• 대한통합의학회지
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• 제8권1호
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• pp.101-111
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• 2020

Purpose : The purpose of this study was to identify the comparison of the effects of manual therapy combined with exercise on range of motion (ROM), muscle strength, and functional performance in adolescent baseball players with internal impingement syndrome of the shoulder. Methods : The subjects were 30 patients diagnosed with impingement syndrome of the shoulder. Thirty subjects are randomly assigned to each 3 different groups; Group 1. (exercise group), Group 2. (exercise+mobilization; EMOB group), Group 3. (exercise+mobilization with movement; EMWM group). The interventions were performed three times a week for 4 weeks. The main outcome measures were goniometer, Biodex dynamometer, and Korean Kerlan Jobe shoulder-elbow (K-KJOC) scores. The ROM (external and internal rotation), muscle strength (external and internal rotation: 60 °/sec., 180 °/sec.), and functional performance were compared among the groups. Results : No significant difference was observed among the groups in the range of external rotation of the shoulder before and after the intervention, but the range of internal and total rotation was significantly increased in Group 2, 3 compared to Groups 1. Muscle strength of external and internal rotation (60 °/sec., 180 °/sec.) was not significantly different among Group 1, 2, 3, and functional performance was significantly increased in Group 2, 3 compared to Group 1. However, there was no significant difference between Group 2 and Group 3 in all measurements. Conclusion : An intervention with manual therapy such as EMOB and EMWM was more effective than exercise alone for rapid recovery from shoulder injury and improvement in functional performance. However, further efforts are needed to identify effects of specific interventions with manual therapy.

• 대한물리의학회지
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• 제11권4호
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• pp.147-156
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• 2016

PURPOSE: The purpose of this study was to investigate the effects of sensory motor training using ball exercise on shoulder range of motion, pain, dysfunction, and quality of life in Breast Cancer Women after Mastectomy. METHODS: A total of 26 patients from D University Hospital in Daejeon were included and randomly allocated to two groups (n=13 per group). The two groups performed the exercise five times a week for 4 weeks. A sensory motor training group (SMTG) received general physical treatment for 10 minutes and sensorimotor training for 20 minutes. A control group (CG) received general physical therapy for 30 minutes. Shoulder pain (the Visual Analog Scale), range of motion, disability (the shoulder pain and disability index) and quality of life (the Functional Assessment Cancer Therapy-Breast instrument) were measured in both groups before and after 4-weeks intervention. RESULTS: A significant difference was found in joint range of motion, shoulder pain, functional disability level, and quality of life within the two groups (p <.05). In addition, changes in joint range of motion, pain, functional disability level, and quality of life after then intervention were significantly different between the two groups (p <.05). CONCLUSION: These results suggest that a sensory motor training program is feasible, safe, and suitable exercise for shoulder functions and quality of life in Breast Cancer Women after Mastectomy.

• Clinics in Shoulder and Elbow
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• 제18권3호
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• pp.120-127
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• 2015

Background: We prospectively compared the response to blind and ultrasound-guided glenohumeral injection of corticosteroids for treatment of shoulder stiffness. Methods: A total of 77 patients with shoulder stiffness between April 2008 and March 2012 were recruited. Patients were randomized to receive either a blind (group 1, n=39) or ultrasound-guided (group 2, n=38) glenohumeral injection of 40 mg triamcinolone. The clinical outcomes and shoulder range of motion (ROM) before injection, at 3, 6, and 12 months after injection and at the last follow-up were assessed. The same rehabilitation program was applied in both groups during the follow-up period. Results: There was no significant difference in demographic data on age, sex, ROM, and symptom duration before injection between groups (p>0.05). There were no significant differences in ROM including forward flexion, external rotation at the side, external rotation at $90^{\circ}$ abduction, and internal rotation, visual analogue scale for pain and functional outcomes including American Shoulder and Elbow Surgeons score, Simple Shoulder test between the two groups at any time point (p>0.05). Conclusions: Based on the current data, the result of ultrasound-guided glenohumeral injection was not superior to that of blind injection in the treatment of shoulder stiffness. We suggest that ultrasound-guided glenohumeral injection could be performed according to the patient's compliance and the surgeon's preference. Once familiar with the non-imaging-guided glenohumeral injection, it is an efficient and reliable method for the experienced surgeon. Ultrasound could be performed according to the surgeon's preference.

• Clinics in Shoulder and Elbow
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• 제18권2호
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• pp.91-95
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• 2015

Background: Our aim was to make a comparative analysis of radiological and clinical outcomes of using either one or two interlocking distal screws on a Polarus intramedullary nail for the internal fixation of humeral shaft fractures. Methods: From January 2008 to March 2014, we enrolled 26 patients with humeral shaft fractures who were operated on using intramedullary nails. The patients were divided into 2 groups according to how many interlocking distal screws were used to lock the Polarus nail: in group 1, a single interlocking distal screw was used in 12 patients; and in group 2, double interlocking distal screws, in 14 patients. We compared the degree of recovery of the displaced fracture fragments between the two groups. To compare the nonunion and shoulder function, we assessed each patient's modified American Shoulder and Elbow Surgerns (ASES) score. Results: We found that 10 of 12 fractures achieved union in group 1, and 13 of 14 fractures, in group 2. We did not find a meaningful difference in the time to bone union between the two groups. The percentage of recovery of displaced fracture fragments until union was 66.9% for group 1 and 59.41% for group 2. At the final follow-up, we found that the scores for shoulder joint modified ASES was 78.7 for group 1 and 80.7 for group 2. Conclusions: Our results show that if locked appropriately, even a single screw on a Polarus nail can provide satisfactory radiological union and improved clinical outcome after intramedullary nailing of humeral shaft fractures.

• Clinics in Shoulder and Elbow
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• 제23권2호
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• pp.62-70
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• 2020

Background: Recent studies have reported high rates of recurrence of shoulder instability in patients with glenoid bone defects greater than 20% after capsulolabral reconstruction. The purpose of the present study was to evaluate the failure rate of arthroscopic capsulolabral reconstruction for the treatment of anterior instability in the presence of glenoid bone deficits >20%. Methods: Retrospective analyses were conducted among cases with anterior shoulder instability and glenoid bone defects of >20% that were treated by arthroscopic capsulolabral reconstruction with a minimum 2-year follow-up (30 cases). We included the following variables: age, bone defect size, instability severity index score (ISIS), on-/off-track assessment, incidence recurrent instability, and return to sports. Results: The mean glenoid bone defect size was 25.8%±4.2% (range, 20.4%-37.2%), and 18 cases (60%) had defects of >25%. Bony Bankart lesions were identified in 11 cases (36.7%). Eleven cases (36.7%) had ISIS scores >6 points and 21 cases (70%) had off-track lesions. No cases of recurrent instability were identified over a mean follow-up of 39.9 months (range, 24-86 months), but a sense of subluxation was reported by three patients. Return to sports at the preinjury level was possible in 24 cases (80%), and the average satisfaction rating was 92%. Conclusions: Arthroscopic soft tissue reconstruction was successful for treating anterior shoulder instability among patients with glenoid bone defects >20%, even enabling return to sports. Future studies should focus on determining the range of bone defect sizes that can be successfully managed by soft tissue repair.

• 대한한방부인과학회지
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• 제23권4호
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• pp.176-186
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• 2010

Purpose: To review the effectiveness affecting to the shoulder functionalities and upper numbness by Traditional Korean Medical treatment who are given a surgical operation for breast resection by breast tumor Method: To report the patients with dysfunction of shoulder joint and numbness in upper limb after breast surgery who improved by Traditional Korean Medical treatment and to study Traditional Korean Medicine(TKM) management of complications of breast surgery. Results: After about 2weeks treatment, patient's symptoms and signs were improved. TKM management was effective in recovery of shoulder function and upper limb numbness after breast surgery. Conclusion: We need to actively participate in management of complications of breast surgery as adjuvant therapy. And more study is needed for developing Traditional Korean Medical indication of complications of breast surgery.

• Clinics in Shoulder and Elbow
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• 제19권3호
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• pp.163-167
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• 2016

Septic arthritis in neonates is a rare condition. A failure to make an early diagnosis of septic arthritis in neonates may leave a permanent disability as a result of a delayed treatment. Thus, septic arthritis, requires a prompt diagnosis and a timely treatment especially in this subset of patients. In this case report, we describe our treatment protocol for septic arthritis and concurrent osteomyelitis in the right shoulder of a 28-day-old newborn. Using 2.4 mm wrist arthroscopy, we performed an arthroscopic irrigation and drainage, to remove intra-articular debris and inflammatory tissue, and multiple drilling. We report a satisfactory clinical outcome without any postoperative complications or side effects.

• 대한정형외과학회지
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• 제54권5호
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• pp.384-392
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• 2019

스포츠 활동과 연관된 견관절 통증을 호소하는 환자에 있어서 진단 및 치료 방법의 결정에 초음파 영상 장비가 사용된다. 특히 회전근 개 병변, 이두건 장두 병변 및 견봉 쇄골 관절 손상에 대한 진단에 초음파 영상 장비가 도움이 된다. 휴대용 초음파 영상 장비를 경기장에서 사용하면 견관절에 발생한 통증에 대해 즉각적으로 결정을 내릴 수 있다.

• Clinics in Shoulder and Elbow
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• 제8권2호
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• pp.135-140
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• 2005

Purpose: To find out the early results after surgical treatment of the acute acromioclavicular dislocation with LIGASTIC artificial ligament. Material and Method: 6 patients who were diagnosed as acute acomioclavicular joint dislocation and treated with LIGASTIC artifical ligament through March 2005 to July 2005. The radiologic and clinical results using Imatani evaluation system were analyzed. Results: By clinical evaluation, 4 cases(67%) were excellent and 2 cases(33%) were good. By radiologic evaluation, 3 cases(50%) were excellent and 3 cases(50%) were good. All cases showed satisfactory results. Till the final follow up, there were no complication. Conclusion: Surgical treatment of the acute acromioclavicular dislocation with LIGASTIC articifial ligament is simple, but provides enough stability for early postoperative rehabilitation, decreases arthritis of acomioclavicular joint and there is no burden of removal of the fixture, so it is thought as a very effective surgery.

• Clinics in Shoulder and Elbow
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• 제11권2호
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• pp.185-188
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• 2008

견봉-쇄골 관절 손상은 흔히 견관절 상외측에서의 직접적인 외상으로 발생한다. Rockwood 제4형 손상은 상대적으로 드물게 생기며, 다발성 외상 환자의 경우 타 손상으로 쉽게 잘못 진단되어지거나 간과되어지는 경우가 있다. 제 4형 손상 환자의 잘못된 치료를 피하기 위해서는 견봉-쇄골 관절의 세심한 이학적 검사와 적절한 방사선학적 검사가 필요하다. 이에 저자들은 다발성 늑골 골절이 동반된 제 4형 견봉-쇄골 관절 손상을 초기에 진단하지 못하고 간과한 2예를 변형 Weaver-Dunn 재건술로 치료하였기에 문헌 고찰과 함께 보고하고자 한다.