• Clinics in Shoulder and Elbow
• /
• 제23권3호
• /
• pp.159-165
• /
• 2020

Acromioclavicular (AC) joint dislocations account for about 9% of shoulder injuries. Among them, acute high-grade injury following high-energy trauma accounts for a large proportion of patients requiring surgical treatment. However, there is no gold standard procedure for operative treatment of acute high-grade AC joint injury, and several different procedures have been used for this purpose in clinical practice. This review article summarizes the most recent and relevant surgical options for acute high-grade AC joint dislocation patients and the outcomes of each treatment type.

• 한국전문물리치료학회지
• /
• 제2권2호
• /
• pp.108-118
• /
• 1995

The techniques of joint mobilization and traction are used to improve joint mobility or to decrease pain by restoring accessory movements to the shoulder joints and thus allowing full, nonrestriced, pain-free range of motion. In the glenohumeral joint, the humeral head would be the convex surface, while the glenoid fossa would be the concave surface. The medial end of the clavicle is concave anterioposteriorly and convex superioinferiorly, the articular surface of the sternum is reciprocally curved. The acromioclavicular joint is a plane synovial joint between a small convex facet on lateral end of the clavicle and a small concave facet on the acromion of the scapula. The relationship between the shape of articulating joint surface and the direction of gliding is defined by the Convex-Concave Rule. If the concave joint surface is moving on a stationary convex surface, gliding occur in the same direction as the rolling motion. If the convex surface is moving on a stationary concave surface, gliding will occur in an opposite direction to rolling. Hypomobile shoulder joints are treated be using a gliding technique.

• The Journal of Korean Physical Therapy
• /
• 제32권1호
• /
• pp.14-20
• /
• 2020

Purpose: This study examined the effects of early stabilization exercise focused on the scapulothoracic joint on the recovery of surgical patients due to rotator cuff tear. Methods: The subjects were 30 patients divided randomly into two groups. Group I consisted of 15 patients who practiced shoulder joint stabilization exercises, including glenohumeral joint movement. Group II consisted of 15 patients who practiced scapulothoracic joint stabilization exercises, excluding glenohumeral joint movement. The duration of stabilization exercise was 30 minutes for one day, five days a week, and five weeks. To measure the dependent variables, the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, range of motion (ROM), dynamometer of measured grip were used. Results: The DASH, ROM, and grip power were compared. A significant difference was observed before the intervention in each group (p<.05), and there was no significant difference between group I and group II (p>.05). Conclusion: Both shoulder joint and scapulothoracic joint stabilization exercises were effective after the intervention compared to preintervention, but there was no difference between the two groups. Unlike many recent studies on the initiation of stabilization exercises, this study allays the concerns between the advantages of 'early exercise' and oppositions of previous studies about 'early exercise'. Nevertheless, further research regarding these subjects is needed.

• Clinics in Shoulder and Elbow
• /
• 제19권3호
• /
• pp.179-185
• /
• 2016

Rheumatoid arthritis (RA) is a systemic disease with medication as the treatment of choice. However, surgical treatment is recommended when no improvement is noted despite aggressive conservative treatment. Synovectomy provides desirable outcomes for RA patients in the early stage with a glenohumeral joint of Larsen grade II or less; conversely, arthroplasty is recommended for patients with a glenohumeral joint of grade III or higher. RA patients often have attenuation and dysfunction of the rotator cuff, and reverse shoulder arthroplasty has been proven to provide favorable outcomes in some patients. RA is often complicated with osteoporosis and bony deformity; therefore, close attention is necessary to prevent fractures during shoulder arthroplasty.

• 대한물리치료과학회지
• /
• 제29권4호
• /
• pp.1-16
• /
• 2022

Background: This study was conducted to examine the correlation of VDT, posture and shoulder function among each group divided by according to the neck pain disorder index (NDI) scores for female patients with neck pain. Design: Cross-sectional study. Methods: Fifty adult women with neck pain voluntarily participated in this study and the neck pain disorder index questionnaire, VDT syndrome assessment tool questionnaire, craniovertebral angle, thoracic kyphosis angle, round shoulder posture, pectoralis minor length, shoulder joint hypermobility, and serratus anterior strength tests were conducted respectively. Subjects were divided into two groups where 21 subjects were allocated to the mild pain group whom have rated below 14 points on the NDI scores, and 29 subjects were in the severe pain group, whom have rated above 15 on the NDI score. Results: The study found that in the mean difference between variables in each group, VDT syndrome showed a higher mean score in the severe pain group than the mild pain group (p<0.05). In the group correlation and regression analysis, the mild pain group showed a significant negative correlation between the craniovertebral angle and round shoulder posture (r=-0.467, p<0.05), and the round shoulder posture for craniovertebral angle was shown to have significant positive influence (B=10.162, p<0.05). The severe pain group showed that the NDI and the VDT syndrome had a significant amount of correlation (r=0.520, p<0.01), the VDT syndrome showed significant positive influence (B=0.330, p<0.05), and the craniovertebral angle showed significant negative influence (B=-0.809, p<0.05). It was also shown that shoulder joint hypermobility had a significant negative correlation with the serratus anterior strength (r=-0.437, p<0.01), and that serratus anterior strength had a significant negative influence on shoulder joint hypermobility (B=-4.175, p<0.05). Conclusion: This study is of clinical significance in that it presented variables that should be considered depending on the degree of neck pain in treating patients with neck pain and that it presented patients with not only posture but also the function of the shoulder joint as factors to consider.

• The Korean Journal of Pain
• /
• 제11권2호
• /
• pp.226-229
• /
• 1998

Background: Treatment for frozen shoulder is various and difficult. It is important for pain clinicians to plan more effective and simpler treatment modalities. Pain clinicians have done suprascapular nerve block(SSNB) for treatment of frozen shoulder, but the effectiveness of treatment has been unsatisfactory. Shoulder joint injection(SJI) using local anesthetics and steroid mixture is a relatively simple procedure. This study was performed to compare therapeutic effects of SSNB and SJI in frozen shoulder. Methods: Eighty patients suffering from frozen shoulder were randomly divided into two groups. Group 1 had been treated with SSNB and physiotherapy for 3 weeks. Group 2 had been treated with SJI and physiotherapy for the same duration. Pain scores and treatment results were compared and analyzed at the time of 2 months after treatment started. Results: The VAS scores after SJI were lower than those of SSNB. Therapeutic results according to Haggart's classifications were significantly effective in group 2. Conclusion: These results show that SJI is more effective than SSNB for treatment of frozen shoulder.

• Clinics in Shoulder and Elbow
• /
• 제7권2호
• /
• pp.76-82
• /
• 2004

Purpose: In the traumatic anterior shoulder instability, the laxity of joint capsule and ligament is frequently demonstrated. Although a arthroscopic procedure to address anterior instability with joint capsular redundancy have generally provided good results, its recurrence rate is higher than open procedure. By reducing the capsular redundancy, thermal shrinkage is likely to improve the outcome of arthroscopic anterior stabilization. The objective of this study was to evaluate additional thermal capsular shrinkage as a treatment of joint capsular redundancy in anterior shoulder instability. Materials and Methods: From March 1999 to June 2000, 25 shoulders of 23 patients of recurrent anterior shoulder dislocation underwent arthroscopic Bankart repair with shrinkage procedure. The mean follow up was 29 months and average age at the time of operation was 26 years. Of these patients, 20 were male and 3 were female who had been experienced the average 8 times of dislocation before operation. Thermal shrinkage alone without Bankart repair was performed in two cases who did not have Bankart lesion. The clinical result was evaluated in according to Modified Rowe Score. Results: The Modified Rowe Score was improved from preoperative 35 points to postoperative 88 points. None of cases showed recurrence of dislocation. But, in two cases, temporary sensory hypesthesia of the axillary nerve was developed and in two cases of postoperative stiffness, arthroscopic capsular release and brisement were performed. Conclusion: Additional capsular shrinkage in arthroscopic technique to address recurrent anterior shoulder instability could treat effectively the capsular redundancy.

• 대한통합의학회지
• /
• 제7권3호
• /
• pp.109-115
• /
• 2019

Purpose : The purpose of this study was to investigate the activity of muscles around the scapulothoracic muscles according to the angle of shoulder joint abduction in the prone position. Methods : The participants included 15 adult males who had not undergone orthopedic surgery and did not have shoulder joint impairments. We measured the muscle activity of the upper trapezius, middle trapezius, lower trapezius, and serratus anterior at $120^{\circ}$, $90^{\circ}$, and $60^{\circ}$ shoulder joint abduction angles. Results : There was a significant difference in the comparison of muscle activity in the upper trapezius, middle trapezius, and serratus anterior muscles according to the shoulder joint abduction angle (p<.05). The results of the post test showed that the upper trapezius was significantly different between $120^{\circ}$ and $60^{\circ}$ (p<.01), and the middle trapezius was significantly different between $90^{\circ}$ and $120^{\circ}$, and between $90^{\circ}$ and $60^{\circ}$ (p<.05). There was a significant difference in the serratus anterior between $120^{\circ}$ and $90^{\circ}$ (p<.01), and $120^{\circ}$ and $60^{\circ}$ (p<.01). Conclusion : The results of this study could be used to determine an effective shoulder joint abduction angle to reduce muscle activity of the upper trapezius and increase muscle activity of the middle trapezius, lower trapezius, and serratus anterior.

• 대한기계학회논문집B
• /
• 제41권8호
• /
• pp.505-510
• /
• 2017

본 논문에서는 다양한 견관절 장애 증상에 적용할 수 있는 보급형 상지 재활 로봇의 설계를 다룬다. 견관절의 회전에 수반되는 관절 중심의 위치변화를 추종하고, 사용자의 상지와 장치의 무게를 상쇄하는 3자유도 견관절 추종 및 중력보상 메커니즘을 구현하였다. 다양한 방향의 어깨 재활 동작을 구현할 수 있도록 구동축의 방향을 변환하는 메커니즘을 설계하여, 견관절에 대한 구동기의 상대적인 오리엔테이션을 변화시킴으로써 대표적인 5가지 견관절 동작을 수행할 수 있었다. 동시에 재활 운동 중의 견관절의 위치 변화를 추종하여 자연스러운 견관절 운동을 구현할 수 있었다. 최소의 구동기를 사용하는 보급형 로봇으로도 다양한 견관절 질환에 효과적으로 대응할 수 있음을 확인하였다.

• Clinics in Shoulder and Elbow
• /
• 제9권2호
• /
• pp.196-201
• /
• 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.