• Title/Summary/Keyword: TEAR

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Partial Thickness Rotator Cuff Tears

  • Shin, Sang-Jin;Seo, Myeong-Jae
    • Clinics in Shoulder and Elbow
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    • v.17 no.2
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    • pp.91-100
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    • 2014
  • Partial-thickness rotator cuff tear (PTRCT) is not single disease entity but one phase of disease spectrum. Symptoms of PTRCT vary from being asymptomatic to severe pain leading to deterioration in quality of life. Pathogenesis of degenerative PTRCT is multifactorial. Whereas articular sided PTRCT is usually caused by internal causes, both internal and external causes have important role in bursal sided PTRCT. A detailed history, clinical examination and magnetic resonance angiography are used in the diagnosis of PTRCT. Treatment of PTRCT is chosen based on age, demands of patients, causes and depth of tear. In most patients, non-operative treatment should be initiated. Whereas debridement can be done for less than 6 mm of articular sided PTRCT and in less than 3 mm of bursal sided PTRCT, repair techniques should be considered for higher grade PTRCT than that. Although the effect of acromioplasty is not clear, acromioplasty may be performed when the extrinsic causes appear to be the cause of tear. Either transtendon repair technique or repair after tear completion provided satisfactory clinical outcomes in treatment of articular sided PTRCT.

Effect of Integrative Korean Medicine Treatment for Tear of Supraspinatus Tendon: A Case Report (극상근건 파열에 대한 복합 한방치료의 효과 : 증례보고)

  • Hae-Won Hong;Ji-Won Park;Myung-In Jeong;Ka-Hyun Kim;Joo-Young Yoon;Si-Won Lee
    • Korean Journal of Acupuncture
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    • v.40 no.1
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    • pp.18-24
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    • 2023
  • A 53-year-old woman with right shoulder pain after falling down presented at our outpatient department after conventional treatment that had little effect. She was treated with integrative Korean Medicine treatment as an outpatient from February 2, 2022 to July 4, 2022. Based on Magnetic Resonance Imaging (MRI) findings, the patient was diagnosed with a right rotator cuff tear. With 39 treatment sessions, Numeric Rating Scale (NRS) score decreased and showed improvement in assessment. On May 6, MRI was retaken to show restoration of the supraspinatus tendon tear. The patient felt almost no pain on July 4, declaring the end of treatment. This successful case suggests that integrative Korean Medicine treatment might be an attractive alternative for severe rotator cuff tears.

Classification system for partial distal biceps tendon tears: a descriptive 3-Tesla magnetic resonance imaging study of tear morphology

  • Alex B Boyle;Simon BM MacLean
    • Clinics in Shoulder and Elbow
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    • v.26 no.4
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    • pp.366-372
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    • 2023
  • Background: There is minimal literature on the morphology of partial distal biceps tendon (DBT) tears. We sought to investigate tear morphology by retrospectively reviewing 3-Tesla magnetic resonance imaging (3T MRI) scans of elbows with partial DBT tears and to propose a basic classification system. Methods: 3T MRI scans of elbows with partial DBT tears were retrospectively reviewed by two experienced observers. Basic demographic data were collected. Tear morphology was recorded including type, presence of retraction (>5 mm), and presence of discrete long-head and short-head tendons at the DBT insertion. Results: For analysis, 44 3T MRI scans of 44 elbows with partial DBT tears were included. There were 9 isolated long-head tears (20%), 13 isolated short-head tears (30%), 2 complete long-head tears with a partial short-head tear (5%), 5 complete short-head tears with a partial long-head tear (11%), and 15 peel-off tears (34%). Retraction was seen in 5 or 44 partial tears (11%), and 13 of the 44 DBTs were bifid tendons at the insertion (30%). Conclusions: Partial DBT tears can be classified into five sub-types: long-head isolated tears, short-head isolated tears, complete long-head tears with partial short-head involvement, complete short-head tears with partial long-head involvement, and peel-off tears. Classification of tears may have implications for operative and non-operative management. Level of evidence: III.

Ultrasonographic Assessment for Rotator Cuff Repair According to the Tear Sizes and the Repair Method (회전근 개 파열의 크기 및 봉합 방법에 따른 초음파를 이용한 추적검사의 유용성)

  • Choi, Chang-Hyuk;Park, Jae-Hyun;Shin, Dong-Young;Lee, Jae-Kun
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.2 no.2
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    • pp.53-61
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    • 2009
  • Purpose: This study was designed to evaluate the clinical usefulness of serial ultrasonography (USG) after arthroscopic rotator cuff repair and to assess the re-tear rate and the re-tear time according to the tear sizes and the repair method. Materials and Methods: Between January 2008 and June 2008, 52 patients were treated with arthroscopic rotator cuff repair, Of the 52 patients, 29 patients that had undergone more than six months follow-up underwent preoperative USG examinations and subsequent arthroscopic examinations. MRI and USG findings were compared with intraoperative results of arthroscopic examinations. The postoperative integrity of the rotator cuff was observed using serial USG examination performed postoperatively at two weeks, six weeks, three months, and six months. Results: Small to medium rotator cuff tear were identified in 10 patients where the double pulley suture bridge (DPSB) technique was performed; the re-tear rate was 20%. For 19 patients with large to massive rotator cuff tears, the re-tear rates was 100% for six patients who had undergone tendon to tendon (TT) repair, the re-tear rate was 50% for two patients who had undergone tendon to tendon and bone to tendon (TTBT) repair and the re-tear rate was 55% for11 patients where the DPSB technique was performed. Re-tear rates according to follow-up periods were 7% from two to six weeks, 66% from six weeks to three months and 27% from three to six months postoperatively. Conclusion: Serial USG examinations after arthroscopic rotator cuff repair were useful to assess the re-tear rate and the re-tear time. In addition, USG examination were useful for treatment planning during postoperative rehabilitation.

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Rationale and Technique of Arthroscopic Primary Repair of Posterior Cruciate Ligament (후방 십자 인대 관절경하 일차수복술의 이론적 근거와 술기)

  • Kim, Jung-Man
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.1
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    • pp.21-24
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    • 1998
  • There are many controversies in managing fresh substance tear of PCL. Conservative treatment of partial tear is generalby accepted idea, and less than 10mm posterior instability is known to be acceptable in terms of funtion. More than 10mm posterior instability and complete fresh tear of the ligament are regarded as candidates of reconstruction of the ligament. However, many authors believe that posterior instability may be a cause of early osteoarthritis in the long run. Author described the rationale and the technique of arthroscopic primary repair of the PCL in case of proximal and mid 1/3 substance tear. Postoperative rehabilitation program and their rationale were also described.

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Transdural Nerve Rootlet Entrapment in the Intervertebral Disc Space through Minimal Dural Tear : Report of 4 Cases

  • Choi, Jeong Hoon;Kim, Jin-Sung;Jang, Jee-Soo;Lee, Dong Yeob
    • Journal of Korean Neurosurgical Society
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    • v.53 no.1
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    • pp.52-56
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    • 2013
  • Four patients underwent lumbar surgery. In all four patients, the dura was minimally torn during the operation. However, none exhibited signs of postoperative cerebrospinal fluid leakage. In each case, a few days after the operation, the patient suddenly experienced severe recurring pain in the leg. Repeat magnetic resonance imaging showed transdural nerve rootlets entrapped in the intervertebral disc space. On exploration, ventral dural tears and transdural nerve rootlet entrapment were confirmed. Midline durotomy, herniated rootlet repositioning, and ventral dural tear repair were performed, and patients' symptoms improved after rootlet repositioning. Even with minimal dural tearing, nerve rootlets may become entrapped, resulting in severe recurring symptoms. Therefore, the dural tear must be identified and repaired during the first operation.

Reverse Total Shoulder Replacement for an Enchondroma with Concomitant Rotator Cuff Tear Arthropathy: A Case Report

  • Park, Bong-Ju;An, Ki-Yong;Choi, Yong-Suk
    • Clinics in Shoulder and Elbow
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    • v.20 no.2
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    • pp.100-104
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    • 2017
  • Enchondromas generally occur in the hand and uncommonly in the long bones. Because enchondromas are usually asymptomatic, most are discovered during diagnostic radiology for another disease. Here, we describe a case of enchondroma in the right humerus in a 79-year-old female patient with concomitant rotator cuff tear arthropathy. The patient was initially hospitalized for prolonged pain and pseudoparalysis of the right shoulder. The condition, which was histologically confirmed as an enchondroma in the proximal humerus, was treated with curettage and reverse total shoulder arthroplasty. In this case report, we present a rare case of an enchondroma with combined rotator cuff tear arthropathy.

Effects of Muscle Strengthening Exercises on Function and Pain for Rotator Cuff Partial Tear Patients (근력강화운동이 회전근개 부분 파열환자의 기능과 통증에 미치는 영향)

  • Bang, Hyoji;Lee, Hyojeong
    • Journal of The Korean Society of Integrative Medicine
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    • v.3 no.1
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    • pp.53-62
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    • 2015
  • Purpose: The purpose of this study was to evaluate the effects of muscle strengthening exercise on shoulder function and pain for rotator cuff tear patients. Method: The subjects of this study, partial tear of the rotator cuff diagnosed patients, twelve patients were picked up, who were agreed with this research. The twelve patients received muscle strengthening exercise for 4 weeks, which consisted of 5 times per week, 40 min of supervised exercise program. Shoulder function and pain, measured by ROM, CMS, SST, PPT and VAS. Result: In comparison of VAS, PPT and ROM, CMS, SST were showed a more improved after intervention. Conclusion: Therefore, muscle strengthening exercise is useful to improve the shoulder function and pain for rotator cuff tear patients.

Arthroscopic Partial Repair of Massive Contracted Rotator Cuff Tears

  • Kim, Sung-Jae;Kim, Young-Hwan;Chun, Yong-Min
    • Clinics in Shoulder and Elbow
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    • v.17 no.1
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    • pp.44-47
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    • 2014
  • Typically, massive rotator cuff tears have stiff and retracted tendon with poor muscle quality, in such cases orthopaedic surgeons are confronted with big challenging to restore the cuff to its native footprint. Furthermore, even with some restoration of the footprint, it is related with a high re-tear rate due to less tension free repair and less tendon coverage. In this tough circumstance, the partial repair has yielded satisfactory outcomes at relatively short follow-up by re-creating the transverse force couple of the rotator cuff. Through this partial repair, the massive rotator cuff tear can be converted to the "functional rotator cuff tear" and provide improvement in pain and functional outcomes in patient's shoulder.

Mallory-Weiss Tear After Cardiopulmonary Resuscitation in a Patient Suffering From Acute Myocardial Infarction

  • Yu, Jin Seok;Ko, Woo Suk;Kim, June Hyun;Bae, Kwang Uk
    • Kosin Medical Journal
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    • v.33 no.2
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    • pp.235-239
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    • 2018
  • A report of a 79 year old male patient suffering from acute myocardial infarction with Mallory-Weiss tear after successful cardiopulmonary resuscitation(CPR) by emergency medical technician in the swimming pool is presented. Successful percutaneous coronary intervention(PCI) was done after appropriate transfusion. The patient survived and discharged without major complications after admitting 11days in the hospital. Importance of CPR in AMI patient is reiterated as complication such as Mallory-Weiss tear may arise.