• 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.

• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.161-166
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• 2010

Purpose: Irreparable massive rotator cuff tears pose a distinct clinical challenge for the orthopaedist and non-surgical treatment has had inconsistent results and proven unsuccessful for chronic symptoms, while surgery, including debridement and partial and complete repairs have had varying degrees of success. Materials and Methods: For rotator cuff tears that are deemed irreparable, treatment options are limited. Results and Conclusion: The use of tendon transfers (latissimus dorsi for posterosuperior type cuff defects and pectoralis major for subscapularis defects) in younger patients to reconstruct rotator cuffs and re-establish function and restore shoulder kinematics can be useful in solving this difficult problem.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.7 no.2
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• pp.120-126
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• 2014

Acromioclavicular (AC) joint cyst is an uncommon presentation around the shoulder joint that is usually associated with chronic rotator cuff pathology and degenerative AC joint arthritis. Understanding the underlying pathophysiology of the shoulder joint is essential for appropriate interpretation of the AC joint cyst, assistance in determining the therapeutic strategy, and prevention of complications after treatment. We present a case of AC joint cyst with an aseptic fistula which was complicated by simple excision for recurred AC joint cyst after multiple aspirations. This case revealed a massive rotator cuff tear involving supraspinatus, infraspinatus, and subscapularis tendon on ultrasonography. We also reviewed the clinical approach and treatment options to be considered for its pathogenesis in the literature.

• Clinics in Shoulder and Elbow
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• v.6 no.1
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• pp.27-36
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• 2003

Antegrade interlocking intramedullary nailing (AIIN) for the humeral shaft fracture can induce shoulder pain and decrease of shoulder function postoperatively. The purpose of this study was to estimate the outcome of the shoulder functions after AIIN through the rotator interval between the subscapularis and the supraspinatus to decrease the shoulder pain. Out of consecutive 43 cases that underwent AIIN 42 had been followed for two years or more. Among them we analysized 40 cases of 39 Patients excluding two cases of Pathologic fractures. The average was 47 years. There were 17 men and 23 women. The average follow-up was 34 months. Open nailing was performed in 26 fractures and closed nailing in 14. Bone graft was done in 7 fractures with open nailing. With a single operation, all but two patients achieved osseous union. Average pain score with visual analog scale was one (range; 0∼4) postoperatively By the Neer's score 37 patients received a excellent or satisfactory results while 3 patients' unsatisfactory or failed results. By the functional score of ASES (American Shoulder and Elbow Society) 6 cases received the fair or poor results. Except three cases with persistent nerve palsy and one case of technique failure with protruded nail over humeral head, all patients could achieved satisfactory results with Neer's score and 35 cases (94%) satisfactory results with functional score of ASES. An insertion of antegrade nail to the rotator interval was recommended for better shoulder functions and less pain postoperatively.

• Clinics in Shoulder and Elbow
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• v.13 no.2
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• pp.280-285
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• 2010

Purpose: Coracoid impingement syndrome refers to subscapularis impingement between the coracoid process and lesser tuberosity of the humerus, and pain may occur when the arm is positioned in forward flexion, internal rotation and adduction. This position is common for archers. Material and methods: A female archer with coracoid impingement syndrome that was uncontrolled by conservative therapy underwent arthroscopic subcoracoid decompression. At the 20th postoperative month of follow up, she complained of painful rotator interval widening and so she underwent arthroscopic rotator interval plication. Results: At the postoperative 6th month of follow up after the second operation, she showed no pain and good functional results, and she returned to competing as an archer. Conclusion: We have reported here on a case of successful treatment of painful rotator widening after subcoracoid decompression in an elite archer.

• Food Science of Animal Resources
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• v.35 no.5
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• pp.646-652
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• 2015

The beef forequarter muscle comprises approximately 52% of carcass weight. The objective of this study was to evaluate the physiochemical characteristics and meat color from forequarter muscle of Holstein steers. Fifteen forequarter muscles were trimmed of external connective tissue and fat. An experimental group of eight Holstein steers was assessed using meat color, water-holding capacity, drip loss, and Warner-Bratzler shear force value at the same quality grade. The M. omotransversarius (0.45 kg) had the highest (p<0.05) lightness (L*) value, whereas the M. teres major (0.4 kg) and M. triceps brachii (caput laterale) (0.52 kg) had the lowest (p<0.05) values. The M. semispanitus capitus (1.48 kg), which is a neck muscle, had the highest values for both redness (a*) and yellowness (b*), whereas the lowest (p<0.05) values were for the M. teres major. The M. omotransversarius, M. latissimus dorsi (1.68 kg), and M. rhomboideus (1.2 kg) were ranked high (p<0.05) in water-holding capacity. The drip loss value was the highest for the M. longissimus dorsi thoracis (p<0.05; 1.86 kg), while the M. infraspinatus (2.28 kg), M. supraspinatus (1.38 kg), M. brachiocephalicus (1.01 kg), and M. pectoralis superficialis (1.18 kg) had the lowest (p<0.05). The Warner-Bratzler shear force value indicated that the M. pectoralis profundus (3.39 kg), M. omotransversarius, and M. brachiocephalicus were the toughest (p<0.05), whereas the M. subscapularis (0.86 kg), M. longissimus dorsi thoracis, M. teres major, and M. infraspinatus were the most tender cuts (p<0.05). Here, muscle type explained most of the variability in the forequarter physiochemical characteristics. Thus, our findings suggest that these muscle profile data will allow for more informed decisions when selecting individual muscles to produce value-added products from Holstein steers.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.1 no.2
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• pp.112-116
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• 2008

Ultrasonography of shoulder joint recently enlarges its utility since the knowledge of the shoulder disease is increased by numerous researches. Ultrasonography is not only noninvasive, safe, and relatively cheap, but also an unique modality that can monitor tendon movement during shoulder motion. Sonographic examination generally starts from the front side of the shoulder joint and finishes at back side in sitting position. Many structures in shoulder joint such as muscles, ligaments, glenoid labrum, bone, and especially rotator cuff tendon can be examined by ultrasonography. The rotator cuff is a motion unit consisted with subscapularis, supraspinatus, infraspinatus, and teres minor muscles. It functions as fulcrum and compresses the humeral head onto the glenoid, and steers for shoulder joint.

• Clinics in Shoulder and Elbow
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• v.10 no.2
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• pp.227-231
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• 2007

A posterior shoulder dislocation with a fracture is rare. Most fractures are impression fractures of the humeral head or lesser tuberosity fractures. However, there are no reports of a complete rupture of the rotator cuff with a combined posterior glenohumeral dislocation. We report a unique case of a posterior shoulder dislocation with an avulsion fracture of the greater tuberosity and a complete rupture of infraspinatus, teres minor and subscapularis tendons, which were treated surgically.

• Clinics in Shoulder and Elbow
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• v.21 no.1
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• pp.30-36
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• 2018

Background: The Korean Shoulder Scoring System (KSS) is a reliable and valid procedure for discriminative assessment of the clinical status of patients with rotator cuff tears. This study evaluates the correlation between the preoperative KSS and factors in patients with rotator cuff tears. Methods: From November 2009 to June 2016, 970 patients who underwent arthroscopic rotator cuff repair were retrospectively evaluated. A total of 490 patients met the study criteria. Preoperative factors included age, sex, symptom duration, mediolateral (ML) and anteroposterior (AP) tear size, acromiohumeral distance (AHD), tangent sign, tendon involvement (type I, supraspinatus; type II, supraspinatus and subscapularis; type III, supraspinatus and infraspinatus; type IV, all 3 tendons), fatty infiltration of rotator cuff muscles (group I, Goutallier stages 0 and 1; group II, Goutallier stages 2, 3, and 4), and KSS. Results: Old age, ML tear size, and AP tear size negatively correlated with the preoperative KSS (p<0.001). AHD showed a positive correlation with the preoperative KSS (p<0.001). A significantly inferior preoperative KSS was found in females and type III tendon involvement (p<0.001). For supraspinatus and infraspinatus, the preoperative KSS of group II fatty infiltration showed a significantly lower score than group I fatty infiltration (p<0.05). Conclusions: A relatively lower preoperative KSS was associated with old age, large tear size, narrow AHD, female, type III tendon involvement, and group II fatty infiltration of the supraspinatus and infraspinatus. Our study indicates that preoperative KSS can be a good measurement for the preoperative status of patients with rotator cuff tears.

• Investigative Magnetic Resonance Imaging
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• v.22 no.4
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• pp.229-239
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• 2018

Purpose: To assess the diagnostic performance in detecting rotator cuff tears at 3T of non-arthrographic shoulder magnetic resonance imaging (MRI) using 3D isotropic turbo spin-echo (TSE-SPACE) sequence as compared with 2D sequences. Materials and Methods: Seventy-four patients who were arthroscopically confirmed to have underwent non-arthrographic shoulder MRI with 2D sequences and TSE-SPACE were included. Three independent readers retrospectively scored supraspinatus and infraspinatus tendon (SST-IST) and subscapularis tendon (SCT) tears on 2D sequences and TSE-SPACE. Results: The mean sensitivity, specificity, and accuracy of the three readers were 95%, 100%, and 95% on TSE-SPACE and 99%, 93%, and 98% on 2D sequences for detecting SST-IST tears, respectively, whereas those were 87%, 49%, and 68% on TSESPACE and 88%, 66%, and 77% on 2D sequences for detecting SCT tears, respectively. There was no statistical difference between the two sequences, except for in the specificity of one reader for detecting SCT tears. The mean AUCs of the three readers on TSE-SPACE and 2D sequences were 0.96 and 0.98 for detecting SST-IST tears, respectively, which were not significantly different, while those were 0.71 and 0.82 for detecting SCT tears, respectively, which were significantly different (P < 0.05). Conclusion: TSE-SPACE may have accuracy and reliability comparable to conventional 2D sequences for SST-IST tears at non-arthrographic 3T shoulder MRI, whereas TSE-SPACE was less reliable than conventional 2D sequences for detecting SCT tears.