthroplasty (aTSA). While several PT protocols have been published for these patients, there is no standardized protocol for aTSA rehabilitation. This lack of standardization may lead to confusion between patients and physicians, possibly resulting in suboptimal outcomes. This study examines how PT protocols provided by academic orthopedic surgery programs vary regarding therapeutic goals and activities following aTSA. Methods: PT protocols for aTSA available online from the Accreditation Council for Graduate Medical Education accredited orthopedic surgery programs were included for review. Each protocol was analyzed to evaluate it for differences in recommendation of length of immobilization, range of motion (ROM) goals, start time for and progression of therapeutic exercises, and timing for return to functional activity. Results: Of 175 accredited programs, 25 (14.2%) had protocols publicly available, programs (92%) recommended sling immobilization outside of therapy for an average of 4.4±2.0 weeks. Most protocols gave recommendations on starting active forward flexion (24 protocols, range 1-7 weeks), external rotation (22 protocols, range 1-7 weeks), and internal rotation (18 protocols, range 4-7 weeks). Full passive ROM was recommended at 10.8±5.7 weeks, and active ROM was 13.3±3.9 weeks, on average. ROM goals were inconsistent among protocols, with significant variations in recommended ROM and resistance exercise start times. Only 13 protocols (52%) gave recommendations on resuming recreational activities (mean, 17.4±4.4 weeks). Conclusions: Publicly available PT protocols for aTSA rehabilitation are highly variable. Level of evidence: IV.

• Journal of the Korean Arthroscopy Society
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• v.10 no.2
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• pp.178-183
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• 2006

Purpose: We reported the results and efficiency of arthroscopic treatment in a state of the lateral traction about the degenerative arthris of elbow Materials and Methods: Twenty one elbows with the degenerative arthritis who were followed up for at 12 months were enrolled in this study. Male were 15 cases, female were 6 cases, the mean age was 47 years and right dominant hand was 14 cases. In all cases, during arthroscopic treatment under the traction of 10 pounds, we had done synovectomy, excision of loose body and anteroposterior spur. After operation, immobilization was done in the full extension state, and then continuous passive motion (CPM) was started two day Results: The average preoperative ROM of the elbow joint was $30{\sim}l15$ degree and the average postoperative ROM of the elbow joint was $5{\sim}130$ degree. The increasement of ROM was totally 41 degree in extension 25 degree and flexion 16 degree. The decrement of VAS in pain was from 7.5 into 2.3 and the increasement of the satisfactory function was from 1.8 into 9.0. Complication was in two cases. One was paresthesia of ulnar nerve, but resolved. The other was bullae formation around the elbow joint, but cured. Conclusion: Regarding degenerative arthritis of elbow, arthroscopic treatment showed excellent result in recovery of range of motion and relief of pain. We could obtain good visual field with distraction in lateral position.

• Korean Journal of Applied Biomechanics
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• v.15 no.3
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• pp.161-173
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• 2005

Recently among several tennis techniques forehand stroke has been greatly changed in the aspect of spin, grip and stance. The most fundamental factor among the three factors is the stance which consists of open, square and closed stance. The purpose of this study was to investigate the relations between the segments of the body, the three dimensional anatomical angle according to open stance patterns during forehand stroke in tennis. For the movement analysis three dimensional cinematographical method(APAS) was used and for the calculation of the kinematic variables a self developed program was used with the LabVlEW 6.1 graphical programming(Johnson, 1999) program. By using Eular's equations the three dimensional anatomical Cardan angles of the joint and racket head angle were defined 1. In three dimensional maximum linear velocity of racket head the X axis showed $11.41{\pm}5.27m/s$ at impact, not the Y axis(horizontal direction) and the z axis(vertical direction) maximum linear velocity of racket head did not show at impact but after impact this will resulted influence upon hitting ball It could be suggest that Y axis velocity of racket head influence on ball direction and z axis velocity influence on ball spin after impact. the stance distance between right foot and left foot was mean $74.2{\pm}11.2m$. 2. The three dimensional anatomical angular displacement of shoulder joint showed most important role in forehand stroke. and is followed by wrist joints, in addition the movement of elbow joints showed least to the stroke. The three dimensional anatomical angular displacement of racket increased flexion/abduction angle until the impact. after impact, The angular displacement of racket changed motion direction as extension/adduction. 3. The three dimensional anatomical angular displacement of trunk in flexion-extension showed extension all around the forehand stroke. The angular displacement of trunk in adduction-abduction showed abduction at the backswing top and adduction around impact. while there is no significant internal-external rotation 4. The three dimensional anatomical angular displacement of hip joint and knee joint increased extension angle after minimum of knee joint angle in the forehand stroke, The three dimensional anatomical angular displacement of ankle joint showed plantar flexion, internal rotation and eversion in forehand stroke. it could be suggest that the plantar pressure of open stance during forehand stroke would be distributed more largely to the fore foot. and lateral side.

• Journal of the Ergonomics Society of Korea
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• v.26 no.1
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• pp.39-46
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• 2007

The purpose of this study was to develop a comprehensive posture classification scheme considering the effects of external load and motion repetition as well as those of working posture. The scheme was developed based on a series of existing empirical studies dealing with postural classification scheme, effects of external load and motion repetition. Ranges of joint motions, external load and motion repetition were divided into the groups with the same degree of discomforts. Each group was assigned a numerical relative discomfort score of code on the basis of discomfort values for the neutral position of elbow flexion. The criteria for evaluating stress of working postures were proposed based on the four distinct action categories, in order to enable practitioners to apply appropriate corrective actions. The proposed scheme was compared with OWAS, RULA and REBA. The comparison revealed that while the proposed scheme and RULA showed similar results for the working postures with light external load and non-repetitive postures, the former overestimated postural load for postures with moderate or heavy external load and repetitive postures than the latter.

• Archives of Reconstructive Microsurgery
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• v.10 no.1
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• pp.7-11
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• 2001

Purpose : To evaluate the neurologic abnormalities in the donor limb after contralateral C7 transfer in brachial plexus injury. Materials and Methods : From August 1996 to December 1999, five patients with brachial plexus injury were treated with contralateral C7 nerve root transfer. The average follow up was 16 months(range, 5 to 36 months). The clinical findings were assessed using the British Medical Research Council Grading System, and also measured grip power, pinch power of hand and two point discrimination of the fingers. Results : We had no difference in shoulder abduction and elbow flexion after contralateral C7 transfer. The grip and pinch strength were recovered within 4weeks. Sensory loss occurred in all patients and was noted to be more severe on index and middle finger. Four patients recovered within 2 weeks, one continued till one year. Subjective numbness and pain on percussion minimally persisted until last follow-up. Conclusion : The division of the C7 nerve root resulted in minimal and temporary functional deficit in the donor upper limb.