• 대한정형도수물리치료학회지
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• 제2권1호
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• pp.39-49
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• 1996

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 joint are treated be using a gliding technique.

• Clinics in Shoulder and Elbow
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• 제1권1호
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• pp.123-127
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• 1998

Scapulothoracic dissociation is a rare entity that consists of the disruption of the scapulothoracic articulation. The mechanism of injury is probably traction caused by a blunt force to the shoulder girdle. This lesion is characterized by massive soft-tissue swelling of the shoulder; lateral displacement of the scapula, an injury to bone, and a severe neurovascular injury. An l8-year-old man sustained a scapulothoracic dissociation as a result of severe shoulder girdle trauma. We report the diagnostic method, clinical and surgical management.

• Clinics in Shoulder and Elbow
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• 제22권1호
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• pp.37-39
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• 2019

Irreducible dislocation of the elbow is an uncommon event. We present the case of a posterolateral elbow dislocation after a fall injury in a 67-year-old woman. A closed reduction performed in the emergency department was unsuccessful since the limited passive range of motion resulted in difficulty to perform longitudinal traction and flexion. Computed tomography images showed that the posterolateral aspect of the capitellum was impacted by the tip of the coronoid process, thus appearing similar to the Hill-Sachs lesion in the humeral head. Subsequent open reduction of the elbow revealed the dislocation to be irreducible since the tip of the coronoid process had wedged into a triangular Hill-Sachs-like lesion in the capitellum. The joint was reduced by providing distal traction on the forearm, and main fragments were disengaged using digital pressure. At the 3-month follow-up, the patient reported no dislocations, and had an acceptable range of motion. Thus, we propose that to avoid iatrogenic injury to the joint or other nearby structures, irreducible dislocations should not be subjected to repeated manipulation.

• Clinics in Shoulder and Elbow
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• 제8권2호
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• pp.187-191
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• 2005

Traumatic scapulothoracic dissocation is a rare upper extremity injury caused by massive traction or blunt trauma. Most cases are associated with a large spectrum of concomitant injuries, including severe musculoskeletal injuries and neurovascular injuries around the shoulder. But, it occurs without damaging overlying skin as a closed injury rather than an open injury. We present a case of open scapulothoracic dissociation and describe clinical features with literature review.

• Clinics in Shoulder and Elbow
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• 제5권2호
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• pp.118-123
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• 2002

Purpose: The purpose was to identify the effectiveness of beach-chair position in the arthroscopic Bankart repair over conventional lateral decubitus position with distal traction. Materials & Methods: 36 arthroscopic Bankart repair through July 2000 to July 2001 was done under beach chair position. All cases were shoulder instability. Male patients were 6 and female were 4 with average age of 25 years. Arthroscopic suture anchor was used in 24 cases and average number was 3. Results: Interscalene block was tried in 29 patients and 1 case was changed to general anesthesia. Arthroscopic examination to identify Bankart lesion and associated pathology was done without difficulty Bankart lesions were easily reduced to anatomic position and placed suture anchor and hooking approprately. After the arthroscopic examination,3 cases were converted to open procedure without any positional change. Conclusion: Under interscalene block, the preparation was more simple and the patient could watch arthroscopic procedure with confidence. There was no hindrance in arthroscopic examination and arthroscopic repair could be dont: in more anatomic position. It can be easily changed to open repair if it needed

• 한국전문물리치료학회지
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• 제2권2호
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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.

• 대한관절경학회지
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• 제13권3호
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• pp.212-219
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• 2009

내측으로 퇴축된 대범위 이상의 회전근 개 파열은 대범위 파열과 광범위 파열, 봉합이 불가능한 파열을 포함한다. 봉합 이 가능한 경우 일반적으로 사용되는 관절경 하 봉합술이나 개방적 봉합술을 시행할 수 있다. 그러나 관절경 감시하의 봉 합법은 무척 인내를 요하며 장기간의 긴 학습곡선을 필요로 한다. 봉합이 불가능할 경우에는 관절경 하에서 변연절제술(debridement)이나 부분 봉합술(partial repair)을 시행할 수 있고, 때로 광배근 이전술이나 역형 인공관절술을 시행할 수 도 있다. 관절경 하에서 변연절제술(debridement)은 국소 마취제의 견봉하 주사후에 통증의 완화와 운동범위의 향상을 경험한 환자들에게 일시적인 호전을 얻을 수 있다. 역시 봉합이 불가능 할 경우에 관절경하에서의 부분 봉합술(partial repair)을 시행하여 좋은 결과를 얻을 수 있다. 상견갑 신경의 신연에 의한 생리적 신경차단(suprascapular nerve traction neurapraxia)이 있는 경우에 특히 좋은 결과를 얻을 수 있다. 건 이식은 수평까지 어깨를 들어 올릴 수 있을 정도의 경도에 서 중등도 근력 약화의 경우에 장기적인 치료로 사용될 수 있다. 전상방 회전근 개 파열에 대하여 대흉근(Pectoralis major sternal head)의 근 이전술이 사용될 수 있으며, 후상방 회전근 개 파열의 경우에는 광배근(Latissimus dorsi) 근 이전술이 사용되고 있다. 역 견관절 치환술(Reverse Shoulder Prosthesis)은 어깨 관절의 근력이 극도로 약화된 가성 마비 (pseudoparalysis)에서 유용한 치료로 사용될 수 있다. 저자들은 내측으로 퇴축된 대범위 이상의 회전근 개 파열에서 관절경하 봉합법의 시행에 대하여 고찰하고자 하였으며, 봉합이 불가능한 파열의 경우에 변연절제술, 부분 봉합 및 건 이전술과 역 견관절 치환술의 이용에 대하여 고찰하고자 하였다.

• 대한정형외과스포츠의학회지
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• 제7권2호
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• pp.146-150
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• 2008

견갑-흉곽 해리는 둔상이나, 견갑부 전외측 방향으로 가해진 강한 견인력에 의해 견갑-흉곽 관절의 붕괴를 야기하는 드문 손상이다. 이 손상은 견갑부에 피부 손상은 없으나 심한 부종, 손상받은 견갑부의 외측이동으로 특징 지어지며, 많은 경우에 다양한 근골격계 손상과 신경혈관 손상이 동반된다. 본원에서는 체포과정에서 발생된 33세 남자환자에서 골절과 혈관 손상이 관찰되지 않은 견갑-흉곽 해리를 경험하였기에, 진단 방법과 임상 양상, 치료 방침을 문헌 고찰과 함께 보고하는 바이다.

• Clinics in Shoulder and Elbow
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• 제11권1호
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• pp.66-69
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• 2008

외상성 견갑 흉곽간 절단은 극히 드물게 발생하는 매우 심각한 손상이다. 견갑부의 심한 둔상이나 상지에 발생한 심한 견인력에 의해 발생하며, 광범위한 동반 손상을 초래하므로 그 예후가 지극히 불량한 것으로 보고되고 있다. 외상성 견갑 흉곽간 절단은 매우 드물게 보고되어 있으며, 국내에서는 현재까지 보고된 바가 없다. 이에 저자들은 컨베이어 벨트에 수상하여 견갑골을 포함한 상지 전체가 체간에서 완전 분리된 채로 내원한 52세 남자 환자에 대해 즉각적인 응급 소생술 및 수술을 시행한 외상성 견갑 흉곽간 절단 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Clinics in Shoulder and Elbow
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• 제20권1호
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• pp.49-56
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• 2017

Since the olecranon fractures are caused by relatively low-energy injuries, such as a fall from standing height, they are usually found without comminution. Less commonly they can be developed by high-energy injuries and have severe concomitant comminution or injuries to surrounding structures of the elbow. Because the fracture by nature is intra-articular with the exception of some avulsion-type fracture, a majority of olecranon fractures are usually indicated for surgical treatment. Even if there is minimal displacement, surgical treatment is recommended because there is a possibility of further displacement by the traction force of triceps tendon. The most common type of olecranon fracture is displaced, simple non-comminuted fracture (that is, Mayo type IIA fractures). Although tension band wiring was the most widespread treatment method for these fractures previously, there is some trends toward fixation using locking plates. Primary goal of the surgery is to restore a congruent joint and extensor mechanisms by accurate reduction and stable fixation so that range of motion exercises can be performed. The literature has shown that good clinical outcomes are achieved irrespective of surgical fixation technique. However, since the soft tissue envelope around the elbow is poor and the implants are located at the subcutaneous layer, implant irritation is still the most common complication associated with surgical treatment.