• Clinics in Shoulder and Elbow
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• v.21 no.3
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• pp.127-133
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• 2018

Background: This study was undertaken to evaluate the outcome of the arthroscopic capsular release for adhesive capsulitis of the shoulder. Methods: This study retrospectively investigated thirty shoulders in 29 patients who presented with recalcitrant adhesive capsulitis and underwent arthroscopic treatments. Other than typical findings of adhesive capsulitis, combined pathologies in the glenohumeral joint and subacromial space were evaluated by arthroscopy. Clinical evaluations were performed using the Constant's score and ranges of motion (ROM) at preoperative, 6 months postoperatively and at the final follow-up. Results: Our study included 17 women and 12 men with a mean age of 53.8 years (range, 34-74). Mean follow-up duration was 24 months (range, 12-40 months). Assessment of combined pathologies revealed that partial rotator cuff tear of less than 25% thickness, was most common (overall 83.3%; with bursal 57% and articular 23%). Subacromial synovitis and adhesion were also frequent (53.3%). The Constant score and ranges of motion significantly improved at the final follow-up, compared with preoperative levels. However, clinical results at 6 months postoperatively were found to be significantly inferior to those observed at the final follow-up ($p{\leq}0.001$ for all factors). Functional impairment was the major complaint in 59.3% patients at the 6 months follow-up. Conclusions: Although arthroscopic capsular release yielded favorable outcome at the mean 24 months follow-up, pain and motion limitations at 6-month postoperatively persisted in more than 50% of our patients. While combined pathologies were commonly encountered during arthroscopy, although their effects on surgical outcome in adhesive capsulitis remains unclear in this study.

• Clinics in Shoulder and Elbow
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• v.20 no.1
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• pp.46-48
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• 2017

There are many methods of making cement spacer in patients who require a two-staged operation for humeral head osteomyelitis. However, limitation of motion after the first surgery-due to inadequate size and insufficient intra-articular space for second surgery-remain to be an issue. To mitigate this issue, we made a cement spacer with the same size and shape of the patient humeral head. Four patients with humeral head osteomyelitis were enrolled in this study. To make the cement spacer, we used the Mimics program, and designed the molding box by a reverse engineering technique. We evaluated the range of motion and pain using a Constant score. The mean abduction was $50^{\circ}$($40^{\circ}-60^{\circ}$), forward flexion was $50^{\circ}$ ($30^{\circ}-70^{\circ}$), and average Constant score was 47.75 (44-52). Three-dimensional printed molding technique is one of the effective methods for humeral head osteomyelitis allowing for daily activities prior to the second surgery.

• Physical Therapy Korea
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• v.2 no.2
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• pp.108-118
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• 1995

The techniques of joint mobilization and traction are used to improve joint mobility or to decrease pain by restoring accessory movements to the shoulder joints and thus allowing full, nonrestriced, pain-free range of motion. In the glenohumeral joint, the humeral head would be the convex surface, while the glenoid fossa would be the concave surface. The medial end of the clavicle is concave anterioposteriorly and convex superioinferiorly, the articular surface of the sternum is reciprocally curved. The acromioclavicular joint is a plane synovial joint between a small convex facet on lateral end of the clavicle and a small concave facet on the acromion of the scapula. The relationship between the shape of articulating joint surface and the direction of gliding is defined by the Convex-Concave Rule. If the concave joint surface is moving on a stationary convex surface, gliding occur in the same direction as the rolling motion. If the convex surface is moving on a stationary concave surface, gliding will occur in an opposite direction to rolling. Hypomobile shoulder joints are treated be using a gliding technique.

• Journal of the Korean Arthroscopy Society
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• v.8 no.2
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• pp.119-123
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• 2004

Purpose: The purpose of this study is to check the range of motion of shoulder and inverstigate the frequencies and patterns of partial thickness rotator cuff tear in SLAP lesions. Materials and Methods: Forty-six patients, forty-seven cases who had SLAP lesions at shoulder arthroscopy were analyzed spectively using the medical records, intra-operative arthroscopic photo & video for SLAP lesions and rotator cuff articular side partial tear. Under the interscalene anesthesia, the range of notion of foreward elevation, internal rotation and external rotation was measured on fixed scapula and 90 degree abduction of the shoulder. Results: The rang of Motion are 150 degree on foreward elevation, 65.5 degree on external rotation, 61.7 degree on internal rotation. By Snyder's classification, type ll SLAP lesion is noted in 24 cases (five cases in type 1, one case in type IV). Rotator cuff articular side partial tear is noted in 24 cases ( one case in type I, 22 cases in type II, one case in type IV SLAP). All the rotator cuff articular side partial thickness tear were located in the anterior part of the supraspinatus. Conclusion: The rotator cuff partial thickness tear is mostly noted on the articular side and frequently found in the relatively more unstable type of SLAP lesions. So we consider that SLAP lesion may be a one of the causes for partial tear of the rotator cuff articular side.

• Journal of the Korean Arthroscopy Society
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• v.4 no.1
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• pp.42-48
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• 2000

We retrospectively reviewed the results of arthroscopic adhesiolysis on postoperative knee stiffness in order to observe the clinical improvement and to evaluate the prognostic factors. Arthroscopic adhesiolysis without extraarticular procedure was performed in 31 knees displaying persistent flexion or extension loss. The causes of arthrofobrosis were previous ligament surgeries in 17 knees, surgery for a fracture involving the articular surface of the knee in 10 cases and other causes in four cases. The average range of motion was $60^{\circ}(range,\;14^{\circ}-74^{\circ})$ preoperatively, and improved by $120^{\circ}(range,\;7^{\circ}-127^{\circ})$ immediately following the procedure. The range of motion at the final follow-up (average 34 months) was $129^{\circ}(range,\;3^{\circ}-132^{\circ})$. In the 17 patients with arthrofibrosis fellowing ligament surgery, the range of motion was improved from $65^{\circ}$ preoperatively to $135^{\circ}$ at final follow-up. The improvement in function and motion was achieved during the first postoperative year. In the 10 patients with arthrofibosis following intraarticular fractures, the range of motion was improved from $60^{\circ}$ preoperatively to $125^{\circ}$ at the final follow-up, and most of the increase in motion was achieved within the first 6 months. Patients who suffered from a limitation of motion for less than 7 months gained an average $70^{\circ}$ improvement in total range of motion following arthroscopic surgery. However, the total range of motion in patients with a duration of symptoms greater than 7 months improved by an average $49^{\circ}$ postoperatively. In conclusion, arthroscopic adhesiolysis without incisional procedure is an effective therapeutic modality in arthrofibrosis of intraarticular origin. Improved outcomes can be expected in stiffness after ligament surgery and a symptom duration of arthrofibrosis less than 7 months.

• Archives of Plastic Surgery
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• v.45 no.5
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• pp.458-465
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• 2018

Background Volar plate avulsion fracture of the proximal interphalangeal (PIP) joint is one of the most common hand injuries. In this study, we divided patients into two groups: patients with pure volar plate avulsion fracture, and patients with volar plate avulsion fracture concomitant with collateral ligament rupture. The purpose of this study was to compare long-term surgical outcomes between the two groups. As a secondary measure, the Mitek bone anchoring and polydioxanone (PDS) bone suturing techniques were compared. Methods A single-institutional retrospective review of the surgical treatment of volar plate avulsion fracture was performed. The cases were divided into those with pure volar plate avulsion fracture (group A, n=15) and those with volar plate avulsion fracture concomitant with collateral ligament rupture (group B, n=15). Both groups underwent volar plate reattachment using Mitek bone anchoring or PDS bone suturing followed by 2 weeks of immobilization in a dorsal protective splint. Results The average range of motion of the PIP joint and extension lag were significantly more favorable in group A (P<0.05). Differences in age; follow-up period; flexion function; visual analog scale scores; disabilities of the arm, shoulder, and hand scores; and the grip strength ratio between the two groups were non-significant. No significant differences were found in the surgical outcomes of Mitek bone anchoring and PDS bone suturing in group A. Conclusions Overall, the surgical outcomes of volar plate reattachment were successful irrespective of whether the collateral ligaments were torn. However, greater extension lag was observed in cases of collateral ligament injury.

• Journal of Korean Neurosurgical Society
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• v.62 no.5
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• pp.603-609
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• 2019

Objective : The purpose of this retrospective study was to determine which of the proximal adjacent segment disease (ASD) and distal ASD was more prevalent and what parameters is more related to ASD in proximal levels and distal levels after more than 2 levels fusions. Methods : The medical records were reviewed retrospectively for 856 cases. A total of 66 cases of ASD were enrolled. On preop magnetic resonance imaging, disc degeneration was measured at the upper and lower parts of surgically treated levels and confirmed by the commonly used Pfirrmann grade. Segmental flexibility in sagittal plane was embodied in segment range of motion (ROM) obtained through flexion and extension X-ray before surgery. Coronal angle was recorded as methods Cobb's angle including fusion levels preoperatively. For the comparison of categorical variables between two independent groups, the chi-square test and Fisher exact test were performed. Results : Proximal ASD and distal ASD were 37/856 (4.32%) and 29/856 (3.39%), respectively. The incidence of proximal ASD was relatively high but insignificant differences. In comparison between ASD group and non ASD group, proximal Pfirmman was higher in proximal ASD and distal Pfirmman was higher in distal ASD group (p=0.005, p<0.008, respectively). However, in the ROM, proximal ROM was higher in proximal ASD, but distal ROM was not different between the two groups (p<0.0001, p=0.995, respectively). Coronal angle was not quite different in both groups (p=0.846). Conclusion : In spite of higher frequency in ASD in proximal level in spinal fusion, it is not clear that incidence of ASD in proximal level is not higher than that of distal ASD group in more than 2 level thoracolumbar fusions. Not only Pfirrmann grade but also proximal segmental ROM is risk factor for predicting the occurrence of ASD in patients more than 2 level of thoracolumbar spine fusion operation excluding L5S1.

• Journal of Korean Foot and Ankle Society
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• v.24 no.1
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• pp.19-24
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• 2020

Purpose: Anterolateral minimally invasive plate osteosynthesis (MIPO) was performed to treat patients with distal tibial fractures associated with open fractures or extensive soft tissue injuries, which is limited medial MIPO. The treatment results of the anterolateral MIPO technique were evaluated and analyzed. Materials and Methods: Seventeen patients with distal tibial fractures associated with an open fracture or large bullae formation on the distal tibia medial side were treated with anterolateral MIPO using anterolateral locking plates. Within 24 hours of visiting the emergency room, external fixation was applied, and the medial side wound was managed. After damage control, the anterolateral locking plate was applied using an anterolateral MIPO technique. The union time, nonunion, or malunion were evaluated with regular postoperative radiographs. The ankle range of motion, operative time, blood loss, Iowa score, and wound complications were investigated. Results: Radiological evidence of bony union was obtained in all cases. The mean time to union was 16.7 weeks (12~25 weeks). The mean operation time was 44.0 minutes. Regarding the ankle range of motion, the mean dorsiflexion was 15°, and the mean plantarflexion was 35°. Satisfactory results were obtained in 15 out of 17 cases; five results were classified as excellent, four were good, and six were fair. The mean blood loss was 125.2 mL. Two complications were recorded. Conclusion: In distal tibial fractures with severe medial soft tissue damage caused by high-energy trauma, the staged anterolateral MIPO technique using anterolateral locking plates is a useful alternative treatment to achieving optimal wound care, rapid union with biological fixation, and intra-articular reduction.

• Journal of Trauma and Injury
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• v.28 no.2
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• pp.55-59
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• 2015

Purpose: To compare clinical and radiographic outcomes of between two and three Kirschner wire(K-wire) intramedullary fixation for fractures in the neck of the metacarpal bone. Methods: A single institutional retrospective review identified 28 cases of metacarpal fractures between March 2010 and August 2014. Each of the cases met the inclusion criteria for closed, extra-articular fractures of the neck of the metacarpal bone. The patient groups were divided by the number of K-wire. Outcomes were compared for range of motion of the metacarpophalangeal joint, radiographic parameters, and period until union. Results: The fractures were treated with either 2 Kirschner wire fixation (n=10) or 3 Kirschner wire fixation (n=18). The active range of motion of metacarpophalangeal joint and radiographic result showed no statistically significant difference between the two groups. The mean union period was 5.9 weeks. However, four cases suffered distal head perforation in 2 K-wire fixation group and one case in 3 K-wire fixation group. Conclusion: Multiple retrograde intramedullary Kirschner wire fixation is a good treatment of choice for fractures in the neck of the metacarpal bone. To prevent metacarpal head perforation, it is preferred to use three K-wires than two K-wires.

• Archives of Plastic Surgery
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• v.36 no.3
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• pp.318-321
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• 2009

Purpose: The bony mallet finger injury is generally managed by conservative treatments, but operative treatments are needed especially when the fractures involve above 30% of articular surface or distal phalanx is accompanied by subluxation in the volar side. This is the reason they often result in chronic instability, articular subluxation and unsatisfactory cosmetic. In this report, We describe new method using the hook plate as an operative treatment of Mallet finger deformity. Methods: Among 13 patients with Mallet finger deformity who came from February 2006 to February 2008, six patient were included in surgical indication. Under local anesthesia, H or Y type incision was made at the DIP joint area. After the DIP joint extension, the hook plate was put on the fracture line, and one self tapping screw was used for fixation. 2 hole plate which was one of the holes in 1.5 mm diameter was cut in almost half and bended through approximately $100^{\circ}$. Results: In all six cases which applied the hook plate, complications such as loss of reduction or nail deformity were not seen. In only one patient, hook pate was removed due to inflammatory reaction after surgery. At 2 weeks after operation, active motion of DIP joint was performed. The result was satisfactory not only cosmetically but also functionally. At 6 weeks after operation, the range of motion of DIP joint was average $64^{\circ}$. Conclusion: The purpose of the operative treatment for mallet finger deformity using the hook plate is to provide anatomical reduction with rigid fixation and to prevent contracture at the DIP joint. While other operations take 6 weeks, the operation using the hook plate begins an active motion at 2 weeks after operation. Complication rate was low and the method is rather simple. Thus, the operation using the hook plate is recommended as a good alternative method of the mallet finger deformity treatment.