• Title/Summary/Keyword: Shoulder complex

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Evaluation of Varying Shoulder Postures with External Loads using a Psychophysical Method (외부 부하가 부과된 어깨 자세의 심물리학적 불편도 평가)

  • Ryu, Tae-Beum;Park, Young-Ju;Na, Seok-Hee;Chung, Min-K.;Kee, Do-Hyung
    • Journal of the Ergonomics Society of Korea
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    • v.24 no.2
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    • pp.9-15
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    • 2005
  • The purpose of this study is to quantitatively investigate perceived discomfort of complex shoulder postures with external loads and to propose a preliminary evaluation scheme of shoulder postures. Twelve healthy male adults participated in an experiment to rate their perceived discomfort of shoulder postures. The independent variables were shoulder flexion angle(45, 90 and 150$^{\circ}$), adduction/abduction angle(-30, -10, 0, 30 and 60$^{\circ}$), and external load(0, 1.5 and 3.0kg). The results revealed that the flexion angle, external load and their interaction significantly affected the perceived discomfort(p$<$0.05) but the effect of adduction/abduction angle on the discomfort was not significant(p$>$0.05). The effect of external load was much larger than that of any other factor with explaining about 81% of the total variation of discomfort scores. Based on the experimental results a preliminary scheme was presented to evaluate the stress of shoulder postures with external loads.

Biceps long head tendon revisited: a case report of split tendon arising from single origin

  • Kim, Kyung-Cheon;Rhee, Kwang-Jin;Shin, Hyun-Dae;Byun, Ki-Yong
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2008.03a
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    • pp.165-165
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    • 2008
  • A 27-year-old, right-hand-dominant woman with a posttraumatic anterior shoulder dislocation 3 months earlier after traYc accident presented because of pain and limited range of motion in the right shoulder. On physical examination, the patient had negative instability tests and a sulcus sign. On arthroscopic examination, a bifurcate long biceps tendon with two limbs was observed about 1 cm distal to the origin in the supraglenoid tubercle. We found no evidence of a tear in the long biceps tendon on probing, and the margin of each limb was smooth and round. Although this anatomic variant may be benign, its presence might be associated with other shoulder pathology. It is interesting to speculate whether the aberrant biceps anatomy in our patient contributed to transfer of injury at dislocation to the rotator cuff rather than to the classic anterior-inferior capsulolabral complex. In addition, recognition of the described anatomic variant on arthroscopy can aid the shoulder surgeon in focusing treatment on the actual pathology.

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Shoulder Injuries in Throwing Athletes (Throwing athletes에서 어깨 관절의 손상)

  • Lee Kwang-Won
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.2
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    • pp.119-126
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    • 2003
  • The shoulder is a complex joint and, by virtue of having a large range of motion, is inherently unstable, relying on the surrounding soft tissue structures for stability. The bony joint consists of the glenoid, acromion, and humoral head, while the soft tissues include the glenoid labrum, the glenohumeral ligaments. and coracoacromial ligament as well as the muscles of the rotator cuff, the long head of the biceps, and the scapulothoracic muscles. Dysfunction in any one of these components can cause shoulder problems. The throwing motion involves a series of phases that stress to their limits the dynamic and static restraints of the glenohumeral and scapulothoracic joints. . Therefore, maintaining a balance of proper biomechanical forces is essential to avoiding shoulder injuries in throwing athletes. Over the last decade, signficant advances have been made in the study and understanding of the shoulder mechanics, and pathophysiology of injury. Additionally, advances in surgical techniques, particularly arthroscopy , have aided in the diagnosis of and the developement of less invasive surgical treatments for injuries that do not respond to nonoperative measures. In this article, we reviewed the pathophysiology of injuries , diagnostic techniques, and surgical management of shoulder injuries in throwing athletes .

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Biceps Load Test: A Test of SLAP lesion in the Recurrent Anterior Dislocation of the Shoulder (이두건 부하 검사(Biceps Load Test): 견관절 재발성 전방 탈구시 SLAP 병변 진단의 새로운 검사방법)

  • Kim Seung-Ho;Ha Kwon-Ick;Han Kye-Young
    • Clinics in Shoulder and Elbow
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    • v.1 no.1
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    • pp.78-82
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    • 1998
  • The following will describe a method of evaluating the SLAP lesion in the recurrent anterior dislocation of the shoulder. We have named it the biceps load test. The biceps load test is performed with the patient in the supine position and the arm to be examined is abducted 90/sup°/, and the forearm is in the supinated position. First, the anterior apprehension test is performed. When the patient become apprehensive, the patient is allowed active flexion of the elbow, while the examiner resists elbow flexion. If the apprehension is relieved or diminished, the test is negative. If aggravated or unchanged, the test is positive. A prospective study was performed, in which 75 patients who were diagnosed as having recurrent unilateral anterior instability of the shoulder underwent the biceps load test and arthroscopic examination. The biceps load test showed negative results in 64 of these patients, of which the superior labral-biceps complex was intact'in 63 cases and only I shoulder revealed a type n SLAP lesion. E]even patients with a positive test were confirmed to have type n SLAP lesions. A positive biceps load test represents an unstable SLAP lesion in a patient with recurrent anterior dislocation of the shoulder. The biceps load test is a reliable test for evaluating the SLAP lesion in the recurrent anterior dislocation of the shoulder(sensitivity: ,9] .7%, specificity: 100%, positive predictive value: 1.00 and negative predictive value: 0.98). Biceps contraction increases the torsional rigidity ?of the glenohumeral joint and long head of biceps tendan act as internal rotator of the shoulder in the abducted and externally rotated position. These stabilize the shoulder in abduction and external rotation position in the biceps load test.

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Short- to mid-term outcomes of radial head replacement for complex radial head fractures

  • Baek, Chung-Sin;Kim, Beom-Soo;Kim, Du-Han;Cho, Chul-Hyun
    • Clinics in Shoulder and Elbow
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    • v.23 no.4
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    • pp.183-189
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    • 2020
  • Background: The purpose of the current study was to investigate short- to mid-term outcomes and complications following radial head replacement (RHR) for complex radial head fractures and to identify factors associated with clinical outcomes. Methods: Twenty-four patients with complex radial head fractures were treated by RHR. The mean age of the patients was 49.8 years (range, 19-73 years). Clinical and radiographic outcomes were evaluated for a mean follow-up period of 58.9 months (range, 27-163 months) using the visual analog scale (VAS) score for pain, the Mayo elbow performance score (MEPS), the 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, the mean VAS score, MEPS, and Quick-DASH score were 0.6±1.1, 88.7±11.5, and 19.4±7.8, respectively. The mean range of motion was 132.7° of flexion, 4.7° of extension, 76.2° of pronation, and 77.5° of supination. Periprosthetic lucency was observed in six patients (25%). Heterotopic ossification was observed in four patients (16.7%). Arthritic change of the elbow joint developed in seven patients (29.2%). Capitellar wear was found in five patients (20.8%). Arthritic change of the elbow joint was significantly correlated with MEPS (P=0.047). Four cases of complications (16.6%) were observed, including two cases of major complications (one stiffness with heterotopic ossification and progressive ulnar neuropathy and one stiffness) and two cases of minor complications (two transient ulnar neuropathy). Conclusions: RHR for the treatment of complex radial head fractures yielded satisfactory short- to mid-term clinical outcomes, though radiographic complications were relatively high.

Effects of complex exercises in pressure-pain threshold, pain and postural alignment of women university students with shoulder pain (복합운동이 어깨통증을 경험한 여대생들의 압통역치, 통증 및 자세정렬에 미치는 영향)

  • Park, Chung-hyun;Woo, Jae-seung;Lee, Jae-hyun;Jo, Eun-jeong;Hwang, Su-jeong;Woo, Sung-hee;Kang, Soon-hee
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2017.05a
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    • pp.704-707
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    • 2017
  • The purpose of this study was to examine if complex exercises could improve pressure-pain threshold and postural alignment in university students. Subjects in the CON group did not receive an intervention. Subjects in the EXP1 group were applied stretching exercises after applying hot packs on their both shoulders. Subjects in the EXP2 group were applied complex exercises including stretching, stabilization exercises of shoulder girdle and correction of wrong postures. Changes in pressure-pain threshold in the EXP1 group and EXP2 group were greater than that in the CON group (p<0.05). Changes in VAS scores in the EXP1 group and EXP2 group were greater than that in the CON group (p<0.05). Changes of postural alignment did not significantly differ among three groups (p>0.05). The results of this study indicates that complex exercises including stretching exercises, stabilization exercises of shoulder girdle and correction of wrong postures about neck and scapular can be an effective in reduction of shoulder pain and increase of pressure-pain threshold in women university with shoulder pain.

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Humeral Avulsion of the Glenohumeral Joint Capsule - Case Report - (상완골 부착 부위에서 파열된 견관절 낭(증례 보고))

  • Lee Young-Soo;Baek Joon-Sik;Shin Dong-Rae
    • Clinics in Shoulder and Elbow
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    • v.2 no.2
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    • pp.199-203
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    • 1999
  • It is well known that the essential pathology in traumatic anterior dislocation of the shoulder is the avulsion of the glenohumeral ligament complex from the glenoid rim, However, there were some reports that the avulsion can occur from the humeral attachment site. We have experienced a 42-year-old man who had complained of persistent shoul­der pain after traffic accident and showed the instability on physical examination. The MR arthrogram and arthro­scopic surgery revealed the avulsion of glenohumeral ligament from the humeral attachment site. We repaired the lesion using the suture anchor through the anterior axillary approach and had a good result after 1 year.

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The Effect of Eccentric Strengthening Exercise on Athletes after Shoulder Rotator Cuff Tear (운동선수들의 견관절 회전근 손상 이후 등속성 측정을 통한 원심성 근력운동의 효과)

  • Kim, Jwa-Jun;Kim, Dae-Kyeong;Ha, Kyung-Jin
    • PNF and Movement
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    • v.12 no.1
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    • pp.33-37
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    • 2014
  • Purpose: In this research, the properties of the shoulder joint were measured through eccentric resistive exercise with the patients who have rotator cuff tear of shoulder joints as the targets. Methods: 23 patients who have pain due to the rupture of rotator cuff on shoulder joints were selected and divided into Exercise group (12) and Control group (11). Two groups executed exercise for 30 minutes 3 days a week. Exercise group had executed eccentric resistive exercise, and the Control group executed Complex exercise. Results: In external rotation $180^{\circ}/s$, $240^{\circ}/s$, the Exercise group showed to be an average of 8% higher than the Control group. For Internal rotation $90^{\circ}/s$, $180^{\circ}/s$, $240^{\circ}/s$ the Exercise group showed to be an average of 30% higher that the Control group. Conclusion: To lessen the rupture of rotator cuff on shoulder joints, muscles strengthening is very important across various methods of eccentric exercise programs which are external/internal rotators of the shoulder joint needed for throwing. This is effective in preventing injury and improving rotation.

Physical Therapy and Rehabilitation of Complex Regional Pain Syndrome in Shoulder Prosthesis

  • Celik, Derya;Demirhan, Mehmet
    • The Korean Journal of Pain
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    • v.23 no.4
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    • pp.258-261
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    • 2010
  • We report a 66-year-old woman with complex regional pain syndrome (CRPS) 1 treated with combined medical and active physical therapy. She was diagnosed with CRPS 1 following partial shoulder prosthesis due to proximal humerus fracture. Despite continuous medication and physical therapy, there was no improvement in her pain and functional outcome. Her overall pain was decreased by stellate ganglion block 3 times in two weeks conducted during the second month of the follow-up period. Following the ganglion blockades, pain and the other symptoms were decreased intermittently but range of motion (ROM) and functional status were not satisfied as much as expected. After the third month of follow-up, her passive and active ROM of the shoulder joint was increased after application of manipulation under general anesthesia. In conclusion, because CRPS 1 remains one of the most difficult pain syndromes, early diagnosis and treatment are important to have adequate functional results from physical therapy. Manipulation under general anesthesia may be an additional effective treatment tool to obtain functional improvement in some patients diagnosed with CRPS 1.

Unrecognized bony Bankart lesion accompanying a dislocated four-part proximal humerus fracture before surgery: a case report

  • Lee, Seungjin;Shin, Daehun;Hyun, Yoonsuk
    • Clinics in Shoulder and Elbow
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    • v.25 no.1
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    • pp.68-72
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    • 2022
  • Proximal humerus fractures are the third most common fractures, totaling 4% to 5% of all fractures. Here, we present the case of a 39-year-old man with a dislocated four-part fracture of the proximal humerus with a huge bony Bankart lesion. Preoperatively, the bony Bankart lesion of the glenoid was not visualized on computed tomography scans or magnetic resonance imaging because the fracture of the proximal humerus was comminuted, displaced, and complex. It was planned for only the humerus fracture to be treated by open reduction and internal fixation using a locking plate. However, a fractured fragment remained under the scapula after reduction of the dislocated humeral head. This was mistaken for a dislocated bone fragment of the greater tuberosity and repositioning was attempted. After failure, visual confirmation showed that the bone fragment was a piece of the glenoid. After reduction and fixation of this glenoid part with suture anchors, we acquired a well-reduced fluoroscopic image. Given this case of complex proximal humerus fracture, a glenoid fracture such as a bony Bankart lesion should be considered preoperatively and intraoperatively in such cases.