• Hip & pelvis
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• v.35 no.3
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• pp.200-205
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• 2023

Purpose: The aim of this study was to assess the current status of venous thromboembolism (VTE) prevention in Korean patients with hip fractures. Materials and Methods: A survey using a questionnaire on the experiences and protocols of VTE prevention was conducted among 570 members of the Korean Hip Society. Results: A total of 97 surgeons responded, with a response rate of 17.0%. Of the 97 participants, 61.9% answered that they had encountered one or more cases of symptomatic VTE in the past year. Mechanical prophylaxis was applied most often (30.9%) until the point of ambulation in standard-risk patients and most often (34.0%) extended until discharge in high-risk patients. Chemical prophylaxis was most often prescribed for a particular period of time rather than for recovery of walking ability (24.7% in standard-risk patients and 26.8% in high-risk patients). Dual prophylaxis was administered in the standard-risk group by 58.8% of the participants and in the high-risk group by 83.5%. Among the participants, 73.2% answered that they had been attentive to wound complications during chemical prophylaxis. More than half of the participants (59.8%) reported that they did not perform routine screening for VTE after surgery. Conclusion: The results of our survey provided information regarding the current status of VTE prevention for patients undergoing surgery for treatment of hip fractures in Korea as well as a baseline for establishment of educational programs and guidelines in the future.

• Clinics in Shoulder and Elbow
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• v.26 no.3
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• pp.296-301
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• 2023

Background: A supervised physiotherapy program (SPP) is a standard regimen after surgical rotator cuff repair (RCR); however, the effect of a home-based exercise program (HEP), as an alternative, on postoperative functional recovery remains unclear. Therefore, the purpose of this meta-analysis was to compare the functional effects of SPP and HEP after RCR. Methods: We searched electronic databases including Central, Medline, and Embase in April 2022. The primary outcomes included the Constant score, American Shoulder and Elbow Surgeons score, University of California Los Angeles shoulder score, and pain score. Secondary outcomes included range of motion, muscle strength, retear rate, and patient satisfaction rate. A meta-analysis using random-effects models was performed on the pooled results to determine the significance. Results: The initial database search yielded 848 records, five of which met our criteria. Variables at 3 months after surgery were successfully analyzed, including the Constant score (mean difference, -8.51 points; 95% confidence interval [CI], -32.72 to 15.69; P=0.49) and pain score (mean difference, 0.02 cm; 95% CI, -2.29 to 2.33; P=0.99). There were no significant differences between the SPP and HEP. Other variables were not analyzed owing to the lack of data. Conclusions: Our data showed no significant differences between SSP and HEP with regard to the Constant and pain scores at 3 months after RCR. These results suggest that HEP may be an alternative regimen after RCR. Level of evidence: I.

• Clinics in Shoulder and Elbow
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• v.20 no.4
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• pp.189-194
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• 2017

Background: Few studies have reported the results of arthroscopic coracoplasty concomitantly conducted with subscapularis tear. Therefore, this study was conducted to examine and compare the outcomes of arthroscopic subscapularis repair after arthroscopic coracoplasty using either the subacromial approach or rotator interval approach. Methods: We retrospectively reviewed 51 patients who underwent coracoplasty with subscapularis repair. The patients were grouped according to whether the subacromial approach group (24 patients) or rotator interval approach group (27 patients) was used during coracoplasty. Preoperative and postoperative visual analogue scale scores, American shoulder and elbow surgeons scores, Korean shoulder scores, and range of motion (ROM) were assessed. Assessment of repaired rotator cuff tendon integrity was performed at 1 year after surgery using either magnetic resonance imaging or ultrasonography. Results: At final follow-up, overall functional scores and ROM improved significantly in both groups when compared with preoperative values (p>0.05). The re-tear rates were not significantly different between groups; however, the rotator interval approach group showed a significant increase in ROM compared with that in the subacromial approach group (p<0.05). Conclusions: Arthroscopic coracoplasty conducted concomitantly with subscapularis repair can provide a satisfactory outcome. There were no significant differences between the two approach groups regarding final functional scores and re-tear rates. However, the rotator interval approach group showed a greater increase in ROM at final follow-up, especially in external rotation.

• Archives of Reconstructive Microsurgery
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• v.14 no.1
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• pp.24-30
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• 2005

Thigh perforator flaps are used popularly, because they have a small thickness, a long vascular pedicle and a low rate of donor site morbidity. Among thigh perforator flaps, anterolateral thigh perforator flaps are generally used, but it is not easy to dissect the vastus lateralis muscle to find the vasuclar pedicle. The authors have planed 11 anteromedial thigh perforator flaps that have septocutaneous perforators. We were able to find anteromedial thigh perforators in 8 cases(72.7%). The perforators originated from the medial descending branch of the lateral circumflex femoral artery in 2 cases and a branch to the rectus femoris muscle in 6 cases. Of this type of surgery, 7 flaps survived. However, 1 flap failed because of arterial insufficiency. We believe the anteromedial thigh perforator flap is a good option when the thigh region is decided as a donor site, but surgeons should keep in mind that the perforator of anteromedial thigh flap may be absent.

• Proceedings of the KSME Conference
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• 2008.11a
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• pp.1543-1546
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• 2008

The purpose of this study was to investigate factors affecting the change of tibial posterior slope and introduce a mathematical model which calculate, through 3-dimensional analysis of the proximal tibia, how the angle of the opening wedge along the anteromedial tibial cortex influences the tibial posterior slope and valgus correction when performing a medial open wedge osteotomy. This mathematical model with navigation system can be guidelines which provide surgeons on preoperative and intraoperative measurements to maintain or correct the tibial slope and to obtain the desired valgus correction of the lower limb during an opening wedge osteotomy.

• Clinics in Shoulder and Elbow
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• v.3 no.1
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• pp.26-32
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• 2000

Purpose : The aim of this study is the assessment of the clinical outcomes after percutanous pinning of unstable two-parts fracture of surgical neck in humerus. Materials and Methods: This study was based on thirteen cases of non-comminuted unstable surgical neck fracture of humerus among 19 cases, which followed-up more than one year. Follow-up averaged 29 months. We treated with percutaneous pinning techniques and assessed clinical outcomes. Functional evaluation was performed using the standard method of research committee of American Shoulder and Elbow Surgeons(ASES). Results: Last follow-up ROM of shoulder joint were 142 degrees of forward elevation, 57 degrees of external rotation, 72 degrees of external rotation in 90 degrees abduction, and T8 of internal rotation. Pain scale was l(range : 0∼3). ASES scores was 86.2(range : 63.3~98.3). Patient satisfaction based on ASES were excellent in 6 cases, good in 5 cases, fair in 1 case, poor in 1 case. A case of fair result was caused by limitation of motion in shoulder joint and poor case was paraplegia patient after traffic accident. Conclusion : Percutaneous pinning is recommended for non-comminuted unstable fracture of surgical neck in humerus.

• Clinics in Shoulder and Elbow
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• v.19 no.3
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• pp.119-124
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• 2016

Background: The purpose of this study is to evaluate the functional outcomes of reverse total shoulder arthroplasty (RTSA) and to assess factors affecting the patients' subjective satisfaction after RTSA. Methods: Forty-three patients (mean age, $75.0{\pm}5.2years$) who underwent RTSA for cuff tear arthropathy or irreparable cuff tears with preoperative magnetic resonance imaging and pre- and postoperative radiographs at 1 year, and whose various functional outcomes including pain visual analogue scale (VAS), simple shoulder test, Constant score, American Shoulder and Elbow Surgeons score, and active range of motion were evaluated preoperatively and at the last follow-up (>12 months) were enrolled. The outcome parameter was set as a satisfaction scale. Various clinical and radiographic factors were analyzed, and their correlations with postoperative satisfaction were evaluated. Results: All functional scores, VAS pain score, and active forward flexion showed significant improvement after surgery (all p<0.001). Twenty-nine patients were satisfied with the results and 14 were dissatisfied. The presence of pseudoparalysis (p=0.028) and worse preoperative function (all p<0.05) were related with higher satisfaction. Any radiologic parameters did not affect patients' postoperative satisfaction. Conclusions: All patients showed a good functional outcome after RTSA, however the patients' subjective postoperative satisfaction was affected by preoperative functional status (higher satisfaction in poor preoperative function), not by radiological findings.

• Journal of Korean Foot and Ankle Society
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• v.23 no.4
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• pp.201-207
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• 2019

An osteochondral fracture is considered to be an injury involving the cartilage and subchondral bone. Acute traumatic osteochondral fractures can be related to joint instability because abnormal joint motion causes shearing and rotatory stress. Acute osteochondral fractures are frequently missed or misdiagnosed as a pure soft tissue injury. Thus, surgeons' proactive attention is highly required as articular cartilage has limited potential for self-repair and these lesions may develop osteoarthritis. In order to minimize the progression of post-traumatic osteoarthritis, it is important to properly identify and treat osteochondral fractures. Yet, little is known about the operative management of acute osteochondral fractures of the talus. We report here on a case of a middle-aged male with acute osteochondral fractures of the bilateral lateral talar dome. We applied different operative methods on each side with regard to fragment size and stability. A favorable clinical outcome was obtained at 18 months follow-up.

• Clinics in Shoulder and Elbow
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• v.25 no.3
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• pp.195-201
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• 2022

Background: This study aimed to examine the preliminary clinical results of the infraspinatus rotational transfer procedure for irreparable posterosuperior rotator cuff tears. Methods: This study included 34 patients (mean age, 68.4 years). Their mean tear width and length measurements were 50.9 mm and 50.6 mm, respectively. The functional outcomes, including physician-determined and patient-reported scores, were evaluated before and at 1 year after surgery. The structural outcomes determined using the magnetic resonance imaging examination results were also assessed. Results: The clinical scores significantly improved after surgery compared with the scores before surgery: the Constant-Murley score (53.3±21.1 to 76.8±10.5), University of California at Los Angeles Shoulder score (15.6±3.6 to 27.8±6.7), American Shoulder and Elbow Surgeons Shoulder score (51.8±18.3 to 89.1±13.5), and WORC score (925.0±436.8 to 480.3±373.2) (all p<0.001). Postoperative re-tears were noted in two patients (5.9%). Conclusions: One year postoperatively, the patient's clinical scores significantly improved, with a re-tear rate of 5.9%.

• Journal of the Korean Orthopaedic Association
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• v.54 no.1
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• pp.18-23
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• 2019

As the population grows older and medical treatments are advancing, the number of spine surgeries in elderly patients has been increasing. To obtain a successful outcomes of spine surgery in elderly patients, surgeons should prepare meticulously because elderly patients can have osteoporosis and surgery can be more extensive than in younger patients. Therefore, this study reviewed the perioperative medical treatment, particularly for osteoporosis, to improve the surgical outcomes in elderly patients.