• Title/Summary/Keyword: Elbow pain

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The Preliminarily Result of Radiologic Disappearance of the Calcific Material on One Time Ultrasonographic Assisted Needling (견관절의 석회화 건염에서 초음파 유도하 1회 주사요법에 의한 방사선학적 조기 소멸 정도에 대한 예비보고)

  • Yoo, Jae-Chul;Shon, Min-Soo;Koh, Kyoung-Hwan;Lim, Tae-Kang;Lee, Yeong-Seok
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.5 no.1
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    • pp.1-8
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    • 2012
  • Purpose: The purpose of this study is to report the preliminarily result of the radiologic disappearance of the calcific material, regardless of the size, type or location, on one-time ultrasonographic (US) assisted needling for calcific tendinitis of the shoulder. Materials and Methods: From March to August 2011, 46 patients (47 shoulders) with symptomatic calcific tendinitis were treated by one-time US assisted needling. Initially, a diagnostic US was performed with patient to determine the locations, numbers and sizes of calcific deposits. After 1% lidocaine local anesthesia, the calcific material was punctured with an 18-gauge needle under US monitoring. If no calcific material was aspirated after 2 or 3 additional attempts, the deposits was performed multiple puncture to achieve decompression. And then all patients were performed subacromial corticosteroid injection. All patients were followed up 4 weeks after procedure. To assess the radiologic disappearance after one-time US assisted needling, simple radiographs of the treated shoulder were performed and size, dense, and morphology of the calcific deposits were compared with those in baseline radiographs. For clinical evaluations, visual analogue scale for pain and function (PVAS and FVAS), and American Shoulder and Elbow Surgeons (ASES) score were assessed. Results: There were 11 male and 35 female patients with the mean age of 53.8 years (28-71). The morphology of the calcific deposits were 31 type A and 16 type B by French Arthroscopic Society classification and mean size was $2.9{\pm}6.7$ mm before the procedure. At 4 weeks after the index procedure, the radiographic unchanged group was included in 10 cases and changed group was 37 cases. No intergroup difference for the clinical results after the procedure was evident, but group FAS classification before the procedure was significantly different (p=0.011). Conclusion: At 4 weeks after one-time US assisted needling for calcific tendinitis of the shoulder, the radiographic size- or dense-changed cases were showed in 79%, regardless of the size, type or location of the calcific material. But the radiographic nearly or complete disappearance were showed in only 21%.

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The Result of Rotator Cuff Repair Using Arthroscopic Margin Convergence Technique in Irreparable Large and Massive Rotator Cuff Tears (해부학적 봉합이 불가능한 회전근 개 파열에서 관절경하 모서리 맞춤 술식을 이용한 봉합의 결과)

  • Choi, Eui-Sung;Park, Kyoung-Jin;Kim, Yong-Min;Kim, Dong-Soo;Shon, Hyun-Chul;Cho, Byung-Ki;Park, Ji-Kang;Lee, Hyung-Joon
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.46-52
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    • 2011
  • Purpose: This study was performed to assess the usefulness of non-anatomical repair for irreparable large and massive rotator cuff tears by the arthroscopic margin convergence technique. Materials and Methods: Twenty-two patients were followed up more than 1 year after non-anatomical repair for irreparable large and massive rotator cuff tears using the arthroscopic margin convergence technique. The clinical evaluation was performed according to the KSS score, the UCLA score and the Visual analogue scale (VAS). The measurement of the acromio-humeral distance was performed using the shoulder anterior-posterior radiographs. The measurement of fatty degeneration and the healing status was performed using the shoulder MRI after 6 months. Results: Among twenty-two patients, follow up MRI was performed in eleven cases. Three cases were well healed, four cases were partial healed and another four cases were re-torn. The KSS and UCLA scores had significantly improved from a preoperative average of 45.0${\pm}$8.014 and 10.8${\pm}$2.302 points to 77.1${\pm}$10.151 and 30.0${\pm}$1.521 points, respectively, and the pain VAS had decreased from a preoperative average of 7.7${\pm}$0.616 points to 3.0${\pm}$1.021 points at the last follow up. Less favorable results were obtained when the patient had a grade of fatty degeneration higher than grade 3 on the preoperative MRI. Conclusion: Non-anatomical repair for irreparable large and massive rotator cuff tears by the arthroscopic margin convergence technique showed good functional results. It seems to be one of the effective treatment methods for irreparable large and massive rotator cuff tears.

MR Evaluation of Tendinous Portions in the Subscapularis Muscle (견갑하근의 건 부분에 대한 자기공명영상을 이용한 분석)

  • Shon, Min-Soo;Koh, Kyoung-Hwan;Lee, Sung-Sahn;Yoo, Jae-Chul
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.35-45
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    • 2011
  • Purpose: The purpose of this study was to document the structural features of the tendinous portions within the non-pathologic subscapularis muscle by performing high resolution MR imaging of the shoulder. Materials and Methods: Between April 2007 and May 2010, we retrospectively obtained the MR scans of 88 consecutive young patients (88 shoulders) who were in their twenties. MRI and MR arthrography were performed using a 3.0-T system for the evaluation of glenohumeral instability and nonspecific shoulder pain. None of the patient in this study had any evidence of injury to the tendon or muscle belly of the subscapularis. On MR images, we recorded the transverse length of a stout tendinous band and the total tendinous portion of the subscapularis. In addition, we recorded the number of intramuscular tendinous slips of the susbscapularis. Results: The mean transverse length of the tendinous band was 15.0 mm (range: 8 to 20 mm). The mean transverse length of the total tendinous portion was 48.9 mm (range: 40 to 60 mm). The number of intramuscular tendinous slips on the base of the glenoid fossa was 3 in 20 (22.72%), 4 in 45 (51.14%) and 5 in 23 shoulders (26.14%). On the lateral portion, the intramuscular tendinous slips became gradually rounder and thicker and they gave converge in the superior direction. Conclusion: In this study, the structural features of the tendinous portions of the subscapularis on the MR scans were identified. This will in return give good justification for the lines to be pulled during biomechanical stimulation and also for the surgical approach to restore the biomechanical function.

Hook Plate Fixation for Unstable Distal Clavicle Fractures: A Prospective Study (불안정 원위 쇄골 골절의 치료에서 Hook 금속판을 이용한 전향적 연구)

  • Kim, Kyung-Cheon;Shin, Hyun-Dae;Cha, Soo-Min;Jeon, Yoo-Sun
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.6-12
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    • 2011
  • Purpose: We wanted to analyze and report on the radiologic and clinical results of prospective Hook plate fixation for unstable distal clavicle fractures after a minimum of 2 years follow up. Materials and Methods: We followed up 17 out of 20 cases that underwent prospective Hook plate fixation from 2008 to 2009. We performed radiologic follow up at 2 weeks, 6 weeks, 3 months, 6 months, 18 months and 24 months postoperatively. The clinical results were evaluated at 12 months and 24 months postoperatively. Results: The mean period for bony fusion was 14.5 weeks and the plate was removed after an average of 20.2 weeks. The VAS pain scores were 0.7 and 0.8, the UCLA scores were 33.5 and 33.3, the ASES scores were 92.8 and 92.5, the Constant-Murley scores were 81.5 and 77.0, the KSS scores were 92.5 and 94.3 and the ranges of motion were $173.3^{\circ}$ and $173.7^{\circ}$ of flexion, $56.0^{\circ}$ and $54.5^{\circ}$ of external rotation, $62.3^{\circ}$ and $63.5^{\circ}$ of the internal rotation, $172.0^{\circ}$ and $172.6^{\circ}$ of abduction and $43.3^{\circ}$, and $42.9^{\circ}$ of extension at 1 and 2 years follow-up, respectively. There was no statistically significant difference of clinical outcomes and the range of motion at 1 year and 2 year postoperatively (p>0.05). There was no other complication except 1 case of delayed union. Conclusion: For Hook plate fixation at 2 years postoperatively, the complications will be decreased and excellent clinical results should occur.

Ergonomic Evaluation of a Forearm Supporter for a Mouse (마우스 사용시 전완지지대의 인간공학적 평가)

  • Bae Dong Cheol;Chang Seong Rok;Jung Jae Hoon;Jin Sang Eun
    • Journal of the Korean Society of Safety
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    • v.20 no.2 s.70
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    • pp.169-174
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    • 2005
  • Traditionally, keyboards have been one of the most frequently used input devices for information processing using computers. As most computers adopt the Microsoft Windows for their operating system however, the usage of mouse has recently increased to a great extent. Moreover, the mouse has been used as the leading input device in such areas as industrial design and computer aided design. Excessive uses of mouse may cause a severe pain and fatigue on neck and upper limb due to the intensive and repetitive use of corresponding muscles, which renders a decline in efficiency and leads to musculoskeletal disorders. The main purpose of this study is to find the best working conditions to prevent musculoskeletal disorders when using mouse in a neutral posture. Utilizing electromyogram amplitude and Borg's scale, the role change and strength imposed on the muscles were measured and analyzed with and without the forearm support concerned. Also investigated were the effects of changes in elbow forearm supporter.

Musculoskeletal Diseases in 119 Rescuers (119구급대원 구급활동에 따른 근골격계 질환 연구)

  • Shin, Dong-Min;Hong, Eun-Jeong;Kim, Gyung-Yong;Kim, Jee-Hee;Moon, Tae-Young
    • Journal of Digital Convergence
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    • v.11 no.9
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    • pp.209-219
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    • 2013
  • The purpose of this study is to investigate the prevalence and to describe the correlation between the working period and musculoskeletal diseases of 119 rescuers. We conducted 485 surveys from 547 rescuers working in Gyeonggi-do from November 5 to December 20, 2011. The collected data were analyzed by cross tabulation analysis, chi-square test, and correlation analysis using PASW 18.0. The p value was set at p<.05. The prevalence of musculoskeletal diseases, 328(67.6%) rescuers suffering from musculoskeletal diseases. General characteristics included gender(p<.01), age(p<.01), marriage(p<.001),household chores(p<.05), working period(p<.001). The correlation between physical loading of subjects and musculoskeletal diseases was significant(p<.001). The rescuers felt the pain at lower back(36.4%), shoulders(19.2%), neck(14.9%), hip/ankles(13.2%), hand/wrist/fingers(12.0%), elbow(4.3%). This study showed that working period and physical loading affect musculoskeletal diseases.

Comparative study between proportional method and directional method in locating acupoints at forearm (전완부(前腕部) 경혈(經穴) 취혈(取穴)에서 골도분촌법(骨度分寸法)과 일부법(一夫法)의 비교(比較) 연구(硏究))

  • Park, Hi-Joon;Chae, Youn-Byoung;Cha, Wung-Seok;Park, Jong-Bae;Lee, Hye-Jung;Lee, Hyang-Sook;Yin, Chang-Sik;Koh, Hyung-Kyun;Kim, Su-Young;Choe, Il-Hwan;Kim, Kang-Sik;Moon, Jung-Bae;Bae, Ki-Tae;Rheu, Kyoung-Hwan;Yook, Keun-Yung;Jeong, Byeong-Ju;Sohn, In-Chul;Lim, Sabina
    • Korean Journal of Acupuncture
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    • v.21 no.4
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    • pp.31-41
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    • 2004
  • Background : The cun measurement system, an essential and convenient method in locating acupoints, has been widely used in the practice of acupuncture. However, traditional cun measurement has been criticized for its lack of reliability. Objectives : The purposes of this study are to determine if one cun measured by the directional methods have a consistency with that of proportional methods and to investigate which factors are related with these differences, especially in forearm. Methods : The distance between the elbow crease and the wrist crease of forearm was compared to a reference value of one cun obtained by the directional method. In this method, one cun is one third of the distance between index finger and small finger of a subject, measured at proximal interphalangeal joint. In addition, to investigate the factors influencing the differences between these two methods, we measured the height and body weight and calculated body mass index (BMI). Finally we analyzed the factors correlated with these lengths by linear regression test. Results : The results showed that one cun obtained by the directional methods were significantly different from one cun by the proportional methods in forearm. It was demonstrated that the length acquired with the directional method was more correlated with body weight and body mass index, while the length obtained by the proportional method was more correlated with the height. Conclusion : These findings suggest that the directional method is less likely dependable in locating acupoints than the proportional method because the influencing factors are different.

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The Factors Related to Musculoskeletal Symptoms of Family Care-Givers who Have a Patient with Brain Damage (뇌손상 가족 간병인의 근골격계 자각증상과 관련요인)

  • Jeon, Eun-Mi;Lee, Seong-A;Gu, Jung-Whan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.1
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    • pp.336-344
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    • 2017
  • This study was conducted to identify factors related to the musculoskeletal symptoms of 340 family caregivers who have a patient with brain damage based on self-administered questionnaires. The questionnaires included general characteristics, characteristics of care activities and caregivers' musculoskeletal symptoms. Data were collected from many long-term care hospitals and rehabilitation centers during March 17 to March 21, 2014. The results indicated that complaint rates of work-related musculoskeletal systems of the body sites differed. Factor analysis revealed that neck complaints were related to education (under mid), while shoulder complaints were related to sex (female), age (50-59), education (mid) and duration of care (< 2 years). Arm/elbow complaints were related to age (40-49), education (high) and duration of care (12-24). Complaints regarding the hand/wrist/finger were related to age (50-59) and duration of care (12-24), while those associated with the legs/feet were related to age (50-59) and duration of care (< 6[ED highlight - years? Please specify.]). Back problems were related to education (under mid, mid stage, high) and gait. The complaint rate regarding musculoskeletal symptoms during daily life was not statistically significant. Logistic regression analysis of significant factors related to subjective musculoskeletal symptoms identified ambulation and gait as having the greatest influence and complaint factor among family caregivers. The complaint rate of family caregivers differed among body parts. Being a caregiver for less than one year was found to have a significant impact on pain. Overall, long term family caregivers could be faced with risk factors for musculoskeletal problems, but there are many different factors that affect musculoskeletal symptoms with regards to their activities. Accordingly, comprehensive and systematic prevention plans for family caregivers who have patients with brain damage should be developed.

Arthroscopic Repair of Traumatic Subscapularis Tendon Tear (외상성 견갑하건 파열의 관절경하 봉합술)

  • Cho, Su-Hyun;Cho, Hyung-Lae;Ku, Jung-Hoei;Hwang, Tae-Hyok;Park, Man-Jun;Choi, Jae-Hyuk
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.3
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    • pp.180-187
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    • 2010
  • Purpose: Rotator cuff tears involving the subscapularis are less common than those involving the superior and posterior rotator cuff. The purpose of the present study was to report the clinical results of repair of isolated traumatic tears of the subscapularis tendon. Materials and Methods: Fifteen patients (13 males, 2 females; mean age 46.2 years; range 35 to 52) with unilateral ruptures of the subscapularis tendon after trauma who underwent arthroscopic repair between February 2003 and October 2008 were reviewed retrospectively. All the cases were isolated tears of the subscapularis without the involvement of any other rotator cuff tendon and were followed for at least two years (mean 28 months). The entire subscapularis was involved in 9 cases and the tear was localized to the upper two thirds in 6 cases. The preoperative and postoperative status of patients with isolated subscapularis tears were analyzed using the Constant Score, American Shoulder and Elbow Society Index (ASES Index) and postoperative integrity was determined through magnetic resonance imaging. Results: The average clinical outcome scores and strength were all improved significantly at the time of the final follow-up. The constant shoulder score improved from 41.5 to 81.3 points (P<0.05) compared to before surgery and ASES index improved from 46.4 to 89.6 points (P<0.05) postoperatively. Thirteen patients (87%) were satisfied with the result of the treatment. The total tears were significantly more improved by surgery than the partial tears. In 12 of 15 patients (80%) were judged to reveal healed tendon on magnetic resonance imaging at a mean of 13 months postoperatively. The postoperative score was significantly lower for the patients with a failed repair than it was for those with an intact repair (P<0.05). Conclusion: Repair of traumatic isolated subscapularis tears through arthroscopic techniques effectively restores patient function with regard to pain, mobility, strength and postoperative tendon integrity. The postoperative integrity of the repair correlates with the functional results and the total tears were more improved by surgery than the partial tears, but future studies may be needed.

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