• Title/Summary/Keyword: Shoulder Lesions

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Current Concepts in Arthroscopic Treatment of Anterior Shoulder Instability (견관절 전방 불안정에 대한 관절경적 최신 치료 경향)

  • Seo, Jae-Sung
    • Journal of Yeungnam Medical Science
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    • v.20 no.1
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    • pp.13-27
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    • 2003
  • In the past, the report of shoulder instability undergoing open shoulder stabilization had satisfactory outcomes of greater than 90%. However, the functional loss of open procedure is severe in abduction and external rotation especially. Current arthroscopic techniques for shoulder instability result in success rate equal to open surgical procedure when the labrum is properly fixed to the glenoid rim using suture anchors, the capsule is tightened, and associated bony and soft tissue pathology is addressed. The arthroscopic surgery facilitates the view within shoulder joint for more accurate diagnosis, reduces operating time, minimises postoperative pain, reduces operative morbidity, improves shoulder function, and provides the possibility to perform other procedure simultaneously. However, to accomplish a successful arthroscopic stabilization procedure and to prevent complications, numerous advanced arthroscopic skill must be mastered. Although the arthroscope provides means to visualize new lesions, the pathomechanism and biomechanical explanation is not clear yet. Further studies are necessary to develop for shoulder reconstruction.

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Volleyball: Shoulder Injuries and Rehabilitation (배구: 견관절 손상과 재활)

  • Moon, Young-Lae;Han, Jae-Suk
    • Clinics in Shoulder and Elbow
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    • v.5 no.2
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    • pp.63-68
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    • 2002
  • Volleyball has become one of the world's most popular participatory sports in recent years. There are many dynamic skills and movements needed to play the game. As a result, many acute and overuse injuries to the shoulder may occur. This article addresses the common injuries and rehabilitation recommendations for the shoulder injuries in the volleyball players. The glenohumeral instability, primary or secondary impingement, internal impingement, labral injuries, and suprascapular nerve lesions are common problems in volleyball players. A basic knowledge of the biomechanics and volleyball maneuvers (blocking, serving, and spiking) can help in the development of appropriate trainging and reha- bilitation protocols. Special emphasis must be placed on the knowledge of muscular patterns involved in serving and spiking, because they typically require a strenuous unilateral action of the dominant shoulder. It is therefore impera- tive to include adequate stretching and muscular training programme for the prevention, as well as for therapy, of shoulder pain in volleyball players.

Acromioclavicular joint dislocation and concomitant labral lesions: a systematic review

  • Jad Mansour;Joseph E Nassar;Michel Estephan;Karl Boulos;Mohammad Daher
    • Clinics in Shoulder and Elbow
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    • v.27 no.2
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    • pp.247-253
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    • 2024
  • Acromioclavicular (AC) joint dislocations frequently co-occur with intra-articular glenohumeral pathologies. Few comprehensive studies have focused on labral tears specifically associated with AC joint trauma. This systematic review will address this gap. A comprehensive electronic search was conducted across PubMed, Cochrane Library, and Google Scholar (pages 1-20) spanning from 1976 to May 19, 2023. Seven studies met the inclusion criteria for this systematic review, consisting of three retrospective studies and four case series. These studies collectively involved 1,044 patients, of whom 282 had concomitant labral lesions. The pooled prevalence of intra-articular labral injuries associated with acute AC joint dislocation was 27%. The prevalence of these labral lesions varied significantly between studies, ranging from 13.9% to 84.0% of patients, depending on the study and the grade of AC joint dislocation. Various types of labral tears were reported, with superior labrum anterior to posterior (SLAP) lesions being the most common. The prevalence of SLAP lesions ranged from 7.2% to 77.4%, with higher grades of AC joint dislocations often associated with a higher prevalence of SLAP tears. Moreover, grade V dislocations exhibited a complete correlation with SLAP tears. The studies yielded contradictory findings regarding older age and higher grades of AC joint dislocation as risk factors for concurrent labral lesions. This review underscores the frequent association between labral lesions and AC joint dislocations, particularly in cases of lower-grade injuries. Notably, SLAP lesions emerged as the predominant type of labral tear.

Traumatic Anterior Shoulder Dislocation in Patients Older than 60 Years of Age (60세 이상 환자에서 발생한 외상성 견관절 전방 탈구)

  • Ha, Jong-Kyoung;Yoo, Jae-Doo;Park, Sung-Pil;Shin, Sang-Jin
    • Clinics in Shoulder and Elbow
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    • v.9 no.1
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    • pp.42-49
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    • 2006
  • Purpose: This study evaluated clinical results, and recommended treatment protocol of traumatic anterior shoulder dislocation in the patients older than 60 years of age. Materials and Methods: Thirty-eight patients with first traumatic anterior shoulder dislocation aged over 60 years were included. The average age was 69.4 (range, 60 to 87 years). There were 8 men (average age of 71.6) and 30 women (average age of 69). Most common cause of injuries was a fall on the outstretched hand. The additional injuries were evaluated using MRI or CT arthrogram in the patients with significant pain and weakness while movements after 2 weeks sling immobilization. Results: Fifteen patients (39%) had rotator cuff tears and 5 patients (14%) had greater tuberosity fractures. The sizes of rotator cuff tears were diverse; 2 partial tears, 1 small tear, 4 medium tears, 3 large tears and 5 massive tears. Among 5 massive cuff tears, 3 patients revealed cuff arthropathy after reduction. 4 patients (11%) had recurrent dislocation more than one time during 1 month after the first dislocation. Bankart lesions revealed in 5 patients and three of them had associated rotator cuff tears. 3 out of 5 patients with Bankart lesions, 13 out of 15 patients with rotator cuff tears and 3 patients with displaced greater tuberosity fracture had operations. Conclusion: The injury mechanism of shoulder dislocation in patients older than 60 years of age seems to have either anterior or posterior mechanism. The diagnosis and treatment should be approached 2 weeks after dislocation.

Improvement of Upper Extremity Function and Leisure Satisfaction of Children with Brain Lesions through Sports Stacking Activities: A Case Study

  • Ae-Lyeong Kwon;Ki-Jeon Kim
    • The Journal of Korean Physical Therapy
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    • v.36 no.2
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    • pp.53-60
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    • 2024
  • Purpose: This study aimed to investigate changes in upper extremity joints and leisure satisfaction in children with brain lesions through sports stacking activities. Methods: A sports stacking program was conducted on three children with brain lesions who had upper extremity joint limitations and joint range of motion lower than the normal range. It was conducted 10 times, 1 to 2 times a week, 40 minutes each time. Upper extremity joint angles were measured using a goniometer in the order of shoulder, elbow, wrist, and fingers, and leisure satisfaction was measured using a smile evaluation. Results: As a result of measuring the upper extremity joint angles, all three children showed slight angle changes in the shoulder, elbow, and wrist areas. Differences in joint angles appeared differently for each child. Smile evaluation results were evaluated in various psychological, educational, and physical aspects. Only child A was evaluated for Smile Evaluation No. 1. Conclusion: Sports stacking activities changed the upper extremity function of children with brain lesion disorders and showed differences in psychological, physical, and educational aspects of leisure satisfaction. As this is a short-term study result, the change in upper extremity function is minimal, but if sports stacking activities are continued, it will be a rehabilitation program that can prevent upper extremity dysfunction and improve physical strength. Accordingly, continuous attention should be paid to increasing accessibility and enjoyment of daily life according to individual characteristics and level.

Arthroscopic Anterior Acromioplasty for the Treatment of Chronic Impingement Syndrome of the Shoulder (관절경적 전방 견봉 성형술을 이용한 만성 견관절 충돌 증후군의 치료)

  • Park Tae-Soo;Kim Jae-Young
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.1
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    • pp.49-53
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    • 2000
  • Purpose : The purpose of this study was to evaluate clinical efficacy of the arthroscopic anterior acromioplasty for the treatment of chronic impingement syndrome of the shoulder. Materials and Methods : Between July 1995 and December 1997, twenty seven consecutive shoulders of 26 patients with chronic impingement syndrome of the shoulder were treated by arthroscopic anterior acromioplasty. The patients who had severe osteoarthritis of the shoulder full thickness tear of the rotator cuff, and nonoutlet impingement were excluded. The clinical results were evaluated by using UCLA shoulder rating scale. The average follow-up was 2years 3months(range, 1year 7months to 3years 1 11months). Results : Twenty three patients$(85.2\%)$ were rated as excellent or good results, while four patients$(14.8\%)$ were fair. Twenty six cases$(96.3\%)$ were satisfied with the results of the operations, while one case$(3.7\%)$, who had Parkinsonian syndrome, ossification of posterior longitudinal ligament(OPLL) of the cervical spine, and spinal stenosis of the 5th and 6th cervical spine was not satisfied. Conclusion : Arthroscopic anterior acromioplasty was an effective treatment method, especially for relief of pain, for the treatment of chronic impingement syndrome of the shoulder. If the patient has the combined lesions in the cervical spine and the shoulder, and systemic lesions, these lesions may influence the results of treatment after operation, and cause the unpredictable results.

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Arthroscopic Treatment of a Type II Superior Labrum Anterior to Posterior (SLAP) Lesion Combined with a Bankart Lesion: Comparative Study between Debridement and Repair of Type II SLAP Lesion by the Status of Lesion

  • Lee, Sung Hyun;Joo, Min Su;Lim, Kyeong Hoon;Kim, Jeong Woo
    • Clinics in Shoulder and Elbow
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    • v.21 no.1
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    • pp.37-41
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    • 2018
  • Background: The purpose of this study is to evaluate results of superior labrum anterior to posterior (SLAP) repairs and debridement of type II SLAP lesions combined with Bankart lesions. Methods: Between 2010 and 2014, total 58 patients with anterior shoulder instability due to a Bankart lesion combined with a type II SLAP lesion were enrolled. Patients were divided into two groups: group C consisted of 30 patients, each with a communicated Bankart and type II SLAP lesion and group NC consisted of 28 patients, each with a non-communicated Bankart and type II SLAP lesion. Bankart repairs were performed for all patients. SLAP lesions were repaired in group C and debrided in group NC. Clinical results were analysed to compare groups C and NC by using the visual analogue scale pain score, American Shoulder and Elbow Surgeons score, Constant scores, Rowe score for instability and range of motion assessments. Results: The clinical scores were improved in both groups at final follow-up. Also, there were no differences between two groups. No significant difference was found in terms of the range of motion measured at the last follow-up. The number of suture anchors used was significantly higher in group C than in group NC (5.6 vs. 3.8; p=0.021). Conclusions: In this study, it is considered that Bankart repair and SLAP debridement could be a treatment option in patients with a non-communicated type II SLAP lesion combined with a Bankart lesion (study design: IV, therapeutic study, case series).