• Title/Summary/Keyword: shoulder joint

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Descriptive Study for Sonographic Morphology of the 1st Facet of Subscapularis Footprint (견갑하건 부착부의 제1부착면에 대한 초음파 소견의 기술적 연구)

  • Sohn, Hoon-Sang;Wi, Chan Kuk;Shon, Min Soo
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.4
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    • pp.343-352
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    • 2019
  • Purpose: The purpose of this study was to document the sonographic morphology of the subscapularis footprint, particularly the 1st facet, of the non-pathologic subscapularis tendon and footprint, and analyze the correlation between the size of the 1st facet and the demographic variables. Materials and Methods: Between March 2015 and December 2017, retrospectively data analysis was performed for the ultrasound (US) scans of 115 consecutive shoulder (mean age 53.4 years, range 23-74 years) with non-pathologic subscapularis tendon and footprint. The sonographic findings of the 1st facet of the subscapularis footprint was a very unique, flat, broad, and plane angle in the upward direction, which were distinguished from the other facets. On US, the transverse (medio-lateral) and longitudinal (superior-inferior) length of the 1st facet on axis of the humerus shaft were recorded. The demographic variables, including age, site, body height, weight, body mass index (BMI), and arm length, were reviewed. Results: On US, the mean transverse length of the 1st facet was 12.75 mm (range 10.54-14.50 mm, standard deviation [SD] 0.712) and the mean longitudinal length was 12.22 mm (range 9.20-13.30 mm, SD 0.888). The transverse and longitudinal length of the size of the 1st facet were significantly greater in males than in females (p<0.001, p=0.001). Of the demographic data (body height, weight, BMI, arm length) that showed a significant positive linear correlation, the correlation with body height (transverse r=0.749, p<0.001; longitudinal r=0.642, p<0.001) showed the strongest relationship, and the correlation with the BMI was weakly related. The relationships between the size of the 1st facet to site/age were not statistically significant or appeared to have no linear correlation. Conclusion: The structural and morphologic features of the 1st facet of the subscapularis footprint on the US were identified. This will provide anatomic knowledge of an US examination for subscapularis tendon pathology.

Biomechanics analysis by golf drive swing pattern (골프 드라이브 스윙시 구질 변화에 따른 운동학적 분석)

  • Choi, Sung-Jin;Park, Jong-Jin;Yang, Dong-Ho
    • Korean Journal of Applied Biomechanics
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    • v.12 no.2
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    • pp.259-278
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    • 2002
  • This study divided straight success, pade success and failure with 7male golfers who have experiences more than 3 years, analyzed kinematic factors of golf swing to suggest scientifically. The conclusions were follows. 1) The wrist angle has significant difference in straight success, pade success and failure when swing of every pattern. There is no significant difference in pade success and failure. 2) The body twist angle has no significant difference in straight success, pade success and failure when swing of every pattern. There is no significant difference in pade success and failure. 3) The shoulder joint rotation angle has no significant difference in success, pade success and failure when swing of every pattern. There is no significant difference in pade success and failure. 4) The left hip joint vertical angle has no significant difference in straight success, pade success and failure when swing of every pattern. There is no significant difference in pade success and failure. 5) The hip joint rotation angle has no significant difference in straight success, pade success and failure when swing of every pattern. There is no significant difference in pade success and failure. 6) The trunk angle has no significant difference in straight success, pade success and failure when swing of every pattern. There is no significant difference in pade success and failure. 7 )The left knee joint angle has no significant difference in straight success, pade success and failure when swing of every pattern. There is no significant difference in pade success and failure. This study divided golf swing motion of pattern change in straight success, pade success and failure and analyzed the kinematic factors by 3-dimension cinematography to improve performance. In the future, many researchers have to study kinematic analysis to improve performance in every events.

The Etiology and Clinical Features of Acute Osteoarthritis in Children; 2003-2009 (최근 6년간 소아청소년기 급성 화농성 골관절염의 원인균과 임상 양상; 2003-2009)

  • Choi, Jin Hyoung;Choe, Young June;Hong, Ki Bae;Lee, Jina;Yoo, Won Joon;Kim, Han Soo;Park, Moon Seok;Cho, Tae Joon;Chung, Chin Youb;Lee, Hoan Jong;Choi, In Ho;Choi, Eun Hwa
    • Pediatric Infection and Vaccine
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    • v.18 no.1
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    • pp.31-39
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    • 2011
  • Purpose : This study was performed for the purpose of finding causative organisms and clinical features of septic arthritis or acute osteomyelitis in children. Methods : The study involved a retrospective review of the medical records of 63 microbiologically confirmed cases of acute pyogenic arthritis and osteomyelitis. All of the cases were brought about by community-associated infections and managed at the Seoul National University Children's Hospital or Seoul National University Bundang Hospital from June 2003 to July 2009. Results : The median age of all cases was 60 months and there were 35 males and 28 females. Major involved joints included the hip joint (15 cases), knee joint (7 cases), shoulder joint (4 cases), and elbow joint (4 cases). Also, major involved bones included the femur (20 cases), tibia (13 cases), humerus (7 cases), and radius (7 cases). Staphylococcus aureus was the most commonly identified causative organism, accounting for 49 cases (77.8%). Of the 49 isolates of S. aureus, methicillin-resistant S. aureus (MRSA) accounted for 8 cases (16.3%). Group B streptococcus spp. (GBS) and Salmonella spp. accounted for 3 cases, respectively. Nafcillin or cefazolin was often prescribed as an initial empirical antibiotic. There were 9 cases that were managed by a regimen that included vancomycin as the first choice. Fifty four cases (85.7%) recovered without any complications. Methicillin-sensitive S. aureus (MSSA), responsible for 41 cases, caused chronic complications in 3 cases. Of 8 cases caused by MRSA, 1 case showed chronic complication. There were no fatal cases. Conclusion : S. aureus remains the most common organism causing acute pyogenic arthritis and osteomyelitis of childhood acquired in the community. The high prevalence of methicillin resistance among S. aureus should be considered carefully in the selection of initial empirical antibiotics.

New Method and Clinical Results of Arthroscopic Mattress-Locking Suture for Small and Medium sized Rotator Cuff Tear (관절경적 매트리스 잠김 봉합술을 이용한 회전근 개 소범위 및 중범위 파열의 새로운 치료방법과 해부학적인 결과)

  • Ko, Sang-Hun;Park, Hang-Chang;Lee, Chae-Chil;Kim, Sang-Woo;Lee, Seon-Ho;Cha, Jeo-Ryung
    • Clinics in Shoulder and Elbow
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    • v.14 no.2
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    • pp.229-235
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    • 2011
  • Purpose: To compare the clinical and radiological result of arthroscopic Mattress Locking suture repair to that of a Simple suture repair with small and medium-sized rotator cuff tears. Materials and Methods: Among 92 patients who were followed up after arthroscopic repair in patients with small and medium-sized rotator cuff tear from April 2007 to October 2010, 27 patients who took Arthroscopic Mattress Locking suture were set as group I and 65 patients who took Simple suture were set as Group II. The average age of patients were 58 years old and average follow-up period was 30 months. For analysis, VAS, ASES and KSS were used to analyze the range of joint movement and pain. And, for the image result, MRI performed after operation were evaluated. Results: The average VAS, KSS, UCLA score and ASES prior to surgery improved in the last follow-up (p<0.001), while was no difference in two groups (p>0.001). In MRI follow-up examination, the 2 cases (7.41%) of group 1 showed increased rupture lesions with improved symptoms. And the 12 cases (18.47%) of group 2 showed increased rupture lesions with improved symptoms. Retears in the group I were significant less than the group II (p<0.001). Conclusion: Comparing patients with small and medium-sized rotator cuff tear who took arthroscopic mattress locking suture repair to those who took simple suture repair after over one year follow up period, the clinical result showed no significant difference between two groups. However, Mattress Locking suture repair showed excellent radiological result compared to simple suture repair when comparing rerupture.

Usefulness of Blood Pool Half Body in Three Phase Bone Scan in Patients with R/O Reflex Symphathetic Dystrophy Syndrome (반사성교감신경 이영양증후군 환자의 삼상 골 스캔 시 Half Body 혈액 풀 영상의 적용)

  • Lee, Moo-Seok;Lee, Hyo-Yeong;Yun, Jong-Jun;Lee, Hwa-Jin;Song, Hyeon-Seok;Park, Se-Yun;Jeong, Ji-Uk
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.105-110
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    • 2010
  • Purpose: Three phase bone scan was considered sensitive in Patients with Reflex Symphathetic Dystrophy Syndrome (RSDS). Generally, three phase bone scan in the RSDS patients shows increased uptake of one side extremity joint. But three phase bone scan has been performed with flow, blood pool and delayed scan. We performed blood pool half body scan in order to investigate its usefulness. Materials and Methods: From October 2007 to September 2009, three phase bone scan (flow, blood pool, half body blood pool, delayed) was performed after injection of 750 MBq of $^{99m}Tc$-DPD in diagnosed patients with RSDS (M:F=8:7, R:L=9:6). For quantitative analysis, we obtained the count ratios of bilateral hands by drawing a region of interest (ROI) in the three phase images and compared with the count ratios of shoulders in half body blood pool and delayed images. Results: In flow images, right/left ratios were $1.09{\pm}0.53$. In blood pool images, right/left ratios were $1.13{\pm}0.47$ (hand), $1.08{\pm}0.26$ (shoulder). In delayed images, right/left ratios were $1.24{\pm}0.75$ (hand), $1.11{\pm}0.31$ (shoulder). As a result, Log of right/left counts of the others and that of shoulder blood pool image were correlated well with statistical significance (Spearman's R, p<0.005 SPSS for windows ver.12.0). Conclusion: Half body blood pool scan may be helpful in the diagnosis of patients with RSDS. Moreover, Half body blood pool scan reduced false negative and false positive rates. In order to improve agreement on interpretation of RSDS, Blood pool half body scan should be established as common criteria.

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The Use of Arthroscopic UU Stich for Rotator Cuff Tear and Clinical Results (회전근 개 파열의 관절경하 봉합에서 새로운 봉합 방법의 이용)

  • Ko, Sang-Hun;Shin, Seung-Myeong;Choi, Young-Jin;Cha, Jae-Ryong;Park, Han-Chang
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.67-72
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    • 2011
  • Purpose: There are various known methods for arthroscopic rotator cuff repair. The purpose of this retrospective study is to report on the clinical results and anatomical results of UU repair surgery, which is a new repair method. Materials and Methods: We enrolled 156 patients (88 men and 68 women) who underwent UU repair for rotator cuff tears from January 2009 to May 2010 in our hospital. Their average age was 55 years old (range: 38~75 years old) and the average follow-up period was 12 months (range: 6~23 months). For determining the results, we evaluated the VAS for pain, the daily living index (ADL) in the ASES scores, the UCLA and KSS scores, and all these tests were conducted at the first hospital visit and 6 months and 1 year after surgery and at the final follow-up. During the follow-up period, MRI was performed 3 and 6 months after surgery only in the patients who consented to MRI scans to confirm the presence of re-rupture. Results: The average scores of the VAS as a pain indicator decreased from 7.0 before surgery to 2.7 after surgery (p<0.05). The UCLA and KSS scores increased from 22.2 to 32.5 and from 83.7 to 91.5, and the changes was significant (p<0.05). For the active joint range of motion, the average forward flexion was improved from 125 to 175 degrees, the average lateral external rotation was improved from 38 to 58 degrees, and the average abduction was improved from 104 to 169 degrees. Out of a total of 156 patients, re-rupture was observed in 4 cases (3%) of 117 cases (75%) for which MRI was performed (with consent) between 3 and 6 months after surgery. Conclusion: UU repair surgery as arthroscopic repair of rotator cuff tear is a good repair method that shows excellent clinical results and a low re-rupture rate.

Evauation of Injury Mechanism and Clinical Outcome Between Non-Traumatic and Traumatic Type II Slap Lesions (제 2형 SLAP 병변의 외상 유무에 따른 손상 기전 및 치료 결과의 분석)

  • Kim, Yong-Ju;Jeong, Hoon;Ha, Jong-Kyoung;Lee, Kwan-Hee;Choi, Sung-Hyun
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.244-249
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    • 2010
  • Purpose: Our goal of this study was to compare the mechanism of injury and the clinical outcomes between the non-traumatic and traumatic type II SLAP lesions. Materials and Methods: From January 2007 to May 2009, the sunjects of this study were 27 patients who had undergone operations for isolated type II SLAP lesions. The lesions were classified according to Burkhart's method. The lesions that were located on the anterior-superior labrum were classified as type I, those lesions located on the posterior-superior labrum were classified as type II and those lesions located on the anterior-posterior labrum were classified as type III. The clinical outcomes were evaluated by the UCLA score and the KSS score preoperatively and postoperatively. Results: Of the 27 cases, 16 cases were traumatic and eleven cases were non-traumatic. In the traumatic group, there were 12, 2 and 2 cases of type I, type II and type III, respectively (p=0.013). In non-traumatic group, there were 2, 6 and 3 cases of type I, type II and type III (p=0.026). Anterior lesions were more frequent in the traumatic group and posterior lesions were more frequent in the non-traumatic group. For the clinical outcomes, the mean preoperative UCLA score and KSS score were 18 (range: 14~23) and 48 (range: 32~76), respectively, and the postoperative UCLA score and KSS score were 32 (range: 28~33) and 86 (range: 71~92), respectively, in the traumatic group, and the preoperative UCLA score and KSS score were 21 (18~25) and 58 (41~68), respectively, and the postoperative UCLA score and KSS score were 29 (26~31) and 81 (68~89), respectively in the non-traumatic group. There was no significant statistical difference of clinical outcomes between the two groups (p=0.317, 0.405). Conclusion: In this study, the anatomical feature of type II SLAP lesion was associated with a trauma mechanism. Therefore, a trauma mechanism must be considered when planning the surgical treatment for type II SLAP lesions.

Analysis of Anatomical Conformity of Straight Antegrade Humeral Intramedullary Nail in Korean (한국인에서의 직선형 전향적 상완골 골수 내 금속정의 해부학적 적합성 분석)

  • Choi, Sung;Jee, Seungmin;Hwang, Seongmun;Shin, Dongju
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.6
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    • pp.498-503
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    • 2021
  • Purpose: The aim of this study were to find ideal entry point of straight antegrade humeral intramedullary nail (SAHN) for the treatment of proximal humerus fracture in Korean and to analyze anatomical conformity using computed tomography. Materials and Methods: From May 2014 to October 2016, the study was conducted retrospectively on 74 Korean patients who had taken computed tomography on both normal and affected shoulder joint as result of shoulder injury. The mean age of the patients was 64.5 years (range, 22-95 years). Radiologic evaluation was done using multiplanar reconstruction technique of the computer tomography on normal proximal humerus. We located ideal entry point of SAHN as the point where humerus intramedullary center axis and humeral head meet. Distance between the entry point and local anatomical landmark was measured. We defined the critical distance as the distance between entry point and the most medial point of the supraspinatus attachment site. For adequate fixation and avoidance of injury to rotator cuff, critical distance should be over 8 mm according to Euler, and we defined the critical type when it is less than 8 mm. Critical distance, sex, age, height, body weight, body mass index was evaluated for the statistical significance. Results: The ideal entry point was as follows: the mean anteroposterior distance, the sagittal distance to the lateral margin of bicipital groove, was 11.5 mm and the mean mediolateral distance, the coronal distance to the lateral margin of grater tuberosity, was 20.5 mm. The mean critical distance, distance from the entry point to the just medial to insertion of the supraspinatus tendon, was 8.0 mm. Critical type with critical distance less than 8 mm was found in 41 in 74 patients (55.4%). Conclusion: The ideal entry point of SAHN in Korean was located on 11.5 mm posteriorly from the lateral margin of bicipital groove and 20.5 mm medially from lateral margin of greater tuberosity. More than half of the cases were critical type. Since critical type can possibly cause rotate cuff injury during nail insertion on entry point, surgeon should consider anatomical variance before choosing surgical option.

A Comparison between Minimally Invasive Percutaneous Plate Osteosynthesis and Plate Fixation in the Treatment of Clavicle Midshaft Fracture (쇄골 간부 골절의 최소 침습적 경피적 금속판 고정술과 관혈적 수술 비교)

  • Yoo, Seong-Ho;Kang, Suk-Woong;Kim, Bu-Hwan;Song, Moo-Ho;Kim, Yeong-Joon;Park, Gyu-Taek;Kwack, Chang-Hun
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.1-6
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    • 2017
  • Purpose: To retrospectively compare minimally invasive percutaneous plate osteosynthesis (MIPPO) with open plate fixation for the treatment of clavicle midshaft fracture. Materials and Methods: Between November 2011 to May 2014, 40 cases that were followed for more than 1 year-among all cases of MIPPO and open plate fixation-were analyzed. The study population was divided into two groups: group A included 20 cases of MIPPO and group B included 20 open plate fixation cases. The comparative analysis between the two groups was based on the operative time, bone union, functional evaluation (American Shoulder and Elbow Society score), incision length, pain relief (visual analogue scale, VAS), and complication. Results: The bone union was successful for all the cases, and the functional evaluation scores of the shoulder joint were satisfactory for both groups (p>0.05). The operative time was 47.5 minutes and 58.7 minutes for group A and B, respectively (p<0.05). The incision length for group A was 6.2 cm and that for group B was 10.7 cm with statistical significance (p<0.05). Pain relief (VAS) after surgery for group A showed a quick recuperation in the early stages. For complications, there were 2 cases of dysesthesia and 1 case of malunion due to metal fixation failure in group A. There were 6 cases of dysesthesia and 2 cases of cosmetic problem due to hypertrophic scar in group B. Conclusion: Surgical results of clavicle shaft fracture were satisfactory for both groups, but group A had advantages of shorter operative time, minimal incision length, and better pain relief in the early stages compared with group B. However, we need further evaluations with long-term follow-up results and complications, such as malunion and exposure on radiation.

Kinemetic analysis of a thumping security motion with an expandable barton (경호원의 삼단봉 머리치기 동작의 운동학적 분석)

  • Kim, Yong-Hak;Kim, Sin-Hye;Jung, Sung-Bae
    • Korean Security Journal
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    • no.36
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    • pp.93-109
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    • 2013
  • This research is mainly based on the experimental result due to seek different outcomes whena certain security motion with a paticular gear is applied in a plausible confrontational situation. For the purpose of this research an Expandable Baton, which is one of the most commonsecurity equipments, was chosen to be applied in a situation of hitting a person's head. Alsothe results will be studied in the view of Kinematic theory. To demonstrate, 10 students who were majeored in Escort Crane studies at 'H' university werechosen as testees. The participants were grouped into two-one is practiced with the 'expanadable baton use program' and the other is pre-practiced. In this report two groups abovewill be reffered as 'group A' and 'group B' for conveniency. There were a number of differences and changes between two groups. Group B took more timethan the other group did. Group A spent about 0.428sec in section 'e2' and 0.230sec in section'e3' while Group B took 0.435sec, 0.232sec in each sections.To add on, more distinctive results were out when it was more focused on physical movements. Two gropus presented considerable changes- in an 'left-right' moving displacement-Group A;$2.16{\pm}0.9cm$ (left side), $3.78{\pm}1.42cm$ (right side), total $5.94{\pm}2.03cm$. Group B; $2.97{\pm}1.01cm$ (left side),$4.56{\pm}1.57cm$ (right side), total $7.53{\pm}2.13cm$.Continuously, different outcomeswere shown between two groups in a 'back and forth' moving displacement-Group A;$32.48{\pm}3.86cm$, $35.21{\pm}4.64cm$, total $69.36{\pm}5.72$. Group B; $34.50{\pm}6.12cm$, $37.04{\pm}3.70cm$, total $71.46{\pm}7.17cm$. Furthermore, changes in an 'up and down' moving displacement were - GroupA; $5.62{\pm}2.41cm$, $4.54{\pm}1.87cm$, total $10.11{\pm}1.57cm$. Group B; $6.33{\pm}1.78cm$, $4.86{\pm}1.85cm$,total $10.68{\pm}1.81cm$. To continue, there were few modifications of degree on participants' joints, espcially on 'Wristjoint', 'Elbow joint' and 'Shoulder joint', depend on different sections -Wrist joint;Group A; e1 $114.62{\pm}7.13$, e2 $68.27{\pm}6.37$, e3 $131.64{\pm}6.27$. Group B; e1 $112.62{\pm}6.13$, e2 $66.28{\pm}7.38$, e3$137.42{\pm}4.28$ and Elbow joint ; Group A e1 $132.31{\pm}6.55$, e2 $117.92{\pm}8.42$, e3 $144.41{\pm}6.32$. Group B; e1 $133.58{\pm}8.56$, e2 $114.45{\pm}8.21$, e3 $139.89{\pm}4.38$. Lastly, degree changes ofshoulder joint were; Group A; e1 $13.55{\pm}3.85$, e2 $131.42{\pm}11.24$, e3 $78.32{\pm}6.28$. Group B; e1$9.45{\pm}1.23$, e2 $136.74{\pm}13.21$, e3 $79.75{\pm}4.24$.

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