• Clinics in Shoulder and Elbow
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• v.18 no.4
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• pp.229-236
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• 2015

Background: Twenty-six patients (12 male and 14 female) with symptomatic scapular winging caused by serratus anterior dysfunction were managed by split pectoralis major tendon transfer (sternal head) with autogenous hamstring tendon augmentation from 1998 to 2006. Methods: Twenty-five patients showed positive results upon long thoracic nerve palsy on electromyography. The mean duration of symptoms until surgery was 48 months (range, 12-120 months). Four patients had non-traumatic etiologies and 22 patients had traumatic etiologies. On follow-up assessment for functional improvement, a Constant-Murley score was used. Twenty-one patients were completely evaluated, while five patients who had less than 12 months of follow-up were excluded. Results: Pain relief was achieved in 19 of the 21 patients, with 20 patients showing functional improvement. The pain scores improved from 6.0 preoperatively to 1.8 postoperatively. The mean active forward elevation improved from $108^{\circ}$ (range, $20^{\circ}-165^{\circ}$) preoperatively to $151^{\circ}$ (range, $125^{\circ}-170^{\circ}$) postoperatively. The mean Constant-Murley score improved from 57.7 (range, 21-86) preoperatively to 86.9 (range, 42-98) postoperatively. A recurrence developed in one patient. Of the 21 patients, ten had excellent results, six had good results, four had fair results, and one had poor results. Conclusions: Most patients with severe symptomatic scapular winging showed functional improvement and pain relief with resolution of scapular winging.

• Clinics in Shoulder and Elbow
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• v.21 no.4
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• pp.240-245
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• 2018

Rare cases of a congenital absence of the long head of the biceps tendon (LHBT) have been reported, and its incidence is unknown. In a literature review of the congenital absence of the LHBT, only 1 case was associated with posterior shoulder instability and severe posterior glenoid dysplasia. This paper reports the first case of a patient with a bilateral congenital absence of the LHBT with posterior shoulder instability without glenoid dysplasia or posterior glenoid tilt. The patient experienced a traffic accident while holding the gear stick with his right hand. After the accident, a posteroinferior labral tear with paralabral cysts was detected on the magnetic resonance images. The congenital absence of the LHBT was assumed to have affected the posterior instability that possibly increased the susceptibility to a subsequent traumatic posterior inferior labral tear. This case was identified as a posterior inferior tear caused by a traumatic 'gear stick injury'.

• Clinics in Shoulder and Elbow
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• v.24 no.1
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• pp.15-20
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• 2021

Background: The presence of an acromial spur implies a rotator cuff disorder due to impingement between the acromial spur and the rotator cuff. The purpose of the study was to observe acromial spurs using ultrasonography and to compare measurements between plain radiographs and sonograms. Methods: We retrospectively enrolled 51 consecutive patients with acromial spurs, which were interpreted on preoperative plain radiographs (supraspinatus outlet view and 30° caudal tilt) and preoperative sonograms. The ultrasonography transducer was held vertically and continuously moved laterally, which corresponded to the long axis of the long head of the biceps. The distance from the most distal margin of the original acromion to the most projected point of the acromial spur was measured. Results: No significant difference was found between the plain radiograph and ultrasonography measurements (p=0.186). A moderate to strong correlation was detected between the ultrasonography and supraspinatus outlet-view measurements (r=0.776, p=0.000). Conclusions: Anteriorly projected acromial spurs were well-visualized by ultrasonography. No discrepancy in acromial spur length was detected between the use of plain radiography (supraspinatus outlet view and 30° caudal-tilt view) and ultrasonography. The correlation coefficients between the plain radiography and ultrasonography measurements exceeded 0.7.

• Journal of the Korean Society of Costume
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• v.60 no.5
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• pp.88-105
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• 2010

The purpose of this study is to grasp the actual wearing conditions, inconvenience and problems with cycle wear. To attain this purpose, a questionnaire was completed by direct observation and by interviewing bicyclists. The questionnaire was given to 273 bicyclists. The questionnaire consisted of items that are related to concerns with dressing appropriately and enhancement of physical performance through dress. Following are the results of this study. According to the survey, many of them purchased imported cycle wear rather than national cycle wear, and the satisfaction according with purchase rate was low. Bicyclists were uneasy with finding right size cycle wear especially for women. It turned out that the area of the knee and elbow are mostly the areas that they get hurt while riding. Even though the knee and elbow are the mostly hurt area, bicyclists do not prefer to wear appropriate protector for the knee and elbow to excel in their performance in cycling. In material related questions, lower dissatisfaction was indicated for the lints caused by fraction. Average satisfaction was indicated for the distortion after washing, changes in color, touch of the fabric, matters with static and sweat. With regard to the areas where the bicyclists felt discomfort was highly indicated with lower-body clothing. Discomfort was highly indicated with crotch area when riding long period of time. Also when riding a cycle, discomfort was indicated with the leggings cuffs when it comes upward with riding motion. Most of the bicyclists felt the tight fitting leggings were embarrassing.

• Clinical and Experimental Pediatrics
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• v.45 no.10
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• pp.1288-1291
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• 2002

Fetal valproate syndrome has been described as a distinctive pattern of minor anomalies of the face and digits. This pattern has not been delineated completely but appears to involve brachycephaly with a high forehead, shallow orbit, ocular hypertelorism, small nose, small mouth, low set posteriorly rotated ears, long overlapping fingers and toes, and hyperconvex fingernail. Cleft palate and congenital heart disease have occasionally been described in babies exposed to valproate during embryogenesis. We report a neonate born from an epileptic mother receiving sodium valproate during pregnancy. This neonate presented with characteristic facial abnormalities, both elbow contractures, and overlapping of right first and second toe, forth and fifth toe, and left first and second toe. This case raises the possibility that these abnormal appearances might be caused by intrauterine valproate exposure.

• Transactions of the Korean Society of Mechanical Engineers A
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• v.31 no.4
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• pp.496-505
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• 2007

This paper proposes closed-form plastic limit load solutions for elbows under in-plane bending, via three-dimensional (3-D), small strain FE limit analyses using elastic-perfectly plastic materials. A wide range of elbow and thinning geometries are considered. For systematic analyses of the effect of the axial thinning length on limit loads, two limiting cases are considered; a sufficiently long wall thinning, and the circumferential part-through surface crack. Closed-form plastic limit load solutions for wall thinning with intermediate longitudinal extents are then obtained from these two limiting cases. The effect of the axial extent of wall thinning on plastic limit loads for elbows is highlighted by comparing that for straight pipes. Although the proposed solutions are developed for the case when wall thinning exists in the center of elbows, it is also shown that they can be applied to the case when wall thinning exists anywhere within the elbow.

• Clinics in Shoulder and Elbow
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• v.9 no.1
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• pp.20-26
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• 2006

Purpose: To evaluate the usefulness and functional results of open repair of massive rotator cuff tears combined with or without the tenoplasty of biceps long head. Materials and Methods: From March 2003 to August 2004, we evaluated 18 cases of the patient treated with open repair of massive rotator cuff tears. The mean age was 56 years and mean follow-up period was 15 months. We performed open repair of massive rotator cuff tears by tendon to bone repair, but in irrepairable 4 cases for tendon to bone repair performed open repair combined with tenoplasty of biceps long head. The functional results were assessed using the Constant score, the parameters of which were pain, dialy activity, mobility, strength and satisfaction. Results: The functional results were excellent in 4 cases, good in 8 cases, fair in 3 cases and poor in 3 cases. And the results of open repair combined with tenoplasty of biceps long head were good in 2 cases and fair in 2 cases. Re-repair was done in 1 case for re-rupture. And the functional result of this case was fair. The 3 poor cases were suspected re-rupture, the factor of which old age and weakened rotator cuff. It was impossible to do re-repair. Conclusion: The open repair combined with or without tenoplasty of biceps long head is a useful and effective method for massive rotator cuff tear.

• Clinics in Shoulder and Elbow
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• v.26 no.2
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• pp.175-181
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• 2023

Background: Acromioclavicular (AC) osteoarthritis (OA) is a frequent pathology of the shoulder in elderly patients. Drug injection plays an important role in treatment of AC OA. Literature has demonstrated excellent short-term results regarding shoulder function and pain. However, mid- to long-term results are lacking. The aim of this study was to assess the efficacy of a single intra-articular AC injection in patients with AC OA and to identify predictive factors for success. Methods: A retrospective study was performed to analyze success rate, shoulder function, and pain perception after a single intra-articular injection in patients with AC OA. Success was defined as the absence of reinterventions such as additional injection or surgery. Outcome measures were 1-year success rate and clinical outcome scores of Numeric Rating Scale (NRS) for pain, Oxford Shoulder Score, and Subjective Shoulder Value. Results: Ninety-eight patients participated in this study. At a median final follow-up of 0.8 years (interquartile range, 0-6), 57 of these patients (58%) had undergone a reintervention. The 1-year success rate was 47% (95% confidence interval, 37%-57%), with NRS at rest as the sole factor significantly associated with success. Thirty patients not requiring reintervention reported significant improvement from baseline for all reported outcome measures at final follow-up. Conclusions: AC injections offer a 1-year success rate of 47%. The AC injection produces good mid- to long-term clinical outcomes regarding shoulder function, quality of life, and pain perception in one-third of patients. Further research is essential to analyze mid- to long-term outcomes of AC injections.

• Clinics in Shoulder and Elbow
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• v.5 no.1
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• pp.23-28
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• 2002

Purpose Displaced lateral end fracture of clavicle and acromioclavicular dislocation type Ⅲ∼Ⅵ may be required surgical treatment. Material and Methods : From May 1998 to March 2001, we operated with Welter plate with minimal incision by one surgeon. Immediately, pendulum and passive exercise was initiated after surgery. The shoulder function was evaluated using UCLA score. Average follow up was on 28(12∼45) months. Results : All 11 patients were regained satisfactory function. Average UCLA score was 31.9(29~35) at last follow up. Conclusion . The merit of Welter plate fixation with minimal incision is simple technique, reduced surgical time, smaller scar than large plate, strong fixation, early exercise, reduced implant failure. The disadvantage is expensive, skin irritatatation by long hook. But Welter plate fixation with minimal incision is a good method of internal fixation and excellent clinical result in surgical treatment of type H displaced lateral end fracture of the clavicle and type Ⅲ∼Ⅵ acromioclavicular dislocation.

• Clinics in Shoulder and Elbow
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• v.20 no.2
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• pp.100-104
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• 2017

Enchondromas generally occur in the hand and uncommonly in the long bones. Because enchondromas are usually asymptomatic, most are discovered during diagnostic radiology for another disease. Here, we describe a case of enchondroma in the right humerus in a 79-year-old female patient with concomitant rotator cuff tear arthropathy. The patient was initially hospitalized for prolonged pain and pseudoparalysis of the right shoulder. The condition, which was histologically confirmed as an enchondroma in the proximal humerus, was treated with curettage and reverse total shoulder arthroplasty. In this case report, we present a rare case of an enchondroma with combined rotator cuff tear arthropathy.