• Clinics in Shoulder and Elbow
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• 제20권4호
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• pp.230-235
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• 2017

Background: Neer type II distal clavicle fractures have the drawback of coracoclavicular instability and insufficient distal bony fragment, thereby making it difficult to achieve adequate fixation. Although various surgical treatments have been described for Neer type II fracture, the optimal treatment remains controversial. This study reports the clinical results and usefulness of anatomical locking plate with additional K-wire fixation. Methods: A totally of 21 patients with type II distal clavicle fracture were included in the study. The surgical procedure reduced the fracture temporarily; it included insertion of one or two K-wire from the lateral margin of the distal fragment to the proximal fragment through the fracture site, followed by application and fixation of the locking plate. The bony union and migration of K-wire was evaluated in the follow-up radiography. The coracoclavicular distance and acromioclavicular joint arthrosis were assessed at the final follow-up. The Constant Score (CS) and Korean Shoulder Score (KSS) were evaluated for clinical scoring. Results: Bone union was achieved in all cases. At the final follow-up, coracoclavicular distance of the injured shoulder was increased, as compared to the intact shoulder (p=0.002), with no accompanying clinical symptoms. No K-wire migration was observed. At the final follow-up, K-wire irritation was observed in two cases and acromioclavicular arthrosis in one case, with no other adverse effects. Pain visual analogue scale, CS, and KSS were improved in all cases. Conclusions: The method of anatomical locking plate with additional K-wire fixation could be useful in achieving beneficial clinical results.

• Clinics in Shoulder and Elbow
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• 제20권4호
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• pp.222-229
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• 2017

Background: The purpose of this study was to investigate the outcomes after fixation using a 3.5-mm locking compression plate (LCP) hook plate for isolated greater tuberosity (GT) fractures of the proximal humerus. Methods: We evaluated the postoperative radiological and clinical outcomes in nine patients who were followed up at least 1 year with isolated GT fractures. Using the deltopectoral approach, we fixed the displaced GT fragments with a 3.5-mm LCP hook plate (Synthes, West Chester, PA, USA). Depending on the fracture patterns, the hook plate was fixed with or without augmentation using either tension suture or suture anchor fixation. Results: All the patient showed successful bone union. The mean time-to-union was 11 weeks. The radiological and clinical outcomes at the final follow-up were generally satisfactory. The mean visual analogue scale for pain, the University of California at Los Angeles score, the American Shoulder and Elbow Surgeons score, and the subjective shoulder value were 1.4, 30.3, 84.3, and 82.2%, respectively. The mean active forward flexion, abduction, external rotation, and internal rotation of the shoulder were $156.7^{\circ}$, $152.2^{\circ}$, $61.1^{\circ}$, and the 10th thoracic vertebral level, respectively. Only one patient presented with a postoperative complication of shoulder stiffness. The patient was treated through arthroscopic capsular release on the 5th postoperative month. Conclusions: We conclude that fixation using 3.5-mm LCP hook plates for isolated GT fractures of the proximal humerus is a useful treatment method that provides satisfactory clinical and radiological outcomes.

• Journal of Chest Surgery
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• 제30권9호
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• pp.941-944
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• 1997

폐경색은 임상적으로나 방사선학적으로 폐암, 폐출혈, 울혈성 무기폐, 단순괴사와 감별이 힘든 질환으로 흉부외상과 관련되어 보고된 예는 없다. 환자는 45세 남자로 약 3주전 흉부외상에 의한 우측의 다발성 늑골골절과 쇄골골절로 치료를 받아오 다가 증상이 점점 악화되어 본원에 전원된 후 우상엽 절제술을 받았으며, 조직검사 결과 폐경 색으로 진 단되었다. 전원 당시 흉부의 컴퓨터 단층활영상 우상엽에 거대한 종괴음영이 있었고, 양측 폐야에 5개 정도의 작 은 결절상 음영이 있었으나 폐 생검에서 암세포는 발견되지 않았고, 우상엽 절제술 당시 대부분의 작은 결절들은 자연 소실되어 있었다 절제된 우상엽에서 육안적으로 인지되는 혈전은 보이지 않았고, 조직검사상 주로 폐동맥의 분지인 0.6 ∼2.0 mm 정도의 근형 동맥들이 혈전에 의해 폐쇄되어 있었으며 일부는 더 진행하여 기질화를 보이거나 혈류의 재소통이 이루어진 곳도 관찰되었다.

• 한국한의학연구원논문집
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• 제18권2호
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• pp.25-38
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• 2012

Objective : This study was conducted to underpin the theory of Taegeuk Acupuncture systematically and increase the utility of clinical trial and a range of application. Method : This study analysed ByungHaeng Lee's theory, who is the originator of Taegeuk Acupuncture, by focusing on "Young Chu GuChimSibYiWon" Result & Conclusion : 1. ByungHaeng Lee's thought about Viscera and Bowels is following medicine of Internal Classic. Even though JeMa Lee's thought about Viscera and Bowels has same name with ByungHaeng Lee's, but the functional meaning and related part is totally different. So, four constitution types in Taegeuk Acupuncture are different from four constitution types in Four-Constitution Medicine. Therefore, Taegeuk Acupuncture isn't related with Four-Constitution Medicine 2. On the authority of "Young Chu GuChimSibYiWon", we can extend 4 therapeutic acupuncture point combinations of Taegeuk Acupuncture to ten therapeutic acupuncture point combinations which tentatively named 'Five Viscera Source Point Acupuncture'. 3. To consider an example of eight constitutional acupuncture, Taegeuk Acupuncture thoroughly says constitutional acupuncture. Especially, JaeGyuKim's Taegeuk Acupuncture has specific diagnosis standard that after treating a patient with acupuncture, he checks an oppressive pain at the precordial region and a voiced sound at liver and then he makes sure constitution of patient. So we can consider JaeGyuKim's Taegeuk Acupuncture as constitutional acupuncture. However, it has to change the name of four constitution types to taegeuk greater yang person, taegeuk lesser yang person, taegeuk greater yin person, taegeuk lesser yin person so as to avoid confusion. 4. Taegeuk Acupuncture is markedly simple in comparison with other acupuncture, so it needs to extend the utility of clinics by enlarging treatment acupuncture points.

• Clinics in Shoulder and Elbow
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• 제9권2호
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• pp.235-241
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• 2006

Neglected adult Monteggia fracture could induce the pain, instability and malformation of elbow. Especially, compared with the chronic Monteggia fracture of child, that of adult is difficult to treat and could concur with valgus instability and deformity, limitation of range of motion and tardy ulnar nerve palsy. But recently, the chronic Monteggia fracture of adult could be treated by the 3.5 mm compression plate (DCP) or 3.5 mm pelvic reconstruction plate, so that the result improved more and more. The treatment of choice of the chronic Monteggia fracture of adult is the corrective osteotomy and reduction of radial head or resection of radial head. We experienced two patients who had neglected Monteggia fracture over 1 year 6 months and 25 years respectively and we want to report the result of surgical treatment of chronic Monteggia fracture of adult.

• Clinics in Shoulder and Elbow
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• 제9권2호
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• pp.181-188
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• 2006

Purpose: To evaluate the integrity of repair & technical tip in use of Massive Cuff Stitch at arthroscopic repair of rotator cuff tear. Materials and Methods: Twenthy-nine cases of arthroscopically repaired full thickness tear of rotator cuffs which are medium sized were evaluated. Between December 2004 to September 2005 we have studied, the average age 53($42{\sim}69$) years old, mean follow-up was 15($12{\sim}21$) months. We analyzed the results statistically by paired t-test. The integrity of repair were verified by follow up MRI which were checked 11 cases and ultrasound which were checked 10 cases. Results: VAS of pain improved preoperative average 7.1 to postoperative 0.9, ADL improved 11.2 to 25.6 respectively, UCLA improved 13.7 to 32.9(all, P<0.05). 89.7% showed excellent & good results at the final follow-up. The satisfied rate was 93.1%(27 cases). There was re-rupture of the repaired rotator cuff in one case out of 11 cases which were checked by MRI, and in one case out of 10 cases which were checked by ultrasound, and there was one case of thinning of cuff which were checked by ultrasound. Conclusion: The use of Massive Cuff Stitch in arthroscopic repair of rotator cuff tear have been reduced technical failure. It will be good surgical technique which maintain the integrity of repairs.

• Clinics in Shoulder and Elbow
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• 제13권1호
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• pp.117-122
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• 2010

목적: 본 증례 보고는 간질 발작과 동반된 심한 전방 관절와 골결손에 의한 견관절 불안정성에서 자가 삼면피질 장골 이식술을 통한 관절와 재건술 및 안정화 술식을 시행한 증례를 문헌 고찰과 함께 보고하고자 한다. 대상 및 방법: 간질 발작과 동반된 심한 전방 관절와 골결손을 가진 2예의 재발성 전방 탈구를 자가 삼면 피질 장골 이식술을 이용하여 관절와 재건술 및 안정화 술식을 이용하여 치료하였다. 결과: 수술 후 5개월째 단순방사선 촬영상 이식골의 유합 소견이 관찰되었고, 수술 전 소견과 비교해서 골관절염의 진행소견은 관찰되지 않았다. 수술 후 7개월 추시 관찰 상 통증은 거의 없었으며, 관절 운동 범위는 정상 운동 범위를 보였으며, 관절의 안정성을 확보하였다. 결론: 심한 전방 관절와 골결손을 가진 재발성 전방 탈구는 충분한 골 이식을 통해 전방 안정성을 얻을 수 있으며, 관절 면을 비교적 잘 일치시켜 정상 관절와의 오목함을 재건할 수 있고 관절염의 빈도를 줄일 수 있다.

• Clinics in Shoulder and Elbow
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• 제13권1호
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• pp.127-131
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• 2010

목적: 저자들은 관절와 골절의 치료에 있어 고식적인 관절 절개술이 아닌 관절경을 이용한 골절의 정복 및 내 고정한 증례를 보고 하고자 한다. 대상 및 방법: 66세의 남자로 좌측 견관절의 쇄골 골절 및 관절와의 전위된 횡 골절 및 견갑골 골절이 있는 환자였으며 관절경을 이용하여 골절을 정복하고 유경나사로 내 고정 하였다. 결과: 술 후 9개월 째 좌측 견관절의 운동 범위는 완전히 회복 되었으며 환자는 일상 생활에 불편감이 거의 없었다. 술 후 12개월째 전신 마취 하 내 고정물의 제거 술을 시행 하였다. 결론: 관절경을 이용한 수술은 고식적인 수술보다 적은 통증, 적은 출혈량, 술 후 입원기간의 단축 및 조기 관절 운동이 가능하다는 장점이 있었고 술 후 견관절 운동 범위에서도 우수한 결과를 보였으며 임상적 평가에서도 만족스러운 결과를 보였다.

• Clinics in Shoulder and Elbow
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• 제23권1호
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• pp.20-26
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• 2020

Background: High complication rate after open reduction and internal fixation can lead to use of primary total elbow replacement (TER) in treatment of complex distal humerus fractures in elderly patients. The purpose of this study was to investigate the short-term outcomes and complications after primary TER in patients with complex distal humerus fracture. Methods: Nine patients with acute complex distal humerus fracture were treated by primary TER using the semiconstrained Coonrad-Morrey prosthesis. The mean age of patients was 72.7 years (range, 63-85 years). Clinical and radiographic outcomes were evaluated over a mean follow-up of 29.0 months (range, 12-65 months) using visual analog scale (VAS) score for pain; Mayo elbow performance score (MEPS); Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) score; and serial plain radiographs. Complications were also evaluated. Results: At the final follow-up, mean VAS, MEPS, and Quick-DASH scores were 1.2, 80.5, and 20, respectively. The mean range of motion was 127.7° of flexion, 13.8° of extension, 73.3° of pronation, and 74.4° of supination. There was no evidence of bushing wear or high-grade implant loosening on serial plain radiographs. Three complications (33.3%) comprising two periprosthetic fractures and one ulnar neuropathy were observed. Conclusions: Primary TER for treatment of complex distal humerus fractures in elderly patients yielded satisfactory short-term outcomes. However, surgeons should consider the high complication rate after primary TER.

• 근관절건강학회지
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• 제5권1호
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• pp.7-25
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• 1998

Rheumatoid arthritis, unlike other chronic diseases, causes the patients to experience uncertainty in their daily lives and thus to feel threat on their emotional comfort because of inconsistent and unpredictable symptoms such as pain. Therefore, a theoretical framework is needed for explanation of uncertainty in patients having rheumatoid arthritis. A hypothetical model was constructed on the basis of Mishel's Uncertainty Theory and other literature review. The model included 9 theoretical concepts and 19 paths. Subjects of the study constituted 330 partients who visited outpatient clinics of two university hospitals and one general hospital in Seoul. Self report questionnaires were used to measure the variables affecting uncertainty. Reliability coefficients of these instruments were found Cronbach's Alpha=$.70{\sim}.94$. In data analysis, SAS program and PC-LISREL 8.03 computer program were utilized for descriptive statistics and covariance structure analysis. The results of covariance structure analysis for model fitness were as follows : 1) Hypothetical model showed a good fit to the empirical data : Chi-square($X^2$)=41.81 (df=11, P=.000), Goodness of Fit Index=.974, Root Mean Square Residual=.049, Normed Fit Index=.928, Non Normed Fit Index=.814. 2) For the validity and the parcimony of model, a modified model was constructed by appending 2 paths and deleting 5 paths according to the criteria of statistical significance and meaningfulness. 3) The results of hypothesis testing were as follows : (1) Educational level, event familiarity and severity of illness had a direct effect on uncertainty : Event congruency had both direct and indirect effect on uncertainty : Credible authority and symptom consistency had a nonsignificant direct effect on uncertainty, (2) Illness duration, symptom consistency, and event congruency had a direct effect on severity of illness ; Credible authority had a both direct and indirect effect on severity of illness ; Event congruency had the greatest effect on severity of illness, and event familiarity had a nonsignificant direct effect on severity of illness.