• Clinics in Shoulder and Elbow
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• v.7 no.1
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• pp.41-45
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• 2004

In adhesive capsulitis of the shoulder of no response to nonoperative treatment, an arthroscopic capsular release and manipulation improves range of motion and pain relief. We performed an arthroscopic examination in the stiff shoulder, of which she had no response to nonoperative treatment, after the conservative treatment of a clavicular shaft fracture by motorcycle-driver traffic accident. We found the intra-articular 'rotator interval bridging scar adhesion' between subscapularis tendon and antero-superior glenoid fossa under the rotator interval which was no adhesion and contracture itself. We performed the scar adhesion removal and synovectomy, maintaining the rotator interval. We recommended nonsteroidal anti-inflammatory drug for postoperative pain relief and continuous active and passive range of motion (ROM) exercise to gain motions. Preoperatively, active and passive range of motion were 70° for forward elevation, 60° for abduction and especially 0° for external rotation. After postoperative 2 months, active ROM were 150° for forward elevation, 130° for abduction and 80° for external rotation. After postoperative 6 months, passive and active ROM were full. UCLA score improved from preoperative 9 points to postoperative 29 points.

• Journal of Physiology & Pathology in Korean Medicine
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• v.29 no.4
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• pp.337-346
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• 2015

Sprain is the injury of meridian-muscle, and is caused by qi and blood obstruction or regional stagnation of qi and blood. So we take the channel points where pain flows. If we take the locations that feel pain, those locations are treatments points and ashi points. So we searched over the ashi points appearing on the patients with wrist sprain. Ashi points appeared on LI5, TE4, SI5 around wrist joints, LI10, LI11, LU6 around elbow joints, LI14, LU3, LU4, PC2 around upper arm. Also, ashi points appeared much on ST17, KI23, PC1, SP18, ST18 around thoracic region, and, on BL15, BL44, BL13 around anterior and thoracodorsal region, in order stated. Ashi points of the highest frequency appeared on LI14 around upper arm, and on LI5, TE4 around wrist joint, and SI5, ST17, KI12, PC1, SP18 appeared with second highest frequency. And ashi points on elbow points and thoracodorsal region appeared with the same frequency. Therefore, it is possible for us to know that the pain location appears in order of upper arm, anterior thoracic region, elbow joint region, and, thoracodorsal region, in treating wrist joints. There was a tendency that pain and movement disturbance recovered more quickly, depending on the pain reduction, as we found out the ashi points closely from stagnated qi and blood caused by wrist arthritis, and relaxed the stiff location. Rubbing treatments in treating pain ashi points is considered to play an important role to reduce pain effectively, so it is necessary to make a further study.

• Clinics in Shoulder and Elbow
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• v.1 no.2
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• pp.198-204
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• 1998

Unstable fractures of the proximal humerus continue to be difficult problems for orthopaedic surgeons. The optimum treatment of these fractures has remained a matter of controversy. We analyzed the clinical results of open reduction and plate fixation underwent for patients of unstable fractures of proximal humerus after minimum 12 months follow up. The purpose of this study is to evaluate the efficacy of open reduction and rigid plate fixation. Twenty-two patients were managed with open reduction and plate fixation. Mean follow up duration was 20.6 months(range, 12 to 28 mon.). Because the age of patient as a maker of degree of osteoporosis was considered the key factor in the success of anatomic reconstruction, we divided into two groups according to age. Group A was comprised of 12 cases with younger than 50 yrs of age. Ten cases of older than 50 yrs of age were Group B. According to Neer's classification, five cases(22%) were two part fracture, 12 cases(64%) were three part fracture, and three cases(14%) were four part fracture. We used the Neer rating system for evaluating the results. In Group A, overall scores were 79.1. In Group B, overall scores were 76.8. Overall scores in two part fracture were 85, overall scores in three part fracture 78.4 and overall scores in three part fracture 68.3. We achieved excellent or good results in nine cases(75%) of Group A and seven cases(70%) of Group B. Also, we obtained excellent or good results in all cases of two part fracture, ten cases(71%) of three fracture and one case(33%) of four part fracture. The complications were three metal loosening, one avascular necrosis of humeral head, one severe stiff shoulder, one superficial wound infection and one ectopic ossification. The results were excellent or good in 16 cases(73%) out of 22 cases. In conclusion, rigid fixation and supervised early exercise would be a good option for unstable fracture of the proximal humerus.

• Clinics in Shoulder and Elbow
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• v.24 no.3
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• pp.156-165
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• 2021

Background: This study aimed to determine: the perspectives of the patient cohort that underwent telehealth consultation and shoulder rehabilitation during coronavirus disease 2019 (COVID-19) and the differences in the patients' perspectives with the two different telehealth video applications (apps) used in the study. Methods: This is a prospective study carried out during the COVID lockdown period of April to July 2020. Thirty consecutive patients from the orthopedics department of a tertiary institute in India underwent their first-ever session of a video app-based (Zoom or WhatsApp) telehealth consultation with shoulder rehabilitation exercises on a handheld mobile, tablet, or laptop device. After the virtual consultation, the patients were sent a validated telehealth usability questionnaire (TUQ) to evaluate their perspectives. Scores obtained from the TUQ were the primary outcome measure. Results: The study was completed by 30 patients (16 men and 14 women) with an average age of 56 years (range, 20-77 years). The patients who contacted us during the lockdown period with either a stiff shoulder or a conservatively treated shoulder fracture were included in the study. The average TUQ score was 13.6 (median, 14.5; range, 6-21) out of a maximum of 21 points. Eighty percent of the patients were satisfied and found the telehealth service useful. Use of the Zoom app scored significantly higher (median, 17; average, 15.6) than the WhatsApp app (median, 8.5; average, 9.6) (p=0.004). Conclusions: Patients who received telehealth consultation and shoulder rehabilitation were overall satisfied. Telehealth apps with advanced video calling features such as Zoom should be preferred for higher patient satisfaction.

• CELLMED
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• v.12 no.3
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• pp.14.1-14.2
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• 2022

Currently, a 70-year-old woman started suffering from S.I joint pain from 1973 and had severe pain in the S.I joint, wrist, and elbow from 1975 to 1977, and was diagnosed with spinal tuberculosis at a general hospital. From 1978 to 1987, she suffered from chronic fatigue and insomnia, and since January 1, 1988, she was unable to get up while lying down, suffering from whole body joint, muscle pain, and fibromyalgia. In May 1989, she was also diagnosed with ankylosing spondylitis through genetic testing at the Catholic St. Mary's Hospital Rheumatology Department in Korea, and was treated with sulfasalazine, analgesic, and immunosuppressant, methotrexate, for 12 years until 1999, but none of the drugs eliminated the pain. She was hospitalized and discharged repeatedly, and continued to receive salt water poultice and exercise therapy at home, but was unable to move at all. In 2000, after biologic treatment with Remicade injection (Remsima®), she was able to walk and move, and after that, she was continuously prescribed biologics. From 2015 to 2019, Enbrel® (Etanercept) injection was prescribed once a week, but the symptoms such as severe pain (joint and muscle, fibromyalgia), scleroderma, Sjogren's syndrome (dryness of eyes, nose and mouth), difficulty swallowing, chronic fatigue, and stiff body appeared. Around January 2018, hepatic indicators were high and lymphocytes became enlarged. However, most serious injuries were highly improved after the OCNT combination therapy using active phytonutrients, anthocyanin-fucoidan nanocomplex. Therefore, for patients with such experiences, OCNT treatment is proposed as an alternative.

• Clinics in Shoulder and Elbow
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• v.3 no.1
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• pp.1-9
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• 2000

Purpose: To report the mid-term results of the inferior capsular shift procedure for the multidirectional instability, and to analyze whether the bilateral laxity, the generalized ligamentous laxity and the voluntary instability can influence upon the final outcome. Material and Method: We reviewed 95 patients with 96 shoulders treated by the inferior capsular shift procedure for multidirectional instability through an anterior approach. In total, 49 shoulders(51%) showed generalized ligamentous laxity, 56 shoulders(58%) bilateral laxity, and 65 shoulders(68%) voluntary subluxation. Mean follow-up was 27 months(11-60 months). Result: The final Rowe score was 75 points in patients who had had at least one of the bilateral laxity, generalized ligamentous laxity, or the voluntary subluxation and 84 points without any of these in each element. Seventy-five percent of the bilateral laxity and 87% of the unilateral instability continued to function well without any pain and instability postoperatively. Those with a voluntary(74%), those with an involuntary instability(83%), those with a generalized ligamentous laxity(73%) and without laxity(84%) could do well a daily living activity without instability Eighty-six percent who had had the voluntary instability was eliminated completely the voluntability. Eighty-four percent of the patients stated that they were subjectively satisfied with the status of their shoulder. Nine shoulders(9.4%) had recurrence of symptomatic and disabling instability and theses patients had had at least voluntary instability preoperatively. Seven patients(7.3%) suffered from the stiff shoulder after the inferior capsular shift procedure. Conclusion: The inferior capsular shift procedure in multidirectional instability provided satisfactory results both in objective and subjective terms. Nonetheless, a patient who has a bilateral laxity, a generalized ligamentous laxity or a voluntary instability could be expected less favorable results compared to those with neither of these. A careful selection of the inferior capsular shift procedure for the multidirectional instability is needed before surgery. But our results suggests that a voluntary instability is not always poor candidate for the inferior capsular shift procedure.

• Journal of the Korean Arthroscopy Society
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• v.8 no.1
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• pp.45-50
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• 2004

Purpose: The purpose of this study is to compare the outcome of operative results in the impingement syndrome of the shoulder with and without the stiffness. Material and Method: Seventy-six patients who had the impingement syndrome without stiffness were evaluated, and treated with the subacromial decompression and 24 patients who had the impingement syndrome with stiffness, were treated with the subacromial decompression and the manipulation. The average follow-up period was 32 months. Result: The impingement syndrome of the shoulder with stiffness was more severe in the preoperative pain and worse in ASES score than without stiffness. The postoperative pain and ASES score improved in the both group. The satisfactory groups were 67% in the group with stiffness and 80% without stiffness. The satisfactory rate was 83% in the group with stiffness and 93% without stiffness. The satisfactory groups with diabetes were 47% in the group with stiffness and 81% without stiffness. Forward elevation, exeternal rotation at the side and internal rotation improved in both groups postoperatively and there were no statistically significant differences postoperatively External rotation was restricted statistically in the group with stiffness. Conclusion: Although patients may not regain the full range of motion, the technique of manipulation followed by arthroscopic subacromial decompression offers good pain relief and satisfactory functional recovery for the impingement syndrome with stiffness. However preoperative counseling is necessary for the impingement syndrome combined with diabetes and stiffness due to poor out come.

• Journal of Preventive Medicine and Public Health
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• v.38 no.1
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• pp.45-52
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• 2005

Objectives : To investigate the fatigue subjective symptoms and VDT related risk factors in bank workers. Methods : A total of 2178 workers (62.8% male, 37.2% female) were surveyed with a self-administered and structured questionnaire consisting of 30 fatigue symptoms and other VDT related factors regarding work characteristics, work postures, work environments, personal medical histories, etc. Fatigue subjective symptoms were divided into 3 groups of 10 questions each: a dull, drowsy and exhausted feeling (Group I), a mental decline of working motivation (Group II), or a feeling of incongruity in the body and dysfunction of autonomic nervous system (Group III). Each question was weighted as 0 for 'none', 1 for 'sometimes', and 2 for 'always'. Results : Mean age was $35.8{\pm}7.2$ years ($38.9{\pm}6.0$ in males, $30.6{\pm}5.8$ in females), Mean work duration was $7.7{\pm}7.1$ years ($8.4{\pm}7.4$ in males, $6.5{\pm}6.4$ in females). Mean symptom score in males was $11.0{\pm}8.1$ ($4.9{\pm}3.1$ in Group I, $3.0{\pm}3.1$ in Group II, $3.1{\pm}2.8$ in Group III) and in females was $17.5{\pm}9.5$ ($7.0{\pm}3.8$ in Group I, $4.6{\pm}3.5$ in Group II, $5.9{\pm}3.4$ in Group III). Mean scores were higher in the order of Group I>III>II. Females had significantly higher scores than males in all three groups (p<0.001). Most common symptoms complained of as 'always' or 'sometimes' were feel strained in the eyes' (85.4%) among Group I, 'find difficulty in thinking'(54.2%) among Group II, and 'feel stiff in the shoulders (72.3%) among Group III. In multiple regression analysis, female, non-straight spine at workstation, more VDT work hours, history of physical therapy, glare of screen, overtime work, young age, and non-horizontal elbow position were significantly related with high score of symptoms. Conclusions : More supportive VDT work environment and education for correct work postures for VDT workers are recommended.

• The Journal of the Korean bone and joint tumor society
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• v.16 no.1
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• pp.27-36
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• 2010

Purpose: Pigmented villonodular synovitis (PVNS) is a rare soft tissue tumor, which usually arises in larger joints, such as the knee. It has a high recurrence rate after surgical treatment. The purpose of this study is to evaluate and analyze the clinical results of diffuse-type pigmented villonodular synovitis cases that were treated with open total synovectomy. Materials and Methods: Between 1994 and 2006, 21 patients who had diffuse-type pigmented villonodular synovitis were selectively reviewed. Among the 21 cases studied, 14 patients presented at the knee, 5 at the ankle, and 2 at the shoulder and elbow. The mean follow up period was 5.5 years (range, 36-157 months). The average age of the patients was 34 years consist of 7 men and 14 women. Clinical outcomes were analyzed retrospectively, including range of motion and complications. Results: Open total synovectomy and adjuvant electrocautrization were done in all cases except one. During the regular follow-up period after the surgery, two patients showed symptoms of recurrence. After re-operation, only one case was pathologically confirmed as a recurrence. The patient who had partial synovectomy and the other patient who had second operation due to recur rence received additional radiation therapy. Clinical outcome scores were improved in every aspect (p<0.0001). 2 out of 14 Patients who had pigmented villonodular synovitis at the knee developed stiff knee after the surgery. Conclusion: After the open total synovectomy with electrocautrization, a low recurrence rate and satisfactory clinical outcome was achieved, observed in a minimum of 3 years of follow-up.