• Clinics in Shoulder and Elbow
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• v.16 no.2
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• pp.135-140
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• 2013

We report a case of recurrent shoulder dislocation and combined proximal humerus fracture in neurofibromatosis type I. A twenty-year-old male patient with known neurofibromatosis type I presented with right shoulder dislocation and proximal humerus fracture following a minor trauma. His injured arm also had large plexiform neurofibromas on the elbow, and the dislocation of the shoulder joint was proven to be recurrent. Bony deformation of the humerus and scapula were revealed on X-ray and computed tomography, as well as multiple neurofibromatic changes of the deltoid and periscapular muscles were noted on magnetic resonance imaging. Open reduction and capsular reconstruction were performed and humeral fracture was stabilized with a reconstruction plate. Satisfactory union and functional result were achieved and the dislocation did not recur until the 7-month followup after the procedure. Recurrent shoulder dislocation and combined proximal humerus fracture in neurofibromatosis type I are rare complications. However, it should still be considered in the orthopaedic evaluation process of the diseases.

• Clinics in Shoulder and Elbow
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• v.19 no.3
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• pp.125-129
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• 2016

Background: Superior migration of humeral head has been conventionally determined by measuring the acromiohumeral distance (AHD), We sought to devise a novel measurement system more reliably and accurately than AHD. We described a structural landmark called 'C-line'. In this study, we investigated the clinical usefulness of 'step-off of the C-line (SOC)' compared to that of AHD. Methods: The C-line formed from the medial margin of the proximal humeral head continuing up to the inferior margin of the articular glenoid and then to the lateral border of the scapula. The superior migration of the humeral head triggered by a rotator cuff tear introduces a discontinuity in this C-line. We measured the distance of this discontinuity. We enrolled 144 patients who underwent a rotator cuff repair. We selected 58 controls who didn't have any cuff lesions apparent on magnetic resonance imaging. Using radiographs derived from standardized true anteroposterior views of the shoulder, we measured the SOC and the AHD. We used t-tests for statistical analyses. Results: A rotator cuff tear was associated with an increase in SOC and a decrease in AHD. In control group, the mean SOC was $1.29{\pm}1.71mm$ and AHD was $9.71{\pm}2.65mm$. In cuff tear group, the mean SOC was $3.15{\pm}3.41mm$ and AHD was $8.28{\pm}1.76mm$. The mean SOCs of the patient group in relation to the mean SOC of the control group according to tear size, the SOCs of medium tear and lager groups showed statistically significant increase (p<0.05). Conclusions: The SOC may be a similarly effective to diagnose cuff tears of medium size and larger compared with AHD.

• Clinics in Shoulder and Elbow
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• v.23 no.2
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• pp.71-79
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• 2020

Background: The glenoid version of the shoulder joint correlates with the stability of the glenohumeral joint and the clinical results of total shoulder arthroplasty. We sought to analyze and compare the glenoid version measured by traditional axial two-dimensional (2D) computed tomography (CT) and three-dimensional (3D) reconstructed images at different levels. Methods: A total of 30 cases, including 15 male and 15 female patients, who underwent 3D shoulder CT imaging was randomly selected and matched by sex consecutively at one hospital. The angular difference between the scapular body axis and 2D CT slice axis was measured. The glenoid version was assessed at three levels (midpoint, upper one-third, and center of the lower circle of the glenoid) using Friedman's method in the axial plane with 2D CT images and at the same level of three different transverse planes using a 3D reconstructed image. Results: The mean difference between the scapular body axis on the 3D reconstructed image and the 2D CT slice axis was 38.4°. At the level of the midpoint of the glenoid, the measurements were 1.7°±4.9° on the 2D CT images and -1.8°±4.1° in the 3D reconstructed image. At the level of the center of the lower circle, the measurements were 2.7°±5.2° on the 2D CT images and -0.5°±4.8° in the 3D reconstructed image. A statistically significant difference was found between the 2D CT and 3D reconstructed images at all three levels. Conclusions: The glenoid version is measured differently between axial 2D CT and 3D reconstructed images at three levels. Use of 3D reconstructed imaging can provide a more accurate glenoid version profile relative to 2D CT. The glenoid version is measured differently at different levels.

• Physical Therapy Korea
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• v.24 no.2
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• pp.48-57
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• 2017

Background: Rounded shoulder posture (RSP), a postural abnormality, might cause shoulder pain and pathologic conditions. Although most previous research has investigated RSP focusing on the proximal structures of the shoulder, such as the scapula and pectoralis muscles, the relationship between RSP and anterior distal structures of the upper extremity, such as the biceps brachii muscle and elbow joint, is not clearly understood. Objects: This study aimed to investigate the correlations between RSP and the biceps brachii length, elbow joint angle (EJA), pectoralis minor length, general pectoralis major length, humeral head anterior translation (HHAT), glenohumeral internal rotation (IR), external rotation (ER), and horizontal adduction (HAD). Methods: Twelve subjects with RSP (6 male, 6 female) were recruited. All subjects fulfilled the RSP criteria indicated by a distance ${\geq}2.5cm$ from the posterior aspect of the acromion to the table in the supine position. The examiner measured each of the following parameters twice: RSP, biceps brachii length, EJA, pectoralis minor length, pectoralis major length, HHAT, glenohumeral IR, ER, and HAD. Pearson's correlation coefficient(r) was used to assess the correlation between RSP and all the variables. Results: There was a significant moderate positive correlation between RSP and biceps brachii length (r=.55, p=.032), moderate negative correlation between RSP and pectoralis minor length (r=-.62, p=.015), and moderate positive correlation between RSP and HHAT (r=.53, p=.038). Conclusion: The biceps brachii length, pectoralis minor length, and HHAT could be used to evaluate patients with RSP. Better understanding of the correlation between these factors and RSP could help in the development of effective methods to treat patients with this condition in clinical management.

• The Journal of the Korean bone and joint tumor society
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• v.12 no.2
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• pp.118-125
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• 2006

Purpose: We report elastofibroma which is a rare fibrous lesion that most commonly occurs in the between subscapularis and thoracic cage. Materials and Methods: Four patients include one man and three women, the average age was 70 years and the average follow up period was six months. Two patients had on left side, two patients had on both sides. Main symptom was palpable mass. One patient complained mild pain, two complained scapular snapping. Results: All four masses removed with marginal or wide margin. Average mass size was 9.7${\times}$7.2${\times}$3.8 cm. Preoperative symptoms disappeared after surgery. All of the patients have returned to their daily living and showed no recurrence. There was no serious complication such as limitation of shoulder motion and winged scapula. Conclusion: Elastofibroma scapulae can be diagnosed through patient's age, tumor location and radiological finding without preoperative biopsy. When patient is symptomless, observation is enough without surgical operation. Surgical operation considered for relieve of symptoms of pain and snapping.

• Clinics in Shoulder and Elbow
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• v.10 no.2
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• pp.212-219
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• 2007

Purpose: To determine the causes of the surgical treatment results in glenoid fracture by a retrospective analysis. Materials and methods: From March 1999 to February 2004, 9 patients who underwent an open reduction due to a glenoid fracture were reviewed. The modified Ideberg classification was used. There were 1, 3, 2, 1 and 2 cases of modified Ideberg type I, II, III, V, and VI, respectively. The internal fixators were a reconstruction plate, a small plate, a one-third tubular plate, a small screw, and a cannulated screw in 6, 1, 3, 3 and 1 case, respectively. The constant score and Adam's functional assessment method were used to evaluate the postoperative shoulder function. Results: The average time for fracture union was 7 weeks. The functional assessment was excellent in 4 cases, good in 3 cases, and fair in 2 cases. There were two complications related to surgery; articular screw encroachment, and inferior glenoid bone resorption without instability. Conclusion: A glenoid fracture with glenohumeral instability or displaced that was treated by open surgery showed good clinical results. Moreover, the more comminuted fracture had a lower functional score.

• Journal of the Korean Arthroscopy Society
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• v.8 no.2
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• pp.115-118
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• 2004

Purpose: The purpose of this study is to measure the internal and external rotation of shoulder and compare with normal volunteer and patients diagnosed as SLAP lesion. Materials and Methods: Thirty-eight cases (group 1) who had SLAP lesions at shoulder arthroscopy and fourty young volunteers(group 2) were analyzed retrogradely with medical record, intra-operative arthroscopic photo & video for SLAP lesions and the ROM of shoulder Under the interscalene anesthesia, the range of motion of internal rotation and external rotation were measured on flxed scapula and 90 degree abduction of shoulder, and the same method for group 2. We analyzed the results with two sample T-test and Wisconsin signed ranks test. Results: There was a significant difference between group 1 and group 2 for the ROM of shoulder. (IR; p<0.001,ER; p<0.001).For the group 1, internal and external rotation with the arm abducted 90 averaged 50 and 64 degrees and for the group 2, internal and external rotation averaged 77 and 90 degrees with significant difference(IR; p<0.001,ER; p<0.001).Conclusion: The range of motion of shoulder, especially internal and external rotation significantly decreased in SLAP lesions. Our results suggest that a limited rotational motion of shoulder closely related with SLAP lesion.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.4
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• pp.1-13
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• 2022

PURPOSE: This study examined the effects of the craniovertebral angle, proprioception (joint error test), and the upper trapezius on the muscle tone when comparing cervical stabilization and scapula stabilization exercises and when two exercises were performed together. METHODS: The participants in this study agreed in advance, and this study was carried out by recruiting 27 university students in their twenties with mild frontal posture. The subjects were assigned randomly to three groups that performed cervical stabilization exercises, scapular stabilization exercises, and both cervical and scapular stabilization exercises. One-way repeated ANOVA was used to analyze the evaluation values of the 1^st, 3^rd, and 6^th weeks of exercise intervention within the group, and one-way ANOVA was used to compare the difference in the effects of exercise intervention among the three groups. RESULTS: Proprioception was significantly different in the cervical stabilization exercises (CSE) group and the cervical stabilization exercises + Scapular stabilization exercises (CSE+SSE) groups at three weeks, and there was a significant difference between the scapular stabilization exercises (SSE) group and the CSE+SSE group (p < .05). At six weeks, there was a significant difference between the CSE group and the CSE+SSE group, and there was a significant difference between the SSE group and the CSE+SSE group (p < .05). There was a significant difference between three and six weeks in the CSE group (p < .05). In the SSE group, there was a significant difference between pre and six weeks, and between three and six weeks (p < .05). In the CSE+SSE group, there was a significant difference between pre and three weeks, and between pre and six weeks (p < .05). On the other hand, there were no significant differences between CVA and muscular tone in all three groups (P > .05). CONCLUSION: In all groups, the proprioception (joint error test) showed significant improvement, and the CSE+SSE group showed greater improvement than the other groups. As a result, the appropriate combination of neck stabilization exercise and scapular stabilization exercise effectively improved proprioception in the presence of forward head posture (FHP).

• Physical Therapy Korea
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• v.29 no.2
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• pp.117-123
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• 2022

Background: Push-up are effective exercises for shoulder stability. Previous studies have documented the effects of support plane and hand position and width on muscle activities during a push-up. Objects: This study aimed to investigate the changes in muscle activities in the upper extremity when performing the standard and the knee-flexed push-up with different hand shapes. Methods: A total of twenty-six healthy males participated in this study. Three different hand shapes (finger abduction, finger adduction, and fists) and two types of push-up posture (standard and knee-flexed push-up) were set as the independent variables. Electrograms were used to measure the muscle activity of the upper trapezius (UT), triceps brachii (TB), pectoralis major (PM), and serratus anterior (SA). Each participant performed the randomly assigned push-up to the sound of the metronome. The mixed-effect linear regression model was used to detect the changes in muscle activities after changing the hand shape and push-up posture. Statistical significance was set at α = 0.05. Results: The UT muscle activity was statistically significantly higher when performing push-up with fists than finger abduction (p = 0.035) or finger adduction (p = 0.044). During the standard push-up, the muscle activity in all muscles was that the push-up with fists showed the highest muscle activity compared to the finger abduction (p < 0.01) and finger adduction (p < 0.01). Regardless of the shape of the hand, UT had the lowest muscle activity compared to other muscles (p < 0.001). In contrast, the SA muscle had the highest muscle activity among four muscles during the standard push-up. Conclusion: Based on the results of this study, we suggest hand shape is related to the difficulty level of push-up either in the standard or the knee-flexed push-up, especially in the push-up with fists. In addition, knee push-up can be recommended as shoulder muscle-strengthening exercises for individuals with low shoulder muscle strength.

• Korean Journal of Ichthyology
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• v.35 no.2
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• pp.83-90
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• 2023

Five days after hatching in Konosirus punctatus, the larvae were 5.86~6.21 mm (mean 5.96 mm) in TL and ossified parasphenoid, prefrontal, premaxillary, dentary. Sixteen days after hatching, the larvae were 9.66~10.18 mm (mean 9.96 mm) in TL and ossified prootic, opisthotic, ectopterygoid, and epihyal. Twenty-five days after hatching, the larvae were 11.02~12.64 mm (mean 11.03 mm) in TL and ossified supraclavicle, posttemporal, four actinost. Twenty-eight days after hatching, the larvae were 11.98~12.81 mm (mean 12.34 mm) in TL and ossified frontal, pterotic, epiotic, exoccipital, basioccipital, preorbital, maxillary, hyomadibular, preopercle, opercle, hypohyal. Thirty-six days after hatching, the larvae were 15.26~16.39 mm (mean 16.11 mm) in TL and ossified scapula. 37 days after hatching, the larvae were 15.33~16.87 mm (mean 16.25 mm) in TL and ossified ethmoid, nasal, parietal, supraoccipital, and suborbital. Forty-five days after hatching, the larvae were 20.01~21.83 mm (mean 21.14 mm) in TL, and the shoulder girdle was completed by coracoid formation. Forty-eight days after hatching, the larvae were 22.46~24.03 mm (mean 23.20 mm) in TL and ossified articular and subopercle. When the juvenile reached 27.11~34.09 mm (mean 30.11 mm) in TL (53 days after hatching) completed ossification of the cranium, vertebrae, pelvic girdle, shoulder girdle, caudal bone, and pterygiophore.