• Clinics in Shoulder and Elbow
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• v.16 no.2
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• pp.94-99
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• 2013

Purpose: The purpose of this study is to evaluate the clinical results of arthroscopic biceps long head suprapectoral tenodesis using an interference screw. Materials and Methods: We reviewed the cases of 30 patients who underwent arthroscopic biceps long head suprapectoral tenodesis using an interference screw between January 2008 and January 2010. The minimum follow up period was one year. Twenty patients had rotator cuff tears. The results were analyzed by VAS, ASES, tenderness in the bicipital groove, fixation failure, and the degree of deformity. Results: VAS, ASES scores showed a statistically significant increase during the final observation in all patients, compared with those before surgery. However, five patients (17%) had anterior shoulder pain and tenderness in the biceps groove, and three patients (10%) had Popeye deformity. Better results were achieved in patients without rotator cuff tear than in patients with rotator cuff tear (p<0.05). Conclusion: Arthroscopic biceps long head tenodesis above the pectoralis major using an interference screw in patients with a pathologic lesion of the proximal biceps tendon showed good results at the last follow up. However, further study for tenderness in the biceps groove in 17% of patients is needed.

• Physical Therapy Korea
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• v.24 no.2
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• pp.1-8
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• 2017

Background: Individuals with spinal cord injury (SCI) rely on their upper limbs for body-lifting activity (BLA). While studies have examined the electromyography (EMG) and kinematics of the shoulder joints during BLA, no studies have considered foot position during BLA. Objects: This study compared the effects of different foot positions during BLA on the shoulder muscle activities, peak plantar pressure, knee flexion angle, and rating perceived exertion in individuals with SCI. Methods: The study enrolled 13 mens with motor-complete paraplegic SCI, ASIA (American Spinal Injury Association) A or B. All subjects performed BLA with the feet positioned on the wheelchair footrest and on the floor independently. Surface EMG was used to collect data from the latissimus dorsi, pectoralis major, serratus anterior, and triceps brachii. The peak plantar pressure was measured using pedar-X and the knee flexion angle with Image J. Borg's rating perceived exertion scale was used to measure the physical activity intensity level. The paired t-test was used to compare the shoulder muscle activities, peak plantar pressure, knee flexion angle, and rating perceived exertion between the two feet positions during BLA. Results: The activity of the latissimus dorsi, pectoralis major, serratus anterior, and triceps brachii and rating perceived exertion decreased significantly and the peak plantar pressure and knee flexion angle increased significantly when performing BLA with the feet positioned on the wheelchair footrest compared with on the floor (p<.05). Conclusion: These findings suggest that individuals with SCI may perform BLA with the feet positioned on the wheelchair footrest for weight-relief lifting to decrease the shoulder muscle activities and the rating perceived exertion and to increase the peak plantar pressure and the knee flexion angle.

• Archives of Plastic Surgery
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• v.36 no.5
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• pp.611-616
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• 2009

Purpose: The rate of fistulas occuring followed by resection of oral cavity, oropharyngeal, hypopharyngeal, and laryngeal cancer are reported to be 9 ~ 23% according to various documents. Neglected treatment of the fistula can result in a setback in proper treatment with restrictions in oral intake leading to delayed return to daily life. Furthurmore, in severe cases, it may injure important vessels and adjacent structures of the neck area. The author reviewed previously reported cases of treatment methods for fistulas recurring after diverse head and neck operations and with sharing the treatment experiments of our patients, we tried to present a treatment algorism for different fistula types. Methods: Our study was based on retrograde analysis of 64 patients who were clinically diagnosed with fistula after operation for cancer of the head and neck from 1997 to 2008 at Severance Hospital. Their primary sites of cancer were 8 oral cavity, 22 oropharynx, 25 hypopharynx, and 9 larynx. The patients were aged 45 to 75 years and the male to female ratio was 11 to 1. The patient's operation records and progress notes were evaluated for determination of degree of fistula and treatment methods. Results: Most fistulas were clinically suspected after postoperative 5 days and symptoms noted for detection of the fistula were erythema, purulent discharge, edema, tenderness, and fluctuation. The fistula was definitely diagnosed at postoperative 2 weeks with barium test and treatment method ranging from conservative management to operative procedure were applied to each patients. Total 21 patients were managed with conservative protocol. In 15 cases, direct repair of the fistula was done and more stable repair of the fistula was possible with using of TachoComb$^{(R)}$. Pharyngostoma was performed in 14 patients. Among them, 4 patients healed spontaneously, 5 patients were taken direct closure, 4 patients were taken pectoralis major musculocutaneous flap, and one patient was taken esophageal transfer. The other 14 patients were taken 11 pectoralis major musculocutaneous flaps and 3 free flaps without pharyngostoma formation. Conclusion: Fistula is a troublesome complication resulting after resection of head and neck cancer. Early detection and adequate treatment according to the period and condition of the fistula may prevent further complications and reduce the pain of the patient.

• Journal of the Korean Arthroscopy Society
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• v.13 no.3
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• pp.212-219
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• 2009

Medially retracted large-sized rotator cuff tears includes large-sized tears, massive tears and irreparable tears. Generally arthroscopic repair or open repair of rotator cuff tears is used in reparable tears. However, arthroscopic repair requires long period practice and endurance. In irreparable tears, arthroscopic debridement, partial repair, latissimus dorsi transfer and retrograde arthroplasty can be the option. Arthoscopic debridement gives temporal relief who experienced improvement in pain and increase in range of motion after subacromial local anesthetic injection. Also arthroscopic partial repair gives good results in irreparable cases, especially in suprascapular nerve traction neurapraxia. Tendon transfer can be used in mild to moderate muscle weakness in shoulder abduction for long term treatment. Pectoralis major transfer can be used in anterosupeior tears and latissimus dorsi transfer can be used in posterosuperior tears. Reverse shoulder prosthesis is used in extreamly weakened shoulder pseudoparalysis. The authors discussed the method of arthroscopic repair in irreparable tears. The debridement, partial repair, and tendon transfer could be used in medially retracted large-sized rotator cuff tears.

• Journal of Haehwa Medicine
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• v.24 no.2
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• pp.17-24
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• 2016

Objectives : This study was aimed to widen range of comprehesion about meridian muscle system through myological study of meridian muscle system and comparison with deep front arm line in anatomical train Methods : We have studied the similarity and difference between Hand Great Yin Lung Meridian Muscle System and Deep Front Line in Anatomical Train through Principles of Meridians & Acupoints, publications about myology, Anatomical trains. Results : I. Like another advanced studies, muscular system of hand great yin showed similarity to deep front line in anatomical train. II. It is considered that muscular system of hand great yin contains Musculus abductor pollicis brevis, Musculus extensor hallucis longus, Musculus brachioradialis, Musculus biceps brachii, Musculus subclavius, Musculus pectoralis major. III. Comparing muscular system of hand great yin to deep front arm line in anatomical train it showed similarity to part of muscles and pathological symptoms. But it showed difference to part of muscles and pathological symptoms. Conclusions : Hand Great Yin Lung meridian muscle system showed similarity and difference to deep front arm line in anatomical train. Further studies would be needed.

• Clinics in Shoulder and Elbow
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• v.5 no.2
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• pp.73-80
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• 2002

Purpose: Weight lifting is a good training to control body weight, to correct body shape and to relieve stress. How-ever if the training is continued by inadequate training method and technique, the risks of the shoulder injuries are relatively high. Main Subject: The rotator cuff injury is the most common disorder to wright lifters and often results from the train- ing program of upright row, military press and pectoral deck. The chances of subacromial impingement in these postures are high because the shoulder rotates under the acromion at 90 abduction state. Shoulder instability in weight lifters can develop due to various causes. aepeated microtrauma and excessive abduction and external rotation may result in laxity of the anterior capsular structure, ligament and muscles. Behind the neck and bench press are high risk training postures. Other than those injuries, idiopathic osteolysis of distal clavicle, acromioclavicular separation, pectoralis major muscle rupture, and triceps muscle rupture nay develop. Conclusion: The best treatment option of the shoulder injury to weight lifters is to eliminate the possible risk elements for the weight lifters in training program and to provide proper and prompt treatment as soon as possible.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2008.03a
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• pp.53-53
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• 2008

Twenty-six patients (12 male and 14 female) with symptomatic scapular winging caused by serratus anterior dysfunction were managed with split pectoralis major tendon transfer (sternal head) with autogenous hamstring tendon augmentation from 1998 to 2006. Twenty-five patients had positive results for 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 twenty-two patients had traumatic etiologies. At the final follow-up assessment for functional improvement, a Constant-Murley score was used. 21 patients were completely evaluated, while 5 patients who had less than 12 months follow-up were excluded. Pain relief was achieved in 19 of the 21 patients, with twenty 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 $20^{\circ}\sim165^{\circ}$) preoperatively to $151^{\circ}$ (range $125^{\circ}\sim170^{\circ}$) 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 twenty-one patients, eight had excellent results, nine had good results, three had fair results, and one had poor results. Most patients with severe symptomatic scapular winging had functional improvement and pain relief with resolution of scapular winging.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.3
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• pp.119-124
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• 2016

PURPOSE: The aim of this study was to evaluate activation of accessory respiratory muscles using electromyography during chest expansion upper extremity flexion, abduction, and external rotation exercises with an elastic band in children with cerebral palsy. METHODS: The subjects were 10 children with cerebral palsy. The inclusion criterion for participation was a Gross Motor Function Classification System level of I to III. The subjects were instructed to perform upper extremity flexion, abduction, and external rotation exercises with inspiration, and extension, adduction, and internal rotation exercises with expiration while seated on a chair without a backrest. PM (Pectoralis major), SCM (sternocleidomastoid), RA (rectus abdominis), and EO (external oblique) muscle activities were measured using electromyography. RESULTS: All tested muscles showed a statistically significant increase in activity after elastic band exercise. There were significant differences in PM, SCM, RA, and EO results after chest expansion exercise using elastic band. SCM showed the largest increase in activity after use of elastic bands, at $52.37{\pm}45.88$%, followed by the RA ($50.56{\pm}79.31$), EO ($35.42{\pm}35.45$), and PM ($31.72{\pm}25.64$). The increase in the SCM was greatest, followed by increases in the RA, EO, and PM CONCLUSION: These finding suggest that activity of accessory respiratory muscles increases with use of elastic bands during chest expansion exercise in cerebral palsy.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.1
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• pp.55-63
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• 2020

PURPOSE: This study examined the effects of handgrip exercise, which was started two weeks after surgery for shoulder rotator cuff repair, on the extent of muscle activation around the shoulder and the cross-sectional area of the supraspinatus muscle. METHODS: Among patients diagnosed with rotator cuff rupture by an orthopedic surgeon and rotator cuff repair was performed using an arthroscope, 28 were selected as subjects. These subjects were allocated randomly to the experimental group and control group with 14 subjects in each group. An electromyogram was measured as a measure of the extent of muscle activation around the shoulder for a total of six times (%RVC). The cross-sectional area of the supraspinatus muscle was measured before and after the rotator cuff repair by magnetic resonance imaging. RESULTS: The extent of muscle activation in accordance with time in both the experimental group and control group displayed significant differences in various muscles including the anterior deltoid, pectoralis major, upper trapezius and infraspinatus muscle(p<.05). A significant difference in the variation of the cross-sectional area of the supraspinatus muscle was observed between the experimental group and the control group(p<.05). CONCLUSION: Handgrip exercise helps rehabilitate the shoulder joint at the acute stage after rotator cuff repair when assertive exercise therapy cannot be applied.

• Archives of Plastic Surgery
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• v.33 no.6
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• pp.773-775
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• 2006

Purpose: The sternalis muscle is an accessory muscle of the anterior chest wall. This is a rare anatomic variant reported in approximately 8 percent of the population, with variation among races. While several anatomic studies of the sternalis muscle exist, nothing in the literature addresses the implications of this muscle on staged breast reconstruction with implant. Methods: We encountered two consecutive patients with a left sternalis muscle who underwent immediate staged breast reconstruction with a tissue expander. We offer a strategy for dealing with this rare, but known, anatomic variant during staged implant reconstruction. Firstly, recognizing the presence of a sternalis muscle mandates the elevation of the pectoralis major muscle and the sternalis muscle in continuity. Secondly, slight modifications must be made during the submuscular dissection to create a properly placed pocket for the tissue expander. Results: While our encounters with this anatomic variant are few, our experiences with two consecutive patients illustrate that the reconstructive surgeon must be familiar with the sternalis muscle and be prepared to adapt his or her technique for tissue expander placement when faced with this accessory muscle. Conclusion: To date, no reports exist in the literature describing the operative implications of this anatomic variant. We offer our technique for dealing with this accessory muscle during staged implant reconstruction of the breast.