• Title/Summary/Keyword: 상완골 두

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Revision after Instability Surgery (수술 후 재발한 견관절 불안정증의 치료)

  • Kim, Paul Shinil;Jo, Chris Hyunchul
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.5
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    • pp.374-382
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    • 2020
  • Recurrence is the most common complication after shoulder instability surgery, and the main causes of the postoperative recurrence of instability are trauma, misdiagnosis, and technical errors. The risk factors of recurrence may be classified as patient related, anatomical or technical. Causes of failure should be thoroughly evaluated by meticulous history taking, physical examination, and imaging studies, and followed by proper treatment of pathologic lesions. Nonoperative treatment should be considered initially in cases of recurred instability after shoulder instability surgery, but if this fails, repeated recurrence is prevented by performing appropriate anatomical reconstruction of ruptured Bankart lesions, capsular laxities, glenoid deficiencies and humeral head bone defects.

Debridement or Tuberoplasty for Massive Rotator Cuff Tear (광범위 회전근 개 파열에 대한 변연절제술 및 결절성형술)

  • Cho, Nam-Su;Oh, Hyun-Sup;Rhee, Yong-Girl
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.146-152
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    • 2010
  • Purpose: The purpose of this article was to review the effectiveness of arthroscopic debridement and tuberoplasty, and to evaluate the clinical and radiologic results of our series for irreparable massive rotator cuff tears in the elderly. Materials and Methods: We reviewed articles that focused on the treatment options and decision making for irreparable massive rotator cuff tears. In particular, we summarized the reported results of arthroscopic debridement and tuberoplasty for irreparable massive rotator cuff tears in the elderly. Among consecutive patients who had arthroscopic tuberoplasty for irreparable massive rotator cuff tears in our series, thirty-two patients available for clinical and radiological evaluation at a mean follow-up of 29 months (range, 13-52 months) were enrolled and reviewed for the analysis. Results: At the last follow-up, the range of active forward flexion increased significantly with excellent pain relief and improvement in the ability to perform the activities of daily living. However, the group with less than 2 mm in preoperative acromiohumeral distance showed inferior postoperative results. Conclusion: Arthroscopic tuberoplasty may be an alternative option in irreparable massive rotator cuff tears for pain relief and improvement of range of motion. However, good results can not be expected if the acromiohumeral distance is less than 2 mm preoperatively and decreases postoperatively, or when the preoperative range of motion is less than $90^{\circ}$ on flexion and abduction.

Operative Treatment of Fractures of the Midshaft Clavicle using Locking Compression Plate (Locking Compression Plate를 이용한 전위성 쇄골 간부 골절의 수술적 치료)

  • Chung, Nam-Sik;Hong, Ki-Do;Ha, Sung-Sik;Park, Sung-Joon;Kang, Jung-Ho;Sim, Jae-Cheon
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.5 no.1
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    • pp.63-68
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    • 2006
  • Purpose: To assess the effectiveness of the Locking compression plate (LCP) after open reduction for the treatment of the displaced clavicular shaft fracture, the clinical and radiologic outcome of the patients who were managed with the LCP for internal fixation after open reduction has been analyzed. Materials and Methods: We reviewed 26 cases with a displaced clavicular shaft fracture treated by internal fixation using Locking compression plate after open reduction between May 2003 and November 2004. The patients were followed up for at least six months period, and final postoperative outcome was evaluated using clinical results based on Kang's criteria, radiologic signs of fusion. Results: All fractures united by an average of 9.3 weeks without delayed union and showed fast recovery of motion fraction and shoulder function. In addition,24 cases without the fractures of proximal humerus recovered to normal range of shoulder notion within 2.9 weeks. Clinically, according to Kang's criteria, the outcome was good or better in 22 patients. The complications included shoulder joint dysfunction in two cases and keloid formation in one case, and no other complications were observed. Conclusion: The internal fixation using LCP for the treatment of displaced clavicular shaft fracture is a safe, reliable method of treatment, with few complications, and offers rapid recovery of shoulder joint function and bone union.

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Magnetic Resonance Imaging Assessment of Acromion Morphology and Superior Displacement of the Humeral Head in the Impingement Syndrome (충돌 증후군에서 견봉 형태 및 상완골 두 상방 전위의 자기공명영상 분석)

  • Koo Bon Seop;Kim Kyung Chul;Oh Jung Hee
    • 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.

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Exploratory Arthroscopic Treatment to Diagnose and Treat Osteochondritis Dissecans of the Shoulder Joint in a Dog (개의 어깨 관절에서 박리성 골연골염의 진단과 치료를 위한 탐색적 관절내시경의 적용)

  • Kim, Choong-Sup;Lee, Hae-Beom;Choi, Ul Soo
    • Journal of Veterinary Clinics
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    • v.30 no.2
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    • pp.146-149
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    • 2013
  • A 6-month-old, intact male Great Pyrenees (35 kg) was referred with 2 weeks continuous left forelimb lameness to the Chonbuk Animal Medical Center, College of Veterinary medicine, Chonbuk National University. The lameness became worse three days before being referred to the hospital. Upon the physical examination, the patient had pain when the left shoulder joint was palpated, and the lameness was visible in the left forelimb during ambulation on gait examination. There were no remarkable findings on radiological and neurological examination. Osteochondritis dissecans (OCD) was suspected based on medical history and gait tests. As a definitive diagnosis could not be made, exploratory arthroscopic surgery was performed to examine the inside of the shoulder joint. During the operation, mild bicipital tenosynovitis, synovitis and OCD which was located on the caudal medial area of humeral head were revealed. Arthroscopic procedures were used for the treating OCD, including the removal of the OCD flap and debriding of the subchondral defect until hemorrhaging by use of an electrical burr. The patient was discharged a day after surgery. After 2 weeks, the patient again presented at the hospital due to complications, including inflammation of the surgical lesion because of licking and seroma within the subcutaneous tissue. Antibiotics were administered and an aseptic bandage was applied. And simple surgical operations were performed for the removal of the cyst and seroma. Eleven weeks following arthroscopy, the lameness was completely resolved. Arthroscopy has the advantage of allowing gross examination inside the joint capsule. Due to this advantage, arthroscopy is one of the best advanced options for diagnosis in dogs with undiagnosed joint pain.

Arthroscopic Bankart Repair with Suture Anchor (Bankart 병변의 봉합나사를 이용한 관절경적 봉합술)

  • Kim Kyung Taek;Kim Chul Hong;Kim Sung Hoo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.2
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    • pp.149-153
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    • 2002
  • Purpose: To evaluate the efficacy of arthroscopic Bankart repair using suture anchors for treatment of traumatic anterior instability of shoulder joint .Materials and Methods: We performed arthroscopic Bankart repair using suture anchor in 54cases and evaluated the results with the functional grading system of Rowe and Zarins after patients were followed up for more than 12 months. Results: Combined pathologies identified under arthroscopy were Hill-Sachs lesion in 28 cases, SLAP lesion in 6 cases and chondromalacia of humeral head in 6 cases. The results were excellent or good in 50 cases(92.6$\%$), and redislocation was happened only two cases. Conclusion: We conclude that arthroscopic Bankart repair with suture anchors is one of the reliableand effective method for treatment of recurrent shoulder dislocation with Bankart lesion.

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Compression Neuropathy (압박성 신경병증)

  • Kim, Byung-Sung
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.1 no.2
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    • pp.128-133
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    • 2008
  • Nerve compression is caused by external force or internal pathology, which symptom develops along nerve distribution. There are median, ulnar and radial nerve compression neuropathies below elbow. Carpal tunnel syndrome at the flexor retinaculum is most common among all the entrapment neuropathies. Other causes of median nerve neuropathy include Struther's ligament, biceps aponeurosis, pronator teres, FDS aponeurosis and aberrant muscles, which induce pronator syndrome or anterior interosseous nerve syndrome. Ulnar nerve can be compressed at the elbow by arcade of Struther, medial epicondylar groove, FCU two heads, which develops cubital tunnel syndrome, at the wrist by ganglion, fracture of hamate hook and vascular problem, which develops Guyon's canal syndrome. Radial tunnel syndrome is caused by supinator muscle, which compresses its deep branch. Treatment is conservative at initial stage like NSAID, night splint or steroid injection. If symptom persists, operative treatment should be considered after electrodiagnostic or imaging studies.

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Effect of Different Maturity Scores and Number of Extractions on the Sensory Traits of Water Extract from Hanwoo Shank Bones (한우 성숙도와 추출횟수가 사골용출액의 관능 특성에 미치는 영향)

  • Kim, Jin-Hyoung;Cho, Soo-Hyun;Seong, Pil-Nam;Hah, Kyung-Hee;Yun, Yeong-Tak;Lim, Dong-Gyun;Park, Beom-Young;Lee, Jong-Moon;Kim, Dong-Hun;Ahn, Chong-Nam
    • Food Science of Animal Resources
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    • v.28 no.1
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    • pp.45-50
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    • 2008
  • This study was conducted to investigate the effect of different maturity scores [2 (bull), 2 (steer), 3-9 (cow)] and the number of extractions on water extract from Hanwoo shank bones (arm, fore shank, round and hind shank) with regard to sensory traits (white color, aroma, taste, overall acceptability). The white color of water extract from Hanwoo shank bones of maturity score 2 (bull and steer) was lighter than with maturity scores of 3-9 (cow) (p<0.05). The aroma of water extract from Hanwoo shank bones of maturity score 2 (bull and steer) was stronger than with other maturity scores 3-9 (cow) except for maturity score 5 (p<0.05). The taste and overall acceptability of water extract from Hanwoo shank bones of maturity score 2 (bull and steer) were higher than with maturity scores of 3-9 (cow) (p<0.05). The white color, aroma, taste and overall acceptability of water extract from Hanwoo shank bones of all maturity scores significantly decreased as the number of extractions (from 2nd to 4th) increased (p<0.05). In conclusion, there were significant differences between maturity scores 2 and maturity scores 3-9 (cow) with regard to sensory traits. Further studies need to address whether different maturity scores affect the price of shank bones in the meat industry.

Effect of Maturity Scores and Number of Extractions on the Chemical Properties of Water Extract from Hanwoo Shank Bones (한우 성숙도와 추출횟수가 사골용출액의 화학적 특성에 미치는 영향)

  • Kim, Jin-Hyoung;Cho, Soo-Hyun;Seong, Pil-Nam;Hah, Kyung-Hee;Jeong, Jin-Hyung;Lim, Dong-Gyun;Park, Beom-Young;Lee, Jong-Moon;Kim, Dong-Hun;Ahn, Chong-Nam
    • Food Science of Animal Resources
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    • v.27 no.4
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    • pp.463-468
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    • 2007
  • This study was conducted to investigate the effect of maturity scores [2 (bull), 2 (steer), 3-9 (cow)] and the number of extractions (up to 4 times) on the chemical properties of water extract from Hanwoo shank bones (arm, fore shank, round and hind shank). The turbidity, meat color (CIE L value), collagen, protein, caloric and chondroitin sulfate contents of samples were observed. The turbidity and lightness were higher for water extract of Hanwoo shank bones with a maturity score of 2 (bull and steer) than maturity scores of 3-9 (cow) (p<0.05). The turbidity and lightness of water extract from shank bones of all Hanwoo maturity scores significantly increased with the 1st and 2nd extractions, but significantly decreased with 3rd and 4th extractions (p<0.05). The collagen and protein contents were highest for water extract from Hanwoo shank bones of maturity score 2 (bull and steer) (p<0.05). The caloric and chondroitin sulfate contents were higher for water extract from Hanwoo shank bones of maturity score 2 (bull and steer) than maturity scores of 3-9 (cow) (p<0.05). As the number of extractions increased, the chondroitin sulfate content significantly decreased (p<0.05). Based on these results, differences correlating with maturity scores were found only with collagen and protein contents. Therefore, further studies should be considered to address whether different maturity scores affect the price of shank bones in the meat industry.