• Title/Summary/Keyword: Elbow surgery

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Transarticular Portal for Elbow Arthroscopy (Transarticualr portal를 이용한 주관절의 관절경술)

  • Kim, Sung-Jae;Park, In-Seop;Kim, Ju-Young;Jeong, Jae-Hoon;Ryu, Sang-Wook;Cheon, Yong-Min
    • Clinics in Shoulder and Elbow
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    • v.6 no.2
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    • pp.127-130
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    • 2003
  • Arthroscopy of the elbow is a very precise and demanding procedure due to the closeness of the recommended portals to neurovascular structures and complexity of articular geometry. So to establish safe portal is not always reproducible especially in case of stiff elbow, even for the experienced arthroscopist. We described new tip of elbow arthroscopy using a new starting portal. This procedure is almost always reproducible even in stiff elbow, and minimizes risk of damage to neurovascular structures.

Intramedullary fibula strut bone allograft in a periprosthetic humeral shaft fracture with implant loosening after total elbow arthroplasty

  • Jo, Young-Hoon;Lee, Seung Gun;Kook, Incheol;Lee, Bong Gun
    • Clinics in Shoulder and Elbow
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    • v.23 no.3
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    • pp.152-155
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    • 2020
  • Periprosthetic fracture after total elbow replacement surgery is a difficult complication to manage, especially when it comes together with implant loosening. If stem revision and internal fixation of the periprosthetic fracture are performed simultaneously, this would be a very challenging procedure. Most of total elbow replacement implants are cemented type. Cement usage at periprosthetic fracture site may interfere healing of fractured site. Authors underwent internal fixation with use of locking plate and cerclage wire for periprosthetic fracture, allogenous fibular strut bone inserted into the humerus intramedullary canal allowing the fractured site to be more stable without cement usage. At 10-month follow-up, the complete union and good clinical outcome was achieved. We present a novel technique for treating periprosthetic fracture with implant loosening after total elbow replacement surgery, using intramedullary allogenous fibula strut bone graft.

Risk Factors for Recurrence of Anterior Shoulder Instability after Arthroscopic Surgery with Suture Anchors

  • Choi, Chang-Hyuk;Kim, Seok-Jun;Chae, Seung-Bum;Lee, Jae-Keun;Kim, Dong-Young
    • Clinics in Shoulder and Elbow
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    • v.19 no.2
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    • pp.78-83
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    • 2016
  • Background: We investigated the risk factors for the recurrence of anterior shoulder instability after arthroscopic surgery with suture anchors and the clinical outcomes after reoperation. Methods: A total of 281 patients (February 2001 to December 2012) were enrolled into our study, and postoperative subluxation and dislocation were considered as recurrence of the condition. We analyzed radiologic results and functional outcome including the American Shoulder and Elbow Surgeons Evaluation Form, the Korean Shoulder Society Score, and the Rowe scores. Results: Of the 281 patients, instability recurred in 51 patients (18.1%). Sixteen out of 51 patients (31.4%) received a reoperation. In terms of the functional outcome, we found that the intact group, comprising patients without recurrence, had a significantly better functional outcome than those in the recurrent group. The size of glenoid defect at the time of initial surgery significantly differed between intact and recurrent group (p<0.05). We found that the number of dislocations, the time from the initial presentation of symptoms to surgery, and the number of anchor points significantly differed between initial operation and revision group (p<0.05). The functional outcome after revision surgery was comparable to intact group after initial operation. Conclusions: Eighteen percent of recurrence occurred after arthroscopic instability surgery, and 5.6% received reoperation surgery. Risk factors for recurrence was the initial size of glenoid defect. In cases of revision surgery, good clinical outcomes could be achieved using additional suture anchor.

Arthroscopic Treatment of Stiff Elbow (주관절 관절경을 이용한 구축의 치료)

  • Rhee Kwang-Jin;Kim Kyung-Cheon;Hong Chang-Hwa;Song Ho-Sup;Shin Hyun-Dae
    • Clinics in Shoulder and Elbow
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    • v.8 no.1
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    • pp.14-18
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    • 2005
  • Purpose: Limitation of motion of the elbow joint due to stiffness affect on life quality of the patients. So contracture of the elbow should be treated as soon as possible. Among the many treatment modalities, we described the result of arthroscopic treatment. Materials and Methods: From Mar. 2000 to Mar. 2003, 40 patients, who received the arthroscopic treatment by author for contracted elbow, were the subjects. We estimated the range of motion (ROM) of elbow joint before and after surgery by goniometer. The clinical result was evaluated by Severance elbow scoring system. The final ROM was evaluated at the point of no further increasement of joint motion. Male ware 30 cases, female ware 7 cases, average 42.6 years old and mean follow up period were 31 months. During arthroscopic treatment we had done release of the joint capsule or resection, synovectomy, removal of loose bodies. We used traditional portals. Results: The avarage preoperative ROM of elbow joint was 72.5 degree(range, 5 - 132 degree) and the increasement of ROM was totally 49.3 degree in flexion 26.5 degree and extension 22.8 degree. There was no other complication. Conclusion: Arthroscopic treatment for contracted elbow permit early joint ROM and it decrease the secondary injury to the elbow joint. Also there are few complications. It is thought to be a good treatment modality in contracted elbow joint.

Use of custom glenoid components for reverse total shoulder arthroplasty

  • Punyawat Apiwatanakul;Prashant Meshram;Andrew B. Harris;Joel Bervell;Piotr Lukasiewicz;Ridge Maxson;Matthew J. Best;Edward G. McFarland
    • Clinics in Shoulder and Elbow
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    • v.26 no.4
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    • pp.343-350
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    • 2023
  • Background: Our purpose was to evaluate a custom reverse total shoulder arthroplasty glenoid baseplate for severe glenoid deficiency, emphasizing the challenges with this approach, including short-term clinical and radiographic outcomes and complications. Methods: This was a single-institution, retrospective series of 29 patients between January 2017 and December 2022 for whom a custom glenoid component was created for extensive glenoid bone loss. Patients were evaluated preoperatively and at intervals for up to 5 years. All received preoperative physical examinations, plain radiographs, and computed tomography (CT). Intra- and postoperative complications are reported. Results: Of 29 patients, delays resulted in only undergoing surgery, and in three of those, the implant did not match the glenoid. For those three, the time from CT scan to implantation averaged 7.6 months (range, 6.1-10.7 months), compared with 5.5 months (range, 2-8.6 months) for those whose implants fit. In patients with at least 2-year follow-up (n=9), no failures occurred. Significant improvements were observed in all patient-reported outcome measures in those nine patients (American Shoulder and Elbow Score, P<0.01; Simple Shoulder Test, P=0.02; Single Assessment Numeric Evaluation, P<0.01; Western Ontario Osteoarthritis of the Shoulder Index, P<0.01). Range of motion improved for forward flexion and abduction (P=0.03 for both) and internal rotation up the back (P=0.02). Pain and satisfaction also improved (P<0.01 for both). Conclusions: Prolonged time (>6 months) from CT scan to device implantation resulted in bone loss that rendered the implants unusable. Satisfactory short-term radiographic and clinical follow-up can be achieved with a well-fitting device. Level of evidence: III.