• The Korean Journal of Pain
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• 제18권2호
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• pp.156-160
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• 2005

Background: Frozen shoulder is not an uncommon disease, which is associated with chronic pain and joint movement limitation. However, there are numerous devices to assist in the treatment of shoulder pain, but their efficacy has not been proven and their use remains immensely controversial. Therefore, a randomized clinical study was conducted to determine the effectiveness of a low-frequency stimulator for the treatment of frozen shoulder. Methods: A randomized clinical trial was carried out on 40 patients with frozen shoulder, with 40 patients assigned to two groups; a control treatment group (group C, n = 20) and a low frequency stimulator application group (group T, n = 20). Both groups were given a routine treatment modality, such as trigger point injection, intramuscular stimulation or suprascapular nerve block etc. The level of the shoulder pain was evaluated using a 100mm VAS (visual analog scale) at each visit, with the limitation in the range of motion simultaneously evaluated. Results: All the subjects improved after treatment, with the VAS scores after termination of treatment showed a statistically significant reduction (P < 0.05). However, there was no significant difference between the two groups. One month after termination of 5 cycles of treatment, group T maintained their improved state, whereas the pain in some of those in group C reemerged, which also showed a statistically significant difference (P < 0.05). The limitation in the range of motion improved, with most subjects able to resume daily activity. Conclusions: Although the low frequency stimulation provided no more pain relief than routine treatment, the effect was significantly prolonged. From this result, low frequency stimulation can be considered to aide the therapeutic effect of classical frozen shoulder therapy.

• Clinics in Shoulder and Elbow
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• 제14권2호
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• pp.253-261
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• 2011

목적: 정형외과 의사로 하여금 비구속형 견관절 전치환술의 기본적인 원칙들을 더 잘 이해할 수 있게 함과 동시에, 적절한 수술적 치료를 시행하는데 도움을 주고자 한다. 대상 및 방법: 비구속형 견관절 전치환술의 생역학, 적응증 및 금기, 수술 기법, 합병증 및 결과에 관한 최근 추세를 심도 있게 다루고자 하였으며, keel 형태 또는 peg 형태의 관절와 삽입물중 어느 것을 사용하는 것이 적합한 지에 관한 논란 등 견관절 전치환술과 관련된 최근의 주된 관심사에 대해서도 살펴보고자 하였다. 결과 및 결론: 수술 후 합병증을 피하며 최선의 기능적 결과를 얻기 위해서는 견관절 전치환술의 생역학, 그리고 그 수술 기법과 주의점에 대한 철저한 이해가 필수적이다.

• Clinics in Shoulder and Elbow
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• 제10권1호
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• pp.136-139
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• 2007

견관절경 수술로 많은 질환을 치료할 수 있으며 개방 술식에 비하여 많은 장점을 가지고 있다. 드물게 견관절 수술 후 세척액이 관절외 연부조직으로 유출되어 목과 인두에 부종을 유발하는 기도합병증이 보고되고 있다. 이 논문은 관절경하 회전근 개 봉합 수술 후 치명적으로 발생했던 기도 폐쇄를 보고하고자 한다. 결론적으로 이러한 위험한 합병증을 예방하기 위해서는 마취된 환자의 경우 불편감을 호소할 수 없으므로 술자들의 경부 부종 상태를 주기적으로 점검하여야 할 것이다.

• The Korean Journal of Pain
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• 제21권1호
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• pp.57-61
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• 2008

Background: Shoulder joint injection is currently performed under fluoroscopic or computed tomography scan guidance. We performed this study to determine if an ultrasound guided shoulder joint injection through rotator cuff interval would have clinical usefulness. Methods: A total of 17 volunteers [12 women, 5 men; mean age 28 yr (23-32 yr)] received shoulder joint injection under multilinear ultrasound (5-10 MHz). Volunteers were positioned supinely on a table with their arm in a neutral position. The anterior shoulder region of the patient was sterilized using povidone iodine. A 24 gauge needle was introduced and directly visualized in real time as it passed obliquely from the skin surface to the inferior space of the biceps tendon. If there was little or no resistance to the injection, a contrast media (omnipaque) was injected and checked fluoroscopically. Results: Ultrasound guided shoulder joint injection through rotator cuff interval was successful in all cases. The average time taken for the procedure was $27.5{\pm}16.5sec$. The vertical distance from skin to the inferior space of the biceps tendon was $1.6{\pm}0.4cm$ and the distance of needle from the skin to the inferior space of biceps tendon was $2.8{\pm}0.6cm$. The procedure was well tolerated by all volunteers. Conclusions: Ultrasound guided shoulder joint injection through rotator cuff interval is an effective, rapid, and easy-to-perform injection technique. Ultrasound guided injection enables exact needle placement and avoids the use of both ionizing radiation and iodinated contrast material.

• 국제물리치료학회지
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• 제2권1호
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• pp.229-236
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• 2011

The purpose of this study was to comparatively analyze the active stability of shoulder joints according to the frequency of overhead motions, such as serving and spiking, engaged in by female professional volleyball athletes who play different positions, and to provide the results as the basic data for developing exercise programs to prevent shoulder joint injuries. The subjects of this study were 50 Korean female professional volleyball players and positions were as follows: left and right attackers, centers, setters, and liberos. The external rotation and internal rotation muscle strength and muscle strength ratios of the dominant and non-dominant arms of all subjects were measured using Biodex. The results of this study are as follows: Frist, no significant differences were found in the internal and external rotation muscle strength of the dominant and non-dominant arms between positions. Second, for the shoulder joint muscle strength ratio of the dominant arm, by position, the setter showed significantly greater stability compared to the other positions. Third, for the shoulder joint muscle strength ratio of the non-dominant arm, by position, no significant difference in stability between positions was found. Fourth, it was found that the dominant arm had significantly greater instability of the shoulder joint than the non-dominant arm for attackers and centers, but no significant difference was found for setters and liberos. This study comparatively analyzed the muscle strength ratios of the external/internal rotations and dominant/non-dominant arms, which can determine the stability of the shoulder joints between female professional volleyball playing positions that engage in jumps and spikes using only the dominant hand and positions that do not.

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

• Clinics in Shoulder and Elbow
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• 제11권1호
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• pp.13-18
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• 2008

견관절의 모든 병적 상황의 성공적인 치료에는 정확한 진단이 요구된다. 이학적 검사는 견관절 질환의 검사에 필수적인 요소이다. 통증, 근력의 저하, 운동범위의 감소, 그리고 불안정성은 다양한 견관절 병태생리에 의해 발생하는 가장 흔한 증상들이다. 따라서, 견관절 질환을 가진 환자에게 정교한 임상적 접근이 필수적이다. 다양한 진단적 검사와 임상적 측정을 포함한 표준화된 평가가 견관절 복합체에서 한 구성요소를 특정하게 검사함으로써 진단적 정확도를 향상시킨다. 대부분의 경우, 신중한 이학적 검사가 진단과 확진 및 추가적 조사를 위해 선택적으로 시도될 수 있는 영상학적 시술과 같은 특정 진단 기술을 계획하거나 제공하게 된다.

• 대한물리의학회지
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• 제8권1호
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• pp.41-48
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• 2013

PURPOSE: This study was to determine the effect of the plane of movement (sagittal plane vs. scapular plane) and shoulder flexion angle ($90^{\circ}$ vs. $130^{circ}$) during scapular protraction exercises in healthy subjects by investigating the elecromyographic (EMG) activities of the serratus anterior (SA), upper trapezius (UT), and pectoralis major (PM). METHODS: Twenty-one healthy subjects participated in this study. Subjects performed maximal scapular protraction at the $90^{\circ}$ or $130^{\circ}$ shoulder flexion angles in the sagittal or scapular planes. Surface EMG was recorded from the SA and UT, and PM muscles. Dependent variables were examined by 2 (plane) ${\times}$ 2 (angle) repeated measures of analysis of variance (ANOVA). RESULTS: Significantly increased EMG activities in the SA and UT were found during scapular protraction exercise at the $130^{\circ}$ shoulder flexion angle in the sagittal and scapular plane. Also, EMG activity of the PM significantly decreased at the $130^{\circ}$ shoulder flexion angle in the sagittal plane and the $90^{\circ}$ and $130^{\circ}$ shoulder flexion in the scapular plane. CONCLUSION: we recommend scapular protraction exercise at the $90^{\circ}$ shoulder flexion in the sagittal plane to selectively strengthen the SA muscle with limitation of upper trapezius activity and at the $130^{\circ}$ shoulder flexion in the scapular plane to selectively strengthen the SA muscle with limitation of pectoralis major activity.

• 대한관절경학회지
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• 제10권2호
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• pp.135-140
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• 2006

불안정성 견관절에 대한 진단과 치료는 정형외과 영역에서 가장 어려운 분야 중에 하나이다. 관절와 위에서 움직이는 상완골두의 아탈구와 정상적인 전이, 통증과 기능 저하를 일으키는 이완의 정도는 구별하기가 용이하지 않는 경우가 많다. 불행하게도 이 불안정성을 일으키는 모든 병변에 시행할 수 있는 가장 좋은 한가지의 치료법은 개발되어 있지 않다. 그러므로 불안정성의 방향과 정도뿐만 아니라 동반된 문제까지도 정확히 진단하는 것이 절대 필요하다. 해부학적 결손은 반드시 확인해야 한다. 불안정성에 대한 봉합술의 실패에 영향을 미칠 수 잇는 흔한 요인은 다음과 같다. 정확한 해부학적 병리소견을 확인하는 올바른 진단, 올바른 치료 방법에 대한 이유, 필요 없는 내고정물의 사용이나 불안정성, 관절염, 신경 및 혈관 손상 등을 남길 수 있는 도달법의 사용과 같은 기술적 결함 등이 있다. 술후 견관절의 안정성, 유연성, 지구력을 회복시켜 강도높은 스포츠나 노동에 복귀할 수 있는 잘 준비된 재활을 통해 추가적인 손상을 막아야 한다.

• Clinics in Shoulder and Elbow
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• 제14권1호
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• pp.134-139
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• 2011

목적: 광범위한 Hill-Sachs 병변을 동반한 전방 견관절 불안정성에 대한 관절경 하 Remplissage 술기를 고찰하고 저자들의 경험을 소개하고자 한다. 대상 및 방법: 골관절염이 없고, 견관절 주위의 골절이 없으며, 10회 이상의 재발성 탈구를 경험하였던 환자들 중에, 30~40% 이상의 광범위한 Hill-Sachs 병변 및 관절와 골 결손이 20% 미만인 경우를 대상으로 관절경 하 Bankart 병변 복원술과 함께 Remplissage 술기를 시행하였다. 결과 및 결론: 광범위한 Hill-Sachs 병변이 동반된 전방 견관절 불안정성에 대한 Remplissage 술기는 견관절의 안정성 및 임상적, 기능적으로 양호한 결과를 보여줄 수 있을 것으로 생각된다.