• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.1
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• pp.65-70
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• 2002

Purpose : To review the operative results and find out better method of a treatment of suprascapular nerve entrapment syndrome caused by ganglion. Materials and Methods : From March of 1996 to May of 2001, thirteen cases of suprascapular nerve entrapment syndrome caused by ganglion were reviewed which were diagnosed using physical examination, EMG and MRI. All of them were treated with open exision of ganglion, nerve decompression and arthroscopic examination. The clinical results were evaluated using subjective recovery of muscle power and ASES (American Shoulder and Elbow Surgeons) score. Results : Nine cases (69$\%$) showed residual symptom such as intermittent pain, insufficient recovery of muscle power, persistent muscle atrophy. Complete recovery in four cases (31$\%$). Mean value of ASES score was 86.4 (70-99.8) points. Postopertively, pain was relieved in 84$\%$ of patients and muscle power was improved in 53$\%$ of the patients but the atrophy persisted. Conclusions : Excision of ganglion is insuffient to relieve the nerve entrapment. Not only excision of ganglion but also treatment of intraarticular lesion, decompression of suprascapular and spinoglenoid notch which attributable to entrapment should be considered for the better clinical results.

• Journal of the Korean Society of Radiology
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• v.82 no.3
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• pp.613-623
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• 2021

Purpose To evaluate the MRI findings and clinical factors that are characteristic of patients who ultimately undergo surgery for medial epicondylitis. Materials and Methods Fifty-two consecutive patients who were diagnosed with medial epicondylitis and underwent an elbow MRI between March 2010 and December 2018 were included in this retrospective study. The patients' demographic information, clinical data, and MRI findings were evaluated. All variables were compared between the conservative treatment and surgical treatment groups. Logistic regression analyses were conducted to identify which factors were associated with surgical treatment. Results Common flexor tear (CFT) tear size showed a statistically significant difference in both the transverse and longitudinal planes (p < 0.001, p = 0.013). The CFT abnormality grade significantly differed in both the transverse and longitudinal planes (p = 0.022, p = 0.003). A significant difference was also found in the medial collateral ligament abnormality (p = 0.025). Logistic regression analyses showed that only the transverse diameter of the CFT tear size (odds ratio: 1.864; 95% confidence interval: 1.264-2.750) was correlated with surgical treatment. Conclusion Of patients diagnosed with medial epicondylitis, patients with a larger transverse CFT tear size tend to undergo surgical treatment ultimately.

• Archives of Plastic Surgery
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• v.38 no.1
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• pp.15-18
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• 2011

Purpose: The anterior iliac crest is a common source for autologous cancellous bone graft. For patients who have previously received cancellous bone grafts from bilateral anterior iliac crests, there may be concerns of whether a sufficient quantity of autologous cancellous bone remains for additional grafts without harvesting it from other sites, such as the posterior iliac crest. Methods: We experienced 3 cases of reharvesting in 2 patients. The diagnosis of the first patient was bilateral facial cleft number 3. This patient received bilateral side cleft alveoloplasty with corticocancellous bone graft from the both anterior iliac crest respectively by a previous surgeon. This patient then needed reharvesting of the anterior iliac crest cancellous bone to correct an ongoing skeletal problem for the bilateral cleft. The other patient had bilateral incomplete cleft of the primary palate. This patient received left side cleft alveoloplasty with cancellous bone graft from the right anterior iliac crest. Before the patient could receive the alveoloplasty on the other side, a radial head osteotomy and cancellous bone graft was performed by orthopedic surgeons who then used the remaining left iliac crest in order to treat a pulled elbow. For the completion of the right side cleft alveoplasty, the anterior iliac crest cancellous bone needed to be reharvested. Prior to the reharvesting, a preoperative computed tomography scan of the pelvis was obtained to assess the maturity of the donor site regeneration. The grafts were then taken from site where a greater amount of regeneration was evident. Results: Long term follow ups showed that the grafts were successfully taken. This sufficient volume was obtainable 14 months after the first harvest. Conclusion: Satisfactory results were achieved after the reharvesting of iliac cancellous bone. Thus, it appears that the reharvesting of the iliac bone is a possible alternative to multiple site grafting, use of allograft or bone substitute materials.

• Archives of Reconstructive Microsurgery
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• v.7 no.1
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• pp.1-9
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• 1998

From January 1985 to February 1997, 96 patients had undergone the free vascularized groin flap on the upper and lower extremities with microsurgical technique at the department of orthopaedic surgery, Yonsei University College of Medicine. The results were as follows: 1. Average age at the time of operation was 24.9 years. and there were 71 men and 25 women and mean follow up was 62.4 months. 2. The lesion site was 82 cases on the lower extremity: foot(40), leg(20), ankle(13), and 14 cases on the upper extremity: forearm(6), elbow(3), hand(3), wrist(2). 3. The anatomical classification of the superficial circumflex iliac artery was as follows: 1) 39.8% of common origin with superficial inferior epigastric artery, 2) 30.1% of isolated origin and absent superficial inferior epigastric artery, 3) 13.3% of separate origin, 4) 16.9% of origin from the deep femoral artery. 4. There was no statistical significance on arterial anastomosis between end to end and end to side, and on venous anastomosis(end to end) between one vein and two veins. 5. The success rate was average 84.4% in 81 of 96 cases. 6. In the 15 failed cases, the additional procedures were performed: 5 cases of free vascularized scapular flap, 6 cases of full thickness skin graft, 2 cases of cross leg flap, 1 case of latissimus dorsi flap, 1 case of split thickness skin graft. In conclusion, the free vascularized groin flap can be considered as the treatment of choice for the reconstruction of the extensive soft tissue injury on the extremities, and show the higher success rate with the experienced surgeon.

• The Journal of the Korean dental association
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• v.55 no.10
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• pp.706-714
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• 2017

Background Synocial chondromatosis(SC), a proliferative disorder of the synovial membrane. The etiology or cause of SC remains unclear. SC usually occurs in large articular joints such as knee, hip, elbow, and ankle. SC of the TMJ is very rare. It is a benign disease that mainly affects unilateral side. It can form cartilagenous and calcified loose bodies of various sizes and cause abnormal function of TMJ. Case Report In this paper, we report two cases of SC in the upper joint space of the left TMJ. One complained that "Sometimes the left jaw joint feels disoriented" and the other had no symptoms. CT scan and MRI showed left TMJ space widening, multiple tiny calcified mass. After clinical and radiographic analysis, we performed surgical removal of the lesion under genereal anesthesia. In the histologic examination, synovial chondromatosis was diagnosed in both patients. Conclusions We report two cases of synovial chondromatosis in the upper joint space of the left TMJ. We performed surgical removal of the lesion. The two patients showed good prognosis without recurrence or pain up to date.

• Korean Journal of Radiology
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• v.25 no.5
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• pp.449-458
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• 2024

Selective fascicular involvement of the median nerve trunk above the elbow leading to anterior interosseous nerve (AIN) syndrome is a rare form of peripheral neuropathy. This condition has recently garnered increased attention within the medical community owing to advancements in imaging techniques and a growing number of reported cases. In this article, we explore the topographical anatomy of the median nerve trunk and the clinical features associated with AIN palsy. Our focus extends to unique manifestations captured through MRI and ultrasonography (US) studies, highlighting noteworthy findings, such as nerve fascicle swelling, incomplete constrictions, hourglass-like constrictions, and torsions, particularly in the posterior/posteromedial region of the median nerve. Surgical observations have further enhanced the understanding of this complex neuropathic condition. High-resolution MRI not only reveals denervation changes in the AIN and median nerve territories but also illuminates these alterations without the presence of compressing structures. The pivotal roles of high-resolution MRI and US in diagnosing this condition and guiding the formulation of an optimal treatment strategy are emphasized.

• 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.

• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.115-125
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• 2009

Purpose: The purpose of the study is to evaluate the usefulness of CT arthrography (CTA) by conducting a comparative study of CTA and MR arthrography (MRA) with the arthroscopic findings in the same patients. Materials and methods: Forty nine patients who suffered from shoulder disease underwent MRA and CTA concurrently. The sensitivity and specificity of CTA was evaluated, as compared to MRA, in the case of four types of shoulder pathological lesions. The accuracy of CTA was evaluated by analyzing the arthroscopic findings of thirty four patients. Results: Compared to MRA, CTA showed a sensitivity of 90% and a specificity of 100% for diagnosing supraspinatus tendon (SST) full thickness tear, and CTA showed a sensitivity of 100% and a specificity of 97.5% for making the diagnosis of superior labrum anterior to posterior (SLAP) lesion. For diagnosing partial articular side supraspinatus avulsion (PASTA) lesion, some studies have shown the usefulness of CTA with a sensitivity of 71.4% and a specificity of 97.7%. However, for diagnosing SST bursal side partial tear, the sensitivity of CTA was as low as 10%. CTA has been shown to be relatively accurate when the diagnoses were verified with the arthroscopic findings; diagnosing SST full thickness tear and SLAP lesion with CTA has shown an accuracy of 100% and87.5% respectively, and CTA showed 71.4% diagnostic accuracy for PASTA lesion. Conclusion: CTA was a useful tool and it was equivalent to MRA for the assessment of SST full thickness tear, SLAP lesion and PASTA lesion, but not bursal side partial tear. Thus, it may be used preferably to diagnose shoulder pathology and for follow up as an inexpensive tool after operation.

• Journal of the Korean Orthopaedic Association
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• v.52 no.1
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• pp.1-6
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• 2017

Purpose: To retrospectively compare minimally invasive percutaneous plate osteosynthesis (MIPPO) with open plate fixation for the treatment of clavicle midshaft fracture. Materials and Methods: Between November 2011 to May 2014, 40 cases that were followed for more than 1 year-among all cases of MIPPO and open plate fixation-were analyzed. The study population was divided into two groups: group A included 20 cases of MIPPO and group B included 20 open plate fixation cases. The comparative analysis between the two groups was based on the operative time, bone union, functional evaluation (American Shoulder and Elbow Society score), incision length, pain relief (visual analogue scale, VAS), and complication. Results: The bone union was successful for all the cases, and the functional evaluation scores of the shoulder joint were satisfactory for both groups (p>0.05). The operative time was 47.5 minutes and 58.7 minutes for group A and B, respectively (p<0.05). The incision length for group A was 6.2 cm and that for group B was 10.7 cm with statistical significance (p<0.05). Pain relief (VAS) after surgery for group A showed a quick recuperation in the early stages. For complications, there were 2 cases of dysesthesia and 1 case of malunion due to metal fixation failure in group A. There were 6 cases of dysesthesia and 2 cases of cosmetic problem due to hypertrophic scar in group B. Conclusion: Surgical results of clavicle shaft fracture were satisfactory for both groups, but group A had advantages of shorter operative time, minimal incision length, and better pain relief in the early stages compared with group B. However, we need further evaluations with long-term follow-up results and complications, such as malunion and exposure on radiation.

• Clinics in Shoulder and Elbow
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• v.14 no.2
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• pp.229-235
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• 2011

Purpose: To compare the clinical and radiological result of arthroscopic Mattress Locking suture repair to that of a Simple suture repair with small and medium-sized rotator cuff tears. Materials and Methods: Among 92 patients who were followed up after arthroscopic repair in patients with small and medium-sized rotator cuff tear from April 2007 to October 2010, 27 patients who took Arthroscopic Mattress Locking suture were set as group I and 65 patients who took Simple suture were set as Group II. The average age of patients were 58 years old and average follow-up period was 30 months. For analysis, VAS, ASES and KSS were used to analyze the range of joint movement and pain. And, for the image result, MRI performed after operation were evaluated. Results: The average VAS, KSS, UCLA score and ASES prior to surgery improved in the last follow-up (p<0.001), while was no difference in two groups (p>0.001). In MRI follow-up examination, the 2 cases (7.41%) of group 1 showed increased rupture lesions with improved symptoms. And the 12 cases (18.47%) of group 2 showed increased rupture lesions with improved symptoms. Retears in the group I were significant less than the group II (p<0.001). Conclusion: Comparing patients with small and medium-sized rotator cuff tear who took arthroscopic mattress locking suture repair to those who took simple suture repair after over one year follow up period, the clinical result showed no significant difference between two groups. However, Mattress Locking suture repair showed excellent radiological result compared to simple suture repair when comparing rerupture.