• Clinics in Shoulder and Elbow
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• v.19 no.3
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• pp.149-154
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• 2016

Background: The purpose of this study is to compare clinical and radiological outcomes between trans-acromial fixation with Kirschner's wire (K-wire) and AO locking hook plate fixation for acute acromioclavicular (AC) joint dislocation. Methods: This study included 61 patients who underwent either closed reduction and trans-acromial fixation with K-wire (group A, 23 patients) or open reduction and internal fixation with AO locking hook plate (group B, 38 patients). Pain on a visual analogue scale (VAS) score, the University of California Los Angeles (UCLA) shoulder score, the American Shoulder and Elbow Surgeons (ASES) score, and active range of motion (ROM) were used in the functional evaluation. For radiological evaluation, coracoclavicular distance (CCD) was measured on both clavicular anteroposterior view and compared between groups. Results: At one-year follow-up, no significant differences in VAS pain score, UCLA shoulder score, ASES score, and active ROM were observed between groups, despite five cases (22.7%, 5/23) of complication in group A. The side-to-side difference between normal and affected CCD was $2.4{\pm}2.2mm$ in group A and $0.2{\pm}0.7mm$ in group B. This difference showed a statistical significance between groups (p<0.001). Conclusions: For the treatment of acute AC joint dislocation, the K-wire trans-acromial fixation group showed a significantly greater CCD than the AO locking hook plate group. In addition, during the follow-up period, much higher incidence of complication related to implant was observed in the trans-acromial fixation group. Although clinical outcomes between groups were not significantly different, these results should be interpreted carefully.

• Clinics in Shoulder and Elbow
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• v.21 no.3
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• pp.169-175
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• 2018

Traumatic anterior dislocation of the shoulder is one of the most common directions of instability following a traumatic event. Although the incidence of shoulder dislocation is similar between young and elderly patients, most studies have traditionally focused on young patients due to relatively high rates of recurrent dislocations in this population. However, shoulder dislocations in older patients also require careful evaluation and treatment selection because they can lead to persistent pain and disability due to rotator cuff tears and nerve injuries. This article provides an overview of the nature and pathology of acute primary anterior shoulder dislocation, widely accepted management modalities, and differences in treatment for young and elderly patients.

• Clinics in Shoulder and Elbow
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• v.26 no.2
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• pp.212-216
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• 2023

The glenohumeral joint is one of the most commonly dislocated joints. When dislocated, the humeral head typically moves anteriorly and medially within the soft tissues adjacent to the glenoid. We present a case of a 64-year-old female who presented with a locked anterior shoulder dislocation with impaction of the humeral head onto the coracoid. To our knowledge, this is the first reported instance of humeral head impaction onto the coracoid causing the shoulder dislocation to be irreducible by closed means. Complications of this dislocation can include humeral head deformity, pseudoparalysis, brachial plexus injury, and significant pain.

• Clinics in Shoulder and Elbow
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• v.9 no.2
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• pp.196-201
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• 2006

We report two cases of migration of K-wires from the acromioclavicular joint to the neck. A 73-year-old man complained of right shoulder pain for one month and had undergone orthopedic surgery because of acromioclavicular joint dislocation about 27 years earlier. Another 56-year-old man complained of left shoulder pain and neck pain for 5 years and had undergone orthopedic surgery because of acromioclavicular joint dislocation about 25 years earlier. In both cases, we took X-rays to look for the cause of shoulder pain and discovered broken and migrated K-wires in the neck. We removed the K-wires from the trapezius muscle and the paraspinal muscle respectively. K-wire fixation technique is simple and effective but should be followed up with X-rays periodically. In addition, we should warn patients of the possibility of migration of K-wire. And it is desirable for us to avoid using K-wire near major neurovascular structures like the sternoclavicular joint and the clavicle.

• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.264-270
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• 2009

Purpose: The elbow joint is one of the most stable joints. Dislocation and fracture can occur in elbow joint most commonly next to shoulder joint. Various injuries can occur according to generated mechanism, age of patient and impact. Despite proper treatment, various complications can occur. Materials and Methods: We describe etiology and treatment of these complications after elbow trauma such as stiffness, instability and heterotopic ossification. Results and Conclusion: Malunion, nonunion and traumatic arthritis are addressed as a possible complication after fracture around elbow joint.

• Clinics in Shoulder and Elbow
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• v.13 no.2
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• pp.188-193
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• 2010

Purpose: The purpose of this study was to evaluate the clinical and radiological results of a modified Phemister method reinforcing the 4 strands of an Ethibond sling for acromioclavicular joint dislocation. Materials and Methods: Between September 1999 and May 2007, 30 acromioclavicular joint dislocation cases underwent a modified Phemister method reinforcing the 4 strands of an Ethibond sling. The average follow-up period was 28.2 months (range: 24~33 months). Clinical outcomes were evaluated using the Weitzman classification; the state of coracoclavicular space reduction was done using radiologic findings. Results: According to the Weitzman classification, there were 24 excellent, 4 good and 2 fair case outcomes. The average coracoclavicular distance improved from 16.9 mm to 7.3 mm immediately after surgery. The average ratio of coracoclavicular distance comparing to the contralateral side at the final follow-up was 1.24 (range: 0.68~1.71). Complications included retraction of K-wires in 5 cases and restriction of joint motion in 4 cases. Conclusion: The modified Phemister operation using augmentation of the coracoclavicular ligament by 4 strands of Ethibond is an effective treatment modality in acromioclavicular joint dislocation.

• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.167-172
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• 2009

Purpose: We wanted to evaluate the results of treating acromioclavicular joint dislocation using an AO hook plate. Materials and Methods: Between February 2008 and September 2009, 10 patients underwent implant removal after surgical treatment of acromioclavicular joint dislocation using a AO hook plate. The Constant-Murley scoring system was administered postoperatively for evaluating the clinical results, and simple X-ray was taken for evaluating the state of reduction. Results: All cases showed satisfactory results on the clinical and radiological study. The mean Constant-Murley score at follow-up was 90.5 (range: 84~95). Three patients had some degree of discomfort with the hook plate, but these symptoms were relieved on removal of the plate. The radiological evaluation showed restoration of the vertical displacement of the clavicle in all the patients. No complications occurred such as infection, plate failure or redislocation after removal of the plate. Conclusion: The short term follow-up results of treating acromioclvicular joint dislocation using an AO hook plate were satisfactory both clinically and radiologically.

• Physical Therapy Korea
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• v.12 no.3
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• pp.94-100
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• 2005

Eccentric muscle contraction is more effective than concentric and iosmetric muscle contraction in increasing muscle strength. Also, eccentric or concentric-eccentric training has greater effective in neural activation and muscle hypertrophy than concentric training. In some study, eccentric exercises have been shown to reduce pain and improve function on Achilles tendinopathy. The purpose of this study was to evaluate the effect of eccentric isokinetic exercise in a patient with dislocation of the tarsometatarsal joint by traffic accident. After eccentric isokinetic training, peak torque, average work, and average power were increased. Also, the patient was fully weightbearing with a pain free normal gait thus making good recovery.

• Clinics in Shoulder and Elbow
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• v.19 no.3
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• pp.168-171
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• 2016

Fractures at the lateral end of the clavicle inevitably require surgical treatment as there is high potential for delayed union or nonunion. Acromioclavicular dislocation also requires stable and solid fixation for healing, and surgical treatment is recommended for the maintenance of joint function. The hook plate maintains the biomechanics of the acromioclavicular joint, enabling early range of motion. Therefore, for the past 10 years, the hook plate has been widely used in distal clavicle fractures and acromioclavicular joint injuries. However, the hook plate is associated with several complications, such as proximal clavicle fractures, widening of the hook hole, rotator cuff tear, subacromial impingement, and often acromial fractures. We report on two unusual cases of acromion fracture after hook plate fixation in patients with distal clavicle fracture and acromioclavicular dislocation alongside a literature review.

• Journal of dental hygiene science
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• v.9 no.1
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• pp.9-15
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• 2009

Aimed at office workers at their height of Temporomandibular joint disorder(TMD), organized self-filling questionnaires were distributed from January 7 to 26, 2008 to 216 workers in the fields of service, office work, and production in D metropolitan city, to get a proper recognition about prevention and treatment of TMD by observing how strongly occupational stress influence on them. The findings of the study were as follows: 1. For subjective symptoms of joint noise as TMD, occasional was 45.8% and often 12.0%, while for joint dislocation often was 12.0%. 41.2% said they feel pains while chewing, while 24.1% said they occasionally feel pains while not chewing. 2.8% said they often experience mouth-opening disorder. 2. For joint noise, answers were significantly different according to their ages, while 30's are at their height (P < 0.05). For joint dislocation, the shorter they worked the more they have it, so less than a year worker was 37.9%, while less than 3 years 31.0%, and less than 5 years 20.7%. For work type, daytime workers have more dislocation, 58.6%, than shift-workers 34.5% (P < 0.05, P < 0.01). For pains while chewing, the shorter they worked, the more they experienced, which is the same as mouth-opening disorder (P < 0.01). 3. Workers with mouth-opening disorder have much stress on occupational autonomy (P < 0.05) and workers with dislocation and pains while chewing have much stress on relation trouble (P < 0.05, P < 0.01). Workers with highly occupational insecurity has much trouble on dislocation and pains while chewing, while workers with dislocation have significantly much stress on unproper compensation (P < 0.05). 4. For who have joint dislocation, they have much stress on relation-trouble, occupational disorder, and un-proper compensation (P < 0.01, P < 0.05). Workers with pains while not chewing showed significant difference about occupational insecurity and relation troubles (P < 0.05, P < 0.01). Who have mouth-opening disorder showed significant difference about occupational autonomy (P < 0.05).