• Journal of the Korean Arthroscopy Society
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• v.15 no.1
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• pp.19-21
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• 2011

Clavicle Hook pate was commonly used in the injury around distal clavicle such as fractures, acromio-clavicular joint injury. We experienced a case of impingement syndrome following operation of distal clavicle fracture using Clavicle Hook plate. So we report this case with a reiview of current literatures.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.39
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• pp.11.1-11.6
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• 2017

Background: This case report discusses the unusual presentation of limited mouth opening as a result of bilateral coronoid process hyperplasia. Case presentation: A 14.5-year-old male patient of white Caucasian ethnicity presented with limited mouth opening, mandibular asymmetry, and dental crowding. Investigations confirmed bilateral coronoid process hyperplasia and management involved bilateral intraoral coronoidectomy surgery under general anaesthesia, followed by muscular rehabilitation. Mouth opening was restored to average maximum opening within 4 months of surgery. Conclusion: Limited mouth opening is a common presentation to medical and dental professionals. The rare but feasible diagnosis of coronoid impingement syndrome should not be overlooked.

• Journal of the Korean Arthroscopy Society
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• v.12 no.3
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• pp.217-221
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• 2008

Coracoid impingement syndrome results from abnormal contact between the anterosuperior humerus and the coracoacromial arch. The coracoid impingement may occur from traumatic, idiopathic, or iatrogenic causes. Traumatic causes of coracoid impingement include fractures of scapular neck, coracoid process or lesser tuberosity. Coracoid impingement due to lesser tuberosity malunion is a rare disease and most of them were treated by open procedures. The authors present a case of coracoid impingement caused by malunion after isolated lesser tuberosity fracture which was treated by arthroscopic coracoplasty with percutaneous screw fixation.

• Clinics in Shoulder and Elbow
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• v.21 no.3
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• pp.158-161
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• 2018

Hereditary multiple exostosis (HME) is an autosomal dominant disorder manifested by the presence of multiple osteochondromas. Although the lesions are benign in nature, exostoses are often associated with characteristic progressive skeletal deformity and displaying clinical symptoms such as mechanical irritation or impingement. We present the successful arthroscopic resection in a 24-year-old HME male with impingement syndrome and long head tendon tear of the biceps caused by osteochondroma arising from the distal clavicle.

• Journal of Korean Foot and Ankle Society
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• v.8 no.1
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• pp.76-80
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• 2004

Purpose: We assessed the results of open treatment of anterior impingement syndrome of the ankle in elite level soccer players and concomitant injuries were idenfied. Materials and Methods: We retrospectively reviewed twenty one elite level soccer players diagnosed with anterior impingement syndrome who underwent open debridement between January 1997 and January 2002. All were men and the mean age at the operation was 21 years (range 16 to 27). The mean follow-up duration was 31 months (13 to 71). Concomitant abnormalities were idenfied through physical examination, bone scan and MRI. On a preoperative lateral radiograph, patients were classified according to McDermott's stage. Anteromedial or anterolateral approach was used at the operation and osteophyte was removed with osteotome and rongeur. When chronic ankle instability was accompanying, we performed Modified Brostrom-Gould procedure and for osteochondral lesion, multiple drilling was applied. The Ogilvie-Harris scoring system was used as a clinical scale to evaluate pain, swelling, stiffness and limitation of activity. The results were scored as excellent (15 to 16 points), good (13 to 14) and otherwise unsatisfactory. The time to return to full activity including sports activity was determined. Results: Eighteen of twenty one patients had an excellent outcome. Three patients were graded unsatisfactory and two of them abandoned their career due to the persistence of residual pain. Concomitant abnormalities were found including twelve cases of chronic ankle instability, three cases of osteochondral lesion and two cases of flexor hallucis longus tendinitis. Conclusion: Open debridement was successfully applied to the elite level soccer player with anterior impingement syndrome of the ankle. Considerable coexistence of other abnormalities such as chronic ankle instability may encourage us to consider additional operative procedure.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.13 no.1
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• pp.67-72
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• 2007

Anatomy: The rotator cuff comprises four muscles-the subscapularis, the supraspinatus, the infraspinatus and the teres minor-and their musculotendinous attachments. The subscapularis muscle is innervated by the subscapular nerve and originates on the scapula. It inserts on the lesser tuberosity of the humerus. The supraspinatus and infraspinatus are both innervated by the suprascapular nerve, originate in the scapula and insert on the greater tuberosity. The teres minor is innervated by the axillary nerve, originates on the scapula and inserts on the greater tuberosity. The subacromial space lies underneath the acromion, the coracoid process, the acromioclavicular joint and the coracoacromial ligament. A bursa in the subacromial space provides lubrication for the rotator cuff. Etiology: The space between the undersurface of the acromion and the superior aspect of the humeral head is called the impingement interval. This space is normally narrow and is maximally narrow when the arm is abducted. Any condition that further narrows this space can cause impingement. Impingement can result from extrinsic compression or from loss of competency of the rotator cuff. Syndrome: Neer divided impingement syndrome into three stages. Stage I involves edema and/or hemorrhage. This stage generally occurs in patients less than 25 years of age and is frequently associated with an overuse injury. Generally, at this stage the syndrome is reversible. Stage II is more advanced and tends to occur in patients 25 to 40 years of age. The pathologic changes that are now evident show fibrosis as well as irreversible tendon changes. Stage III generally occurs in patients over 50 years of age and frequently involves a tendon rupture or tear. Stage III is largely a process of attrition and the culmination of fibrosis and tendinosis that have been present for many years. Treatment: In patients with stage I impingement, conservative treatment is often sufficient. Conservative treatment involves resting and stopping the offending activity. It may also involve prolonged physical therapy. Sport and job modifications may be beneficial. Nonsteroidal anti - inflammatory drugs(NSAIDS) and ice treatments can relieve pain. Ice packs applied for 20 minutes three times a day may help. A sling is never used, because adhesive capsulitis can result from immobilization.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 1995.05a
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• pp.13-13
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• 1995

The authors performed the arthroscopic decompression and cuff debridement on 47 cases in 45 consecutive patients with either stage II or stage III impingement syndrome from July 1990 to January 1994. The summarized results are as follows. 1. 47 cases in 45 consecutive patients had arthroscopic decompression for the subacromial impingement syndrome. 2. There were 31 males and 14 females and the mean age was 40 years for men and 46years for women. 3. The follow up duration was from 3 years 9 months to 1 year (average 2 years 1month). 4. Among 47 cases, 19 cases were found to have no cuff tear (stageII) 13 cases partial thickness cuff tear (stage IIIa) 10 cases complete tear on cuff less than 3 cm long (stage IIIb) and 5 cases complete tear on cuff more than 3 em in length (stage IIIc). 5. The arthroscopic subacromial decompression and rotator cuff debridement was a good treatment method in stage II and stage IIIa and stage IIIb. in the case of stage IIIc rotator cuff tear, it was useful for pain relief and improvement of shoulder function.

• Korean Journal of Acupuncture
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• v.39 no.3
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• pp.100-106
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• 2022

Posterior ankle impingement syndrome is one of the impingement syndromes characterized by posterior ankle pain that occurs during forced plantar flexion. This report presents a case of a 48-year-old PAIS patient with os trigonum syndrome accompanied by tenosynovitis of flexor hallucis longus. She was treated with complex Korean medicine to a good effect. The Numeric Rating Scale and the EuroQol 5-Dimension 5-Level were used to measure the impact of Korean medicine on the patient's pain and quality of life. Decreased NRS and increased EQ-5D-5L scores reflected improvement in her symptoms within 25 days. This study suggests complex Korean medicine treatment for PAIS may be beneficial for alleviating pain and improving quality of life.

• Clinics in Shoulder and Elbow
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• v.2 no.1
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• pp.28-34
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• 1999

Purpose: We studied magnetic resonance imaging of acromion morphology and superior displacement of the humeral head in the patients with diagnosis of rotator cuff impingement syndrome, and also documented the relationship of type Ⅲ acromion to the rotator cuff tear. Materials and Methods: We reviewed retrospectively 40 patients(40 shoulders) who had arthroscopic treatment for the diagnosis of stage II impingement or rotator cuff partial tear and did not have other risk lesions except acromion factor. The mean age was 48.7 years at operation. 21 men(2l shoulders), mean age of 26 years, were used as controls. Acromial type, tilt, and superior displacement of humeral head in sagittal plane, and acromial lateral angulation in coronal plane were measured. Four parameters of the patients were compared with those of control group. And then, the data were subdivided and analyzed with respect to acromial type and patient age in the impingement group. Student t test and multi-way ANOVA were used. Results: In impingement group, Farley's type I acromion, 33%, type Ⅱ, 38%, type Ⅲ, 27% and type Ⅳ, 2%. Superior displacement of humeral head( 4.8mm) were characteristic in the impingement group compared with the control group(1.3mm)(p<0.05). But acromial tilt and lateral angulation were not statistically different. In the analysis of the impingement group, the change of 4 parameters was not significant with respect to age(p>0.05), but lateral angulation in type I acromion(18 degree) and superior displacement of humeral head in type Ⅲ acromion(6.3mm) were significantly increased(p<0.05). All 4 parameters were not different between two subdivided types of type Ⅲ acromion. Conclusion: All types of acromian and large lateral angulatian cauld develop impingement syndrame, but acromial tilt was nat risk factar. Appearance of type Ⅲ acromian and increased superiar displacement of humeral head were characteristic findings in the impingement syndrame. Superiar displacement of humeral head as a result of degenerative change of rotatar cuff was probably primary cause far impingement. The type Ⅲ acromian might be an acquired farm, which cauld be expected to accelerate the tear of rotatar cuff as a cansequence.

• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.53-57
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• 2010

Purpose: The goal of this study was to evaluate differences in strength deficits between (i) patients with stage 1 or 2 impingement syndrome and (ii) patients with rotator cuff tears. Materials and Methods: We enrolled 43 patients with stage 1 or 2 impingement syndrome (group 1) and 21 patients with rotator cuff tears (group 2). The isokinetic strength of both groups was evaluated at $60^{\circ}/sec$ for external rotation, internal rotation, adduction and abduction. We measured the peak torque, total work, average power of bilateral sides, peak torque relationship to body weight, and the ratio between unilateral agonist and antagonist. Results: The isokinetic strength deficits assessed in ratio of peak torque to body weight for group 1 and group 2 respectively were; $28.48{\pm}23.76%$ and $29.12{\pm}32.81%$ for abduction (p=0.929), $7.20{\pm}13.98%$ and $18.94{\pm}19.52%$; for adduction (p=0.021), $16.88{\pm}13.76%$ and $25.80{\pm}24.07%$; for external rotation (p=0.221), and $14.1{\pm}25.67%$ and $29.02{\pm}35.06%$ for internal rotation (p=0.059). For average power and total work, group 2 showed a significantly greater deficit for adduction and internal rotation than group 1. Conclusion: Those with rotator cuff tears have more isokinetic muscle strength deficits than those with stage 1 or 2 impingement syndrome. Progression from stage 1 and 2 impingement syndrome to stage 3 may result in greatest changes in strength deficits for internal rotation and adduction.