• Clinics in Shoulder and Elbow
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• 제24권1호
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• pp.27-31
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• 2021

A hemiarthroplasty with biologic resurfacing of the glenoid is one procedure that can be performed in young patients where total shoulder arthroplasty may be difficult. The authors introduced two cases in which this procedure was performed. This approach is one treatment option for young glenoid humeral arthritis patients that addresses some of the shortcomings of an isolated hemiarthroplasty.

• The Journal of Korean Physical Therapy
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• 제31권2호
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• pp.94-102
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• 2019

Purpose: This study examined the effects of trunk control rehabilitation robot training (TCRRT) on the dynamic balance, lower extremity strength, gait ability and pain for bipolar hemiarthroplasty. Methods: Hemiarthroplasty (n=28) patients participated in this study. The subjects were randomized into two groups: trunk control rehabilitation robot training group and control group. Results: The TCRRT group showed significantly more improvement in the MFRT, MMT, 10MWT, TUG, and VAS compared to that before intervention (p<0.05). In addition, all tests were significantly greater in the experimental group than in the control group. Conclusion: These results suggest that TCRRT is feasible and effective for improving the dynamic balance, lower extremity strength, gait ability, and pain efficacy after bipolar hemiarthroplasty.

• Clinics in Shoulder and Elbow
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• 제21권3호
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• pp.120-126
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• 2018

Background: Treatment of distal humerus fractures in osteoporotic elderly patients is often challenging. For non-reconstructible fractures with open reduction and internal fixation, total elbow arthroplasty (TEA) is an acceptable alternative. However, the relatively high complication rates and lifelong activity restrictions make TEA less ideal for elderly or low-demand patients. Efforts to identify or develop alternate procedures that benefit relatively young, high-demand patients have resulted in increased interest in hemiarthroplasty. This systematic review reports the clinical outcomes of hemiarthroplasty for distal humeral fractures. Methods: We systematically reviewed the databases of PubMed, Ovid MEDLINE, and Cochrane Library. All English-language studies published before June 2017 were considered for possible inclusion. Search terms included 'distal humerus fracture' and 'hemiarthroplasty'. Studies reporting outcomes (and a minimum of 1 year clinical follow-up) in human subjects after hemiarthroplasty (Latitude system) for distal humeral fractures were assessed for inclusion. Patient demographics, clinical and radiographic outcomes, and complications were recorded, and homogenous outcome measures were analyzed. Results: Nine studies with a total of 115 patients met the inclusion criteria. Among the included studies, the weighted mean follow-up time was 35.4 months. Furthermore, the weighted mean of the postoperative range of motion ($107.6^{\circ}$ flexion-extension, $157.5^{\circ}$ for pronation-supination) and functional outcomes (Mayo elbow performance scores: 85.8, Disabilities of the Arm, Shoulder and Hand score: 19.6) were within the acceptable range. Conclusions: Our study indicates that hemiarthroplasty is a viable option for comminuted distal humerus fracture. Satisfactory functional outcomes were observed in most patients.

• Hip & pelvis
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• 제30권4호
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• pp.241-253
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• 2018

Purpose: This study was conducted to compare cemented and cementless bipolar hemiarthroplasty in elderly patients with unstable intertrochanteric fractures via meta-analysis and systematic review of relevant studies. Materials and Methods: Systematic review and meta-analysis were performed on 31 available clinical studies; 19 of these studies used cemented stems, 12 used cementless stems, one used both types of stems, and two studies involved a comparative analysis of both stem types. Results: There were statistically significant differences in rates of leg length discrepancy (LLD) greater than 1 cm between the cemented (event rate, 0.089) and cementless groups (event rate, 0.015 and 0.047; P=0.03). Conclusion: Cemented bipolar hemiarthroplasty and cementless bipolar hemiarthroplasty performed on elderly patients with unstable intertrochanteric fracture revealed similar mortality and complication rates; however, the rate of LLD greater than 1 cm was significantly higher in the cemented group compared with the cementless group.

• 대한골관절종양학회지
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• 제12권1호
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• pp.9-14
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• 2006

목적: 근위 경골 육종의 절제 후 재건은, 특히 골성장이 완료되지 않은 환자의 경우 많은 문제점이 있다. 본 연구에서는 근위 경골 육종의 절제 후 재건에 따르는 문제점을 보완하기 위한 새로운 술식을 시도해 보고자 하였다. 대상 및 방법: 근위 경골에 발생한 골육종의 절제 후 반관절성형술을 시행한 4례를 대상으로 하였다. 평균 연령은 13세였으며 술후 평균 추시 기간은 64개월이었다. 전례에서 초고분자량 폴리에틸렌 삽입물(ultra-high molecular weight polyethylene liner)을 이용하여 관절면을 재건한 후 엔더정(Ender-nail)과 골시멘트를 이용하여 남아있는 경골에 고정하였다. 결과: 최종 추시상 MSTS 기준에 의한 기능적 점수는 23.5점(78.3%)이었다. 전례에서 술후 슬관절 동통, 불안정성은 관찰되지 않았다. 결론: 골성장이 완료되지 않은 소아 환자의 근위 경골 육종 절제 후 재건 방법으로서 반관절 성형술은 효과적인 술기로 판단된다.

• Clinics in Shoulder and Elbow
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• 제10권1호
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• pp.92-98
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• 2007

목적: 근위 상완골 골절의 치료 방법은 일반적으로 Neer 분류법에 의하고, 심하게 전위된 3분 골절 및 4분 골절의 경우 상완골두 치환술의 적응증이 된다. 저자들은 근위 상완골의 분쇄 골절로 인하여 상완골두 치환술을 시행 받고, 최소 1년 이상 추시 가능하였던 10례의 단기적 임상적 결과를 보고 하고자 한다. 대상 및 방법: 저자들은 1999년 7월부터 2005년 3월까지 상완골 근위부 골절로 상완골 두 치환술을 시행 받은 환자 중 최소 1년 이상 추시 가능 하였던 10명(10 견관절)의 환자를 대상으로 하였다. Neer 분류법에 의하면 5명은 3분 골절이었고, 나머지 5명은 4분 골절이었으며 외상 후 수술까지 소요 시간은 평균 6.1일 이었다. 남자 4명, 여자 6명이었고, 평균 연령은 67.4세(최소 56세, 최고 76세)였다. 술 후 견관절 기능은 Constant score와 SST(Simple shoulder test) 및 UCLA 평가법(modified UCLA score for hemiarthroplasty)을 이용하여 평가하였다. 결과: 최종 방문 시 Constant 점수는 평균 51.4(최저 34점, 최고 60점)점이었고, 변형된 SST의 경우는 12개 문항 중 평균 7.8개 문항이 가능하다고 하였다. 수상 당시 액와동맥 파열 및 상완신경총 손상이 있었던 1예를 제외한 경우 Constant score는 평균 53.5(최저 44점, 최고 60점)점 이었고, SST의 경우는 12개 문항 중 평균 7.2($1{\sim}8$)개 문항이 가능하다고 하였다. 최종 추시 UCLA score는 동통, 기능성, 근력 및 운동 범위 항목 각각이 평균은 8.2($6{\sim}10$)점, 6.6($2{\sim}8$)점, 6.9($4{\sim}8$)점 이었고, 총점 21.7($12{\sim}26$)점 이었다. UCLA 평가법에 의한 결과는 우수 3예, 양호 6예, 불량 1예 이었고 불량의 경우는 혈관 및 신경 손상이 있었던 1예 이었다. 환자의 주관적 만족도는 10명의 환자 중 2명의 환자는 흡족, 7명의 환자는 양호한 결과라고 하였으나, 1명의 경우는 불만이었다. 결론: 단기 추시 결과이지만, 상완골 두 치환술은 관혈적 정복술이 어려운 상완골 근위부 골절에있어서 일차적 치료방법이라고 생각된다. 상완골 두 치환술은 고령의 환자에게 있어서 강직을 예방할 수 있고 일상적인 생활이 가능하도록 하는 수술 방법이나, 관절운동 범위 및 근력의 회복은 충분하지 않았다.

• Clinics in Shoulder and Elbow
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• 제3권2호
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• pp.61-67
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• 2000

Purpose: Most proximal humeral fractures are minimally displaced and can be treated satisfactorily with a conservative method. But in many comminuted fractures, hemiarthroplasty is usually done as a primary treatment. The authors evaluated how much functional improvement was achieved after hemiarthroplasty and which factors influence on the final functional results. Materials and Methods: Eleven hemiarthroplasties were performed for three- and four-part fractures(including fracture-dislocation) between April 1992 and June 1999. There were eight women and three men, and the mean age was 65 years. According to Neer classification, six was three-part fracture and five was four-part fracture. Six patients were injured on their right shoulder and five on the left shoulder. Among the five four-part fractures, three had axillary nerve injury and among the six three-part fractures, only one patient had axillary nerve injury. The average follow-up period was 2.4 years(1 year-7 years) after operation. The functional results were evaluated with the UCLA scoring system(Modification for hemiarthroplasty). In addition to the overall results, we compared the results according to the classification of the fracture, the cause of injury, and whether the axillary nerve was injured. Results: At the last follow-up, average total UCLA score was 18.2. The mean score for pain was 7.0, mean muscle power and motion score was 5.5 and 5.7 respectively. The pain relief was more satisfactory than any other functional results. The average score for three-part fractures was 22, and the average for four-part fractures was 13.6. The average score for the patients fractured by vehicle accidents was 15.3, and 19.3 for the patients fractured by slip-down injury. In patients without axillary nerve injury, the average score was 20, and with axillary nerve injury, the score was 15. Conclusion: Shoulder hemiarthroplasty, for the treatment of proximal humeral fractures, cannot restore the shoulder function to normal, but can achieve the functional result to some degree, especially for the activity of daily living. And as for pain, we think that it is relatively effective measure. And we think that the severer the comminution, the more the chance of axillary nerve injury, and the poorer the functional results. In conclusion, the severity of initial injury seems to be the major prognostic factor.

• Clinics in Shoulder and Elbow
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• 제1권2호
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• pp.205-211
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• 1998

저자들은 상완골 근위부의 골절탈구로 일차성 견관절 반치환술로 치료받은 환자 25례중 14례를 대상으로 치료결과를 분석하여 다음과 같은 결론을 얻었다. 1. 전례에서 동통은 소실되거나 완화되었으나 Neer의 평가에 따라 총 14례중 5례에서만 만족할만 한 결과를 믿었으며 나머지 9례에서는 불만족한 결과를 보였다. 2. 수상시 상완곤두의 분쇄상이 심하거나, 수술이 지연되어 골편치 연화가 심한 경우 상완골 길이와 humeral offset의 유지가 힘들었으며, 견관절 반치환술 시팽한 측이 정상측보다 1cm 이상 단축을 보인 경우가 5례였으며 이 경우 능동적 견관절 운동범위가 정상측보다 감소되었다. 3. 견관절 반치환술은 분쇄상 상완골 근위부 골절에서 사용되어지며 동통의 감소와 기능의 호전은 있으나 완전한 회복은 어려우며 수술시 연부조직 손상이 적고 적당한 후염각, 결절의 재건 과 회전근개의 수복은 필수적이다. humeral offset과 길이의 유지는 술 후 능동적 견관절 운동 범위의 향상에 영향을 미치며 아울러 환자의 협조하에 체계적인 재활운동이 필요할 것으로 사료된다.

• Clinics in Shoulder and Elbow
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• 제1권1호
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• pp.12-18
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• 1998

To purpose of this study was to evaluate clinical results between rheumatoid arthritis shoulder cases and traumatic proximal humerus fracture cases. Fourteen patients who had been shoulder hemiarthroplasties between March 1991 to July 1996, six had rheumatoid arthritis and eight had comminuted proximal humerus fracture by the various trauma. Neer II prothesis were implanted in twenty cases and global prothesis were implanted in two cases. The follow up period was 15 months to 36 months. To evaluate this study, we used the UCLA shoulder rating. We were able to follow up thirteen cases for more than fifteen months, of which five cases had excellent, five cases had good, two cases had fair and one case had poor. And the results were better for patients with rheumaroid arthritis than for patients with trauma.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2004년도 학술대회
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• pp.51-51
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• 2004