• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.73-79
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• 2011

Purpose: To evaluate of the clinical usefulness of minimal invasive ulnohumeral arthroplasty in patients with mild to moderate elbow arthritis. Materials and Methods: From January 2000 to December 2008, twenty-nine patients with mild to moderate elbow arthritis underwent minimal invasive ulnohumeral arthroplasty. Among these patients, we reviewed the cases of 24 patients for whom we had follow-up data for at least 1 year. There were 20 males and 4 females with a mean age of 53 years (range: 31~69). We excluded patients with preoperative ulnar neuropathy symptoms and investigated the mean operation time, the joint range of motion, the time required until the start of joint exercise, and the Mayo elbow performance score (MEPS). Results: Passive and active joint exercises were started in an average of 1.8 days (range: 1~4) after surgery; the mean operation time was 38 minutes (range: 25~55). The elbow joint range of motion was 25-104 degrees (extension 0~70, flexion 80~130) preoperatively and was improved 40 degrees on average to 14-133 degrees (extension 0~45, flexion 90~150) after a year of follow up. The average time required until the start of joint exercise was 1.6 days (range: 1~5). MEPS were excellent in 9 cases and good in 5 cases after a year of follow up. Although there was 1 case of delayed wound healing and 7 cases of postoperative edema, they improved spontaneously. Conclusion: For patients with mild to moderate elbow arthritis, minimal invasive ulnohumeral arthroplasty is a clinically useful surgery since its operation time is short, early joint exercise is possible, and pain is mild.

• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.6-12
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• 2011

Purpose: We wanted to analyze and report on the radiologic and clinical results of prospective Hook plate fixation for unstable distal clavicle fractures after a minimum of 2 years follow up. Materials and Methods: We followed up 17 out of 20 cases that underwent prospective Hook plate fixation from 2008 to 2009. We performed radiologic follow up at 2 weeks, 6 weeks, 3 months, 6 months, 18 months and 24 months postoperatively. The clinical results were evaluated at 12 months and 24 months postoperatively. Results: The mean period for bony fusion was 14.5 weeks and the plate was removed after an average of 20.2 weeks. The VAS pain scores were 0.7 and 0.8, the UCLA scores were 33.5 and 33.3, the ASES scores were 92.8 and 92.5, the Constant-Murley scores were 81.5 and 77.0, the KSS scores were 92.5 and 94.3 and the ranges of motion were $173.3^{\circ}$ and $173.7^{\circ}$ of flexion, $56.0^{\circ}$ and $54.5^{\circ}$ of external rotation, $62.3^{\circ}$ and $63.5^{\circ}$ of the internal rotation, $172.0^{\circ}$ and $172.6^{\circ}$ of abduction and $43.3^{\circ}$, and $42.9^{\circ}$ of extension at 1 and 2 years follow-up, respectively. There was no statistically significant difference of clinical outcomes and the range of motion at 1 year and 2 year postoperatively (p>0.05). There was no other complication except 1 case of delayed union. Conclusion: For Hook plate fixation at 2 years postoperatively, the complications will be decreased and excellent clinical results should occur.

• Clinics in Shoulder and Elbow
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• v.12 no.1
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• pp.53-60
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• 2009

Purpose: Primary osteoarthritis on the elbow is the result of the growth of osteophytes and contracture of the capsule. It often causes disability on joint motion and pain while exercising. As arthroscopy has developed, the arthroscopic diagnosis and treatment of the elbow have recently become more generalized as well. Therefore, we like to report on arthroscopy for treating elbow arthritis and its results. Materials and Methods: This study includes 23 cases of elbow arthritis that were seen between 2005 June to 2007 June and these patients didn't response to conservative treatment. From this we excluded 18 cases that underwent arthroscopic surgery and among these 18 cases, 6 cases underwent ulnar nerve transfer. The average observation time was 21.3 months and the average age was 48.4 years (range: 22-66 years). The pre and post operative pain was evaluated with using the Visual Analogue Scale (VAS) and functional evaluation was done with using the Mayo elbow Performance Score (MEPS) with the range of joint motion. Results: The VAS score at the last follow up was significantly decreased from 3.4 to 1.9 compare to the preoperative score. The range of joint motion was improved by 25 (0-40) to 8.5 (0-20) in extension and 101.7 (80-140) to 125.2 (85-140) in flexion (p<0.05). The MEPS always showed significant improvement by showing an increase from 65.4 (40-85) to 87.9 (55-100). However, 3 cases showed a decreased range of motion after the operation. One case showed ulnar nerve symptoms after surgery. Conclusion: An arthroscopic procedure can treat the pathologic processes associated with arthritis of the elbow and it was safe and effective in this series.

• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.159-166
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• 2009

Purpose: We wanted to evaluate the surgical results of early mobilization after rigid fixation of small coronoid fracture using the tension band technique Materials and Methods: Eight cases of coronoid fracture were fixed with the tension band technique and using K-wire and wire through the medial approach. All the cases were Regan-Morrey type 2. According to O'Driscoll, they were classified as 5 cases of the tip type (subtype 2) and 3 cases of the anteromedial type (1 case of subtype 2, and 2 case of subtype 3). The associated collateral ligament injuries (6 cases) and radial head/neck fractures (4 cases) were managed simultaneously. After immobilization for 5~7 days, active ROM exercise with a fitted hinge brace started and continued till postoperative 6 weeks. The patients were assessed for pain, ROM and functional disability using the Mayo elbow performance score (MEPS) at an average of 11 months (range: 6~28 months). The ulnar nerve symptoms were also investigated. Results: We observed solid union in all the coronoid fractures without hardware failure. An average of 2.2 wires (range: 2~4) were used. The mean extension was $3^{\circ}$(range: $0^{\circ}\sim25^{\circ}$), the mean flexion was $137^{\circ}$(range: $130^{\circ}\sim140^{\circ}$), the mean pronation was $69^{\circ}$(range: $45^{\circ}\sim90^{\circ}$) and the mean supination was $78^{\circ}$(range: $45^{\circ}\sim90^{\circ}$). The mean MEPS was 96 (range: 65~100). Ulnar nerve symptoms occurred at postoperative one day and persisted in one patient with the terrible triad of taking radial head excision and residual medial instability. Conclusion: The tension band technique uses easily obtained, economic K-wires and the wire was strong enough to permit early elbow ROM exercise and the technique might improve the elbow function. It was especially useful for fixation of multiple small fragments.

• Journal of Korean Neurosurgical Society
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• v.58 no.1
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• pp.50-53
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• 2015

Objective : The purpose of this study was to evaluate radiographic/clinical outcomes of adolescent idiopathic scoliosis (AIS) patients treated by a Korean neurosurgeon. Methods : Ten AIS patients were treated by a single neurosurgeon between January 2011 and September 2013 utilizing segmental instrumentation with pedicle screws. Basic demographic information, curve pattern by Lenke classification, number of levels treated, amount of correction achieved, radiographic/clinical outcomes [by Scolisis Resarch Society (SRS-22r) questionnaire] and complications were evaluated to determine the surgical results. Pulmonary function test was utilized to assess forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) before and after surgery. Results : The average percentage of correction of the major structural curve was 73.6% (ranged from 64% to 81.5%). Preoperative and final postoperative absolute FVC averaged 3.03 L and 3.76 L (0.73 L increase, p=0.046), and absolute FEV1 averaged 2.63 L and 3.49 L (0.86 L increase, p=0.021). Preoperative and final postoperative average self-image and function scores of SRS-22r were, $2.6{\pm}0.5$, $3.3{\pm}0.1$, $4.0{\pm}0.5$, and $4.6{\pm}0.0$, respectively. There was a significant improvement of the self-image and function scores of SRS-22r questionnaires before and after surgery (p<0.05). There was no case of neurological deficit, infection and revision for screw malposition. One patient underwent a fusion extension surgery for shoulder asymmetry. Conclusion : Radiographic/clinical outcomes of AIS patients treated by a Korean neurosurgeon were acceptable. Fundamental understanding of pediatric spinal deformity is essential for the practice of AIS surgery.

• Journal of the Korean Arthroscopy Society
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• v.14 no.1
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• pp.49-52
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• 2010

Purpose: We introduce arthroscopically assisted mini-open rotator cuff repair using anterolateral approach. Operative Technique: Placing lateral decubitus position on general anesthesia, a standard arthroscopic glenohumeral examination is performed to evaluate lesions of shoulder joint through posterior and anterior portal. And then arthroscope is placed in the subacromial space and we evaluate the size of the torn tendon and perform arthroscopic acromioplasty through lateral portal. A 3 to 4 cm skin incision is performed from anterolateral edge of acromion to distal and dissected along to raphe between anterior and middle deltoid. A deltoid retractor is then placed, allowing direct visualization of the rotator cuff and humeral head. As torn tendon is tagged by traction suture, we try to anatomical reduction on the footprint and then perform single row or double row repair of the rotator cuff using suture anchors. To prevent avulsion of the deltoid from the acromion, additional sutures by bone tunnel with acromion and deltoid is performed. Conclusion: This technique is useful procedure to get direct approach to anterior portion of supraspinatus tendon and to need lesser deltoid retraction than portal extension approach due to dividing along to raphe between anterior and middle deltoid. Also it provide better visualization of the superior portion of subscapularis and infraspinatus.

• Korean Journal of Applied Biomechanics
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• v.16 no.2
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• pp.97-108
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• 2006

C. H. OH, S. N. CHOI, T. G. NAM, The Kinematic Analysis of the Tennis Flat Serve Motion, Korean Jiurnal of Sports Biomechanics, Vol. 16, No. 2, pp. 97-108, 2006. By the comparison and the analysis of the different factors during the tennis flat serve motion such as the required time per section, the movement displacement of the racket, the velocity of the upper limbs joints, the physical center of gravity, and the angle and the angular velocity of the upper limbs joints between an ace player and a mediocre player, these following results were drawn. First, the experiment result of the total time required per section in a tennis flat serve motion showed that an ace player was faster than a mediocre player by 0.4 seconds. This result suggested that it was required to increase the speed of the racket head by a swift swing to perform an effective flat serve motion. Second, the experiment result of the movement displacement of the racket in the tennis flat serve motion showed that an ace player greatly moved toward the left side on an x-axis. But both an ace and a mediocre player were shown to be at the similar points on a y-axis at the moment of the impact of the racket. An ace player was also shown to be located at a higher position on a z-axis by 0.23m. Third, the velocity of the center of gravity of an ace player was faster in every phase than that of a mediocre player in a tennis flat serve motion. Fourth, the velocity of the upper limb joints of an ace player was faster in every phase than that of a mediocre player in a tennis flat serve motion. Fifth, the experiment result of the speed of the racket head in tennis flat serve motion showed that a mediocre player was faster than an ace player in the first phase, but the latter was faster than the former in the second, third, and the fourth phases. Sixth, at the moment of impact of a tennis flat serve, an ace player had greater flexion of the angle of the wrist joints by an 11.8 degree than a mediocre player. An ace player also had greater extension of the angle of the elbow joint and the shoulder joint respectively by a 5.2 degree and a 1.4 degree with a mediocre player. Seventh, an ace player had greater angular velocity of the upper limb joints and the hip joints than a mediocre player at the moment of the impact of tennis flat serve. Eighth, an ace player was shown to have a greater change of the forward and the backward inclination (or the anterior and posterior inclination) of the upper body

• Korean Journal of Applied Biomechanics
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• v.15 no.3
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• pp.21-30
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• 2005

The purpose of this study is helps to make full use for perfect performance by grasping the defects of Tichonkich motion performed by athlete CSM For this, the study analyzed kinematical variables through Tichonkich motions performed at the first selection competition(1st trial) and final selection competition(2nd trial) for the dispatch to the 28th Athens Olympic Games using the three-dimensional cinematographical method with a high-speed video camera, and obtained the following results. 1. During Tichonkich motion, the execution time of up swing and the right hand moving to the left bar was shorter in the 2nd trial than the 1st one, while the execution time of down swing, the support of the left bar and the right hand moving to the right bar was longer in the 2nd trial than the 1st trial. 2. The horizontal position of COG in the 2nd trial was -35cm in the 1st stage, 42cm in the 3rd stage and 29cm in the 4th stage, that is, it showed a great swing focused on the circular movement compared to the 1st trial, while the vertical position of COG was -59cm in the 2nd stage, that is, it showed a small swing focused on a up and down movement. Also the 5th stage vertical position was 98cm, and the 6th stage vertical position was 95cm in the 2nd trial which were higher than those of the 1st trial, so it has provided magnificence required in the modern gymnastics. 3. And it was indicated that the horizontal velocity at the down swing phase proceeded forward more rapidly in the 2nd trial than that in the 1st trial, and the reverse ascent made a rapid vertical rise lessening left and right velocity change. And in the 5th stage, the 2nd trial was kept very slower in horizontal, vertical and left and right velocity that in the 1st trial, so it reached a handstand with leisurely movement. 4. In the 2nd trial, shoulder joint of the 1st, 2nd, 3rd stages kept a larger angle than that in the 1st trial, that is, it made a great swing while in the 1st trial, it showed a swing movement dependent on kick movement by the flexion and extension of hip joint. Also in the 2nd trial, the body formed a vertical posture with both hands supporting the left bar and hip joint was kept larger as $198^{\circ}$ and $190^{\circ}$ in the 5th and 6th stage than that in the 1st trial, so it made a handstand with the body uprightly stretched out, and magnificent and stable movement.

• Journal of Korean Medicine Rehabilitation
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• v.33 no.4
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• pp.125-144
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• 2023

Objectives This study aimed to investigate domestic clinical research trends in Shinbaro pharmacopuncture, identify diseases managed using Shinbaro pharmacopuncture, and suggest the direction for future studies to increase its clinical utilization. Methods This study used five steps proposed by Arksey and O'Malley and the PRISMA-extension for scoping reviews checklist. We examined published literature on Shinbaro pharmacopuncture studies reported until June 5, 2023, in the following eight databases (Research Information Sharing Service, Science ON, Oriental Medicine Advanced Searching Integrated System, KMBASE, The Society of Internal Korean Medicine, PubMed, EMBASE, and the Cochrane Library). The search terms used were 'Shinbaro' or 'Sinbaro'. Results A total of 47 studies were included in our analysis. Of these, 37 (78.7%) were interference time series studies. Shinbaro pharmacopuncture was the most frequently used treatment for lumbosacral disease (n=15). In the facial area, ST4 and ST6 were used in five out of six studies, and in the shoulder area, TE14 and LI15 were used in all studies. Nine of the 15 studies in the lumbosacral area used the EX-B2. The other parts mostly used the pressure points. Compared to other pharmacopuncture methods, the treatment effect was similar to that of bee venom, and faster than that of jungsongouhyul. Conclusions This is the first scoping review of Shinbaro pharmacopuncture therapy in South Korea. Studies with a high level of evidence based on sole treatment, large capacities, and standardization of Shinbaro pharmacopuncture need to be conducted to increase its clinical utilization.

• The Journal of the Korean bone and joint tumor society
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• v.20 no.1
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• pp.14-21
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• 2014

Purpose: To analyze the clinical features and treatment outcome of Langerhans' cell histocytosis. Materials and Methods: From August 1996 to June 2013, 28 patients who histologically proven with LCH were analyzed of medical records, radiography, pathologic character retrospectively. Results: A total of 28 cases of LCH including 22 child has been reported. Onset age was 0.6 to 51 years old, occurred in the average age was 14.8 years. Follow-up period was 6 months to 134 months average was 44.6 months. The M:F ratio was 2.5:1. The initial symptoms was pain in 18 cases, 5 cases of pathologic fracture, 3 case of palpable mass, 1 case of discovered by accident in radiography, 1 case of torticollis. In radiological examination osteolysis was seen all cases, 7 cases showed a periosteal reaction, 1 case showed soft tissue extension. Clinical type of all cases were eosinophilic granuloma. 25 cases were classified as unifocal disease and 3 cases were multifocal single systemic diseases. In all cases, incisional biopsy was performed. After histologic confirmed, 14 cases was treated with curettage or surgical excision of the lesion and the other 14 cases were followed up without treatment. There is no death during follow up period. 11 cases has no radiological improvement after 3-6 months observation, intralesional steroid injection was performed. Conclusion: Patients with LCH who has rapid systemic onset is very rare, so if you meet the young children who suspected LCH, you shoulder avoid the examination which cause excessive radiation exposure to the young patient. In order to confirm the diagnosis of disease, biopsy is needed. Close observation after confirmed by histological method will bring the satisfactory results. But the patients who had pathologic fracture or wide bone destruction already may need curettage and bone grafting to lesion or internal fixation. The lesion which has no radiological improvement after 3-6 months observation or appear with pain interferes daily life may need local steroid injection as a good treatment.