• Clinics in Shoulder and Elbow
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• v.17 no.3
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• pp.102-106
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• 2014

Background: The purpose of this study was to evaluate the effect of single blinded anterior intra-articular corticosteroid injection to the glenohumeral joint performed by short experienced clinicians in frozen state adhesive capsulitis patients. Methods: From March to June of 2013, among the patients who visited the shoulder outpatient clinic due to shoulder pain for 5-6 months and those patient diagnosed as frozen state adhesive capsulitis was selected. The diagnosis were based on base, first the global limitation of range of motion, defined as forward elevation <100, external rotation at side <10, internal rotation less than buttock, and abduction <70. Second, the patients had additional radiologic evaluations showing no major pathologies for such stiffness. Clinical outcome, were performed with pain visual analog scale (PVAS) and functional visual analog scale (FVAS), American Shoulder and Elbow Surgeons Shoulder score (ASES), preinjection and postinjection after 2-4 weeks. Finally 82-patients were enrolled. Mean age of the patients was 55.1 years and mean follow-up duration was 25.17 days. Results: The mean preinjection PVAS was 6.91 and postinjection was 3.11, there was 3.8 decreases from preinjection status (p < 0.001). The mean FVAS score showed 4.26 at preinjection and 6.63 afterwards (p < 0.001). The ASES score showed 27.89 increases after injection (p < 0.001). There were 64-patients (78.04%) who reported more than 3 points of decrease of PVAS, who could be judged as effective treatment. Conclusions: Single anterior glenohumeral steroid injection by short experienced clinicians to the patients with frozen state adhesive capsulitis has shown relatively high efficacy in clinical result evaluated by means of PVAS.

• Journal of the Korean Arthroscopy Society
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• v.6 no.2
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• pp.126-130
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• 2002

Purpose : To evaluate the diagnostic efficiency of the subacromial bursoscopy with glenohumeral air infusion technique for detection of the full thickness tear which we used to think as a partial thickness tear, because it was hidden by bursal tissue. Materials and methods : We chose 65 cases and divided them into 2 groups. The group I was 18 cases with partial thickness rotator cuff tears on glenohumeral arthroscopic evaluation, and the group 2 was 37 cases with full thickness rotator cuff tears which were repaired. We inflated the glenohumeral Joint with 50-100ml of air and observed air bubble leakage simultaneously on bursoscopy. Results : In group I, we could detect air leakage in 3 cases and found that it was full thickness tear. In group II, 2 cases revealed too much air leakage proved that it was incomplete repair and was in need of additional suture. Conclusion : Air infusion technique is though to be a valuable method in differentiation between the partial and full thickness tear and for evaluation of the security of the repair.

• Clinics in Shoulder and Elbow
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• v.2 no.1
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• pp.84-87
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• 1999

The Buford complex is unusual variant of the glenohumeral joint. This complex is distinguished by a cord-like middle glenohumeral ligament that oriented directly form the superior labrum at the base of the biceps tendon and crosses the subscapularis tendon to insert on the humerus. There is no anterior-superior labral tissue present between this attachment and the mid-glenoid notch. This anatomical variation may lead the surgeon to confuse this complex with a sublabral hole, pathologic labral detachment, Bankart lesion or SLAP lesion. We report a case of Buford complex which was found incidentally during the operation of impingement syndrome with stiffness and treated with subacromial decompression only.

• Clinics in Shoulder and Elbow
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• v.12 no.1
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• pp.76-79
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• 2009

Purpose: Capsulolabral reconstruction in a traumatic anterior instability of the glenohumeral joint is successful not only for the prevention of recurrent instability but also for the restoration of function. Materials and Methods: However, a capsulolabral procedure alone cannot guarantee a successful result when there is severe bone loss of the glenoid. Results: We report the surgical technique and results of capsulolabral repair and extraarticular bone block with an autogenous iliac crest graft performed on three cases (all male, average age 28 years, minimum follow-up 12 months) with traumatic anterior instability associated with more than 30% glenoid bone loss.

• Clinics in Shoulder and Elbow
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• v.25 no.4
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• pp.282-287
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• 2022

Background: Muscular forces drive proximal humeral fracture deformity, yet it is unknown if arm position can help mitigate such forces. Our hypothesis was that glenohumeral abduction and humeral internal rotation decrease the pull of the supraspinatus and subscapularis muscles, minimizing varus fracture deformity. Methods: A medial wedge osteotomy was performed in eight cadaveric shoulders to simulate a two-part fracture. The specimens were tested on a custom shoulder testing system. Humeral head varus was measured following physiologic muscle loading at neutral and 20° humeral internal rotation at both 0° and 20° glenohumeral abduction. Results: There was a significant decrease in varus deformity caused by the subscapularis (p<0.05) at 20° abduction. Significantly increasing humeral internal rotation decreased varus deformity caused by the subscapularis (p<0.05) at both abduction angles and that caused by the supraspinatus (p<0.05) and infraspinatus (p<0.05) at 0° abduction only. Conclusions: Postoperative shoulder abduction and internal rotation can be protective against varus failure following proximal humeral fracture fixation as these positions decrease tension on the supraspinatus and subscapularis muscles. Use of a resting sling that places the shoulder in this position should be considered.

• The Journal of Korean Physical Therapy
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• v.32 no.3
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• pp.157-162
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• 2020

Purpose: This study was to evaluate several tasks performed at a high intensity in terms of their ability to elicit EMG activity in the serratus anterior by comparing the EMG activities of the serratus anterior, upper trapezius, and lower trapezius muscles during six tasks combined shoulder flexion with rotation. Methods: Fifteen healthy males were recruited to this study. Each subject was instructed to assume a sitting position without back support and asked to flex (90° or 120°) the right shoulder and protract the scapula in the sagittal plane with maximal external rotation; to assume a neutral position; or to internally rotate the glenohumeral joint. The EMG data were collected from the serratus anterior (SA), upper trapezius (UT), and lower trapezius (LT) muscles were normalized to maximum voluntary isometric contraction. The UT/LT and UT/SA muscle activity ratios in each task were assessed by calculating the surface EMG. Data were analyzed by two-way repeated-measures analysis of variance, with the level of significance set at p<0.05. Results: The results of this study, shoulder flexion with external rotation resulted in low upper trapezius/serratus anterior and upper trapezius/lower trapezius ratios and a relatively high level of serratus anterior activation. Conclusion: Shoulder flexion with external rotation used herein may be considered as important for clinical interventions aimed at selectively increasing SA strengthen and clinical selection of exercises for improving glenohumeral joint and scapulothoracic control.

• Clinics in Shoulder and Elbow
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• v.1 no.2
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• pp.230-235
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• 1998

Fractures of the scapula are relatively uncommon injuries and treatment in the vast majority of cases remains nonsurgical and the results have been quite satisfactory. But the scapular fracture itself may be neglected because of its high incidence of many kinds of associated injuries so its delayed treatment sometimes gives bad and unpredictable results. Although open reduction and internal fixation has been accepted as the treatment of choice for displaced intra-articular fractures in many anatomical regions, there has been no definite treatment principles of surgical indications and approaches in the glenohumeral joint. At our institution, II displaced intra-articular fractures of the glenohumeral joint were treated with open reduction and internal fixation from March 1993 to February 1997. This paper reports the results of treating 11 displaced intra­articular fractures of the glenoid by open reduction and internal fixation. There were 10 men and one woman and the fractures were classified according to Ideberg : Type Ⅰa(4), Type Ⅱ(3), Type Ⅲ(1), Type IV(1), Type Va(1), and Type Vc(1).

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2009.03a
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• pp.44-44
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• 2009

The purpose of this study was to investigate humeral translation relative to the glenoid invivo during loaded and unloaded shoulder abduction. CT scans of 9 healthy shoulders were acquired and 3D models were created. The subject was positioned in front of a fluoroscope and motions were recorded during active abduction. The subjects performed two trials of holding a 3kg weight and unload. 3D motions were determined using model-based 3D-to-2D registration to obtain 6 degrees of freedom kinematics. Glenohumeral translation was determined by finding the location on the humeral head with the smallest separation from the glenoid. Humeral translation was referenced to the glenoid center in the superior/inferior direction. The humerus moved an average of 2 mm, from inferior to central on the glenoid, during arm abduction for both conditions. The humeral head was centered within 1mm from the glenoid center above $70^{\circ}$. There were no statistically significant differences for both conditions. The standard deviation decreased gradually over the motion, with significantly lower variability at the end of abduction compared to the initial unloaded position. We assumed that the humeral translation to the center of the glenoid provides maximum joint congruency for optimal shoulder function and joint longevity. We believe this information will lead to better strategies to prevent shoulder injuries, enhance rehabilitation, and improve surgical treatments.

• Journal of the Korean Society of Physical Medicine
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• v.10 no.4
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• pp.1-7
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• 2015

PURPOSE: The purpose of this study was to compare the effects of cross-body stretching (CBS) and modified cross-body stretching (MCBS) on the range of motion (ROM) of glenohumeral joint (GHJ) in healthy subjects. METHODS: Thirty subjects were randomly assigned to 1 of 2 groups: CBS group without stabilization of scapula (n=15) and MCBS group with stabilization of scapula (n=15). We measured horizontal adduction and internal rotation ROM of GHJ in pre- and post-intervention. The data were analyzed using the analyses of covariate (ANCOVA) and least significant difference (LSD) post hoc tests (p=.05). RESULTS: In the post-intervention, the MCBS group had a significantly greater increase in horizontal adduction ROM (mean ${\pm}$ SD, $11.46^{\circ}{\pm}0.83^{\circ}$) compared to the CBS group ($7.81^{\circ}{\pm}0.83^{\circ}$) (p=.007) and a greater increase in internal rotation ROM ($62.27^{\circ}{\pm}0.74^{\circ}$) compared to the CBS group ($59.20^{\circ}{\pm}0.74^{\circ}$) (p=.004). CONCLUSION: A single session application of an MCBS provides immediate more improvements in both horizontal adduction and internal rotation ROM than CBS. These results suggest that application of MCBS with stabilization of scapula may be a more useful to gain ROM of GHJ than CBS without stabilization of scapula.

• Journal of the Korean Society of Physical Medicine
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• v.2 no.2
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• pp.243-250
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• 2007

Purpose : Shoulder subluxation is a very common problem in patients with hemiplegia with stroke. Prevention of the low tone subluxed shoulder has been an issue for physical therapists working with neurological patients for many years. Methods : This study reviewed the literature to definite the management and a cause of shoulder subluxation with hemiplegia patients after stroke. Various modalities have been suggested for realigning the glenohumeral joint, but their use is controversial. The purpose of this paper is to review critically the evidence base in order to inform the clinical decision-making process for physiotherapists working in neurology. Results : Literature has identified supports, strapping and functional electrical stimulation(FES) in the management of low tone shoulders. Following review of this evidence it is suggested that there is a lack of reliable and valid research evidence on which to base conclusions. The modalities with the best supporting evidence for realigning the low tone subluxed glenohumeral joint are the triangular sling, Harris hemi sling and the Rolyan humeral cuff used in a standing position and the lap board and arm trough while the patient is sitting. However, due to soft tissue adaptation with associated lack of movement, over-correction and the need for careful patient positioning these supports need to be evaluated for each patient and should be used only in appropriate situations. Conclusion : Similarly, there is a lack of evidence on the effects of long-term use to this equipment. Electrical stimulation is also thought to have potential in the treatment to subluxed low tone shoulders but additional research is required to clarify the parameters for use and the long-term effects of these forms of management.