• Journal of Korean Medicine Rehabilitation
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• v.29 no.3
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• pp.173-182
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• 2019

This study is to report the effectivenes of Meridian-Test (M-test) in 2 cases on shoulder diseases. The M-test was applied to one patient diagnosed with as impingement syndrome and one patient diagnosed with tear of supraspinatus tendon. The changes in numeral rating scale and range of motion were identified to assess the progress of the treatment. After three times treatments, In example 1, the pain decreased from 6 to 0.5 and the range of flexion and abduction increased from $150^{\circ}$ to $180^{\circ}$. In example 2, the pain decreased from 6.5 to 1, and the range of shoulder flexion increased from $120^{\circ}$ to $170^{\circ}$, while the range of abduction increased from $90^{\circ}$ to $170^{\circ}$. Based on the above results, it would be effective to apply M-test to treat shoulder diseases in these two cases.

• Clinics in Shoulder and Elbow
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• v.3 no.2
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• pp.79-86
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• 2000

Purpose: We analysed the clinical efficacy of inferior capsular shift operation in multidirectional instability of the shoulder joint in terms of functional aspects and patient's satisfaction Materials and Methods: From July, 1998 to March, 2000, we treated 23 cases of multidirectional instability of the shoulder joint with T-shaped inferior capsular shift and/or Bankart repair. All of them have complained of an experience about frank dislocations. Two of them has a voluntary component. We evaluated them according to complication, function, range of motion, stability and patient's satisfaction with an average follow-up of 15 months(the range of 9 to 27 months). Results: Eight cases were atraumatic multidirectional instability and coexisting Bankart lesion were present in 15. There was no redislocation, but one case of symptomatic subluxation, 3 cases of transient nerve palsy and 2 cases of feeling of laxity developed. Limitation of motion after surgery was an average of 3.4° in flexion, and 8.5° in external rotation. With Rowe scoring system, the clinical result was excellent or good in 22 cases and poor in one. According to American shoulder and elbow society, pain score improved to 1.4 from 6.1, and stability score also improved to 1.8 from 9.1. Conclusion: In multidirectional shoulder instability, one should pay attention to finding a coexisting Bankart lesion. In that case, adequate capsular volume reduction by using inferior capsular shift as well as repair of Bankart lesion is needed to get a good surgical outcome.

• The Korean Journal of Pain
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• v.18 no.2
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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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• v.25 no.4
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• pp.311-320
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• 2022

Background: The outcomes of patients 50-55 years old or younger undergoing prosthetic shoulder arthroplasty (PSA) may not generalize to younger patients. We report outcomes following PSA in a consecutive series of patients 40 years or younger. We hypothesize that total shoulder arthroplasty (TSA) provides better outcome and durability than resurfacing hemiarthroplasty (RHA). Methods: Patients were stratified by diagnosis and surgical procedure performed, RHA or TSA. Active range of motion and self-assessed outcome were evaluated preoperatively and at final follow-up. Results: Twenty-nine consecutive PSAs were identified in 26 patients, comprising 9 TSAs and 20 RHAs, with a minimum of 2-year follow-up. Twelve PSAs were performed for chondrolysis. Mean active forward elevation, abduction, external rotation, and internal rotation improved significantly (p<0.001 for all). Mean pain score improved from 6.3 to 2.1, Simple Shoulder Test from 4.0 to 9.0, and American Shoulder and Elbow Surgeons score from 38 to 75 (p<0.001 for all). Patients undergoing RHA and TSA had similar outcomes; but three RHAs required revision, two of these within 4 years of implantation. Four of five patients undergoing revision during the study period had an original diagnosis of chondrolysis. Conclusions: PSA in young patients provides substantial improvement in active range of motion and patient reported outcomes irrespective of diagnosis and glenoid management. However, patients undergoing RHA, especially for chondrolysis, frequently require subsequent revision surgery, so that RHA should be considered with caution in young patients and only after shared decision-making and counsel on the risk of early revision to TSA.

• Journal of Korean Orthopaedic Sports Medicine
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• v.2 no.2
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• pp.119-126
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• 2003

The shoulder is a complex joint and, by virtue of having a large range of motion, is inherently unstable, relying on the surrounding soft tissue structures for stability. The bony joint consists of the glenoid, acromion, and humoral head, while the soft tissues include the glenoid labrum, the glenohumeral ligaments. and coracoacromial ligament as well as the muscles of the rotator cuff, the long head of the biceps, and the scapulothoracic muscles. Dysfunction in any one of these components can cause shoulder problems. The throwing motion involves a series of phases that stress to their limits the dynamic and static restraints of the glenohumeral and scapulothoracic joints. . Therefore, maintaining a balance of proper biomechanical forces is essential to avoiding shoulder injuries in throwing athletes. Over the last decade, signficant advances have been made in the study and understanding of the shoulder mechanics, and pathophysiology of injury. Additionally, advances in surgical techniques, particularly arthroscopy , have aided in the diagnosis of and the developement of less invasive surgical treatments for injuries that do not respond to nonoperative measures. In this article, we reviewed the pathophysiology of injuries , diagnostic techniques, and surgical management of shoulder injuries in throwing athletes .

• Clinics in Shoulder and Elbow
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• v.15 no.2
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• pp.117-122
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• 2012

Purpose: To assess the effectiveness of internal fixation using a precontoured locking compression plate for the treatment of the displaced clavicle fracture by analyzing both radiological and clinical outcomes. Materials and Methods: We reviewed 34 cases of displaced clavicle shaft fracture treated by internal fixation using precontoured locking compression plates between May 2009 and February 2010. Radiological outcomes were analized on the basis of bone union and the differences between the time for bone union depending on sex and age. Clinical outcomes were analyzed on the basis of quick DASH Scores and the differences in the range of motion of the affected shoulder compared to the contralateral shoulder. Results: In the radiological evaluation, all fractures showed bone union, and the average time for bone union was 12.3 weeks, without delayed unions. Time for bone union did not differ significantly with respect to sex and age (p=0.87). In the clinical evaluation, the average final quick DASH Score was 23.5 (range, 12~42). At final follow up, the range of motion after bone union in the affected shoulder was not significantly different from that of the contralateral shoulder (p=0.69). Conclusion: The internal fixation achieved using precontoured locking compression plate in displaced clavicle shaft fracture showed effective bone union and can be considered as a reliable method with fine clinical results showing early range of motion at the shoulder joint.

• Journal of Convergence for Information Technology
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• v.10 no.9
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• pp.43-52
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• 2020

The purpose of this study is to develop video exercise education for patients with shoulder-joint and evaluate the effects on range of motion, pain and quality of life. This study was conducted in 30 experimental groups and 26 control groups among shoulder-joint patients who were admitted to orthopedic outpatient clinics at university hospitals in G city from January to June 2020. For data analysis, SPSS was used to analyze the general characteristics of the two groups and the pre-homogeneity test for the dependent variables by 𝑥²-test and t-test. As a result of the study, the subject's pre-post score change was found to have a significant difference in the degree of internal rotation of the range of motion and pain score, but there was no significant difference in the flexion, abduction degree of the range of motion and quality of life. In this study, clinical application of video education can be suggested as a way to improve nursing practice as it saves time spent on patient education of nurses not only in outpatients but also in wards.

• Clinics in Shoulder and Elbow
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• v.21 no.3
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• pp.127-133
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• 2018

Background: This study was undertaken to evaluate the outcome of the arthroscopic capsular release for adhesive capsulitis of the shoulder. Methods: This study retrospectively investigated thirty shoulders in 29 patients who presented with recalcitrant adhesive capsulitis and underwent arthroscopic treatments. Other than typical findings of adhesive capsulitis, combined pathologies in the glenohumeral joint and subacromial space were evaluated by arthroscopy. Clinical evaluations were performed using the Constant's score and ranges of motion (ROM) at preoperative, 6 months postoperatively and at the final follow-up. Results: Our study included 17 women and 12 men with a mean age of 53.8 years (range, 34-74). Mean follow-up duration was 24 months (range, 12-40 months). Assessment of combined pathologies revealed that partial rotator cuff tear of less than 25% thickness, was most common (overall 83.3%; with bursal 57% and articular 23%). Subacromial synovitis and adhesion were also frequent (53.3%). The Constant score and ranges of motion significantly improved at the final follow-up, compared with preoperative levels. However, clinical results at 6 months postoperatively were found to be significantly inferior to those observed at the final follow-up ($p{\leq}0.001$ for all factors). Functional impairment was the major complaint in 59.3% patients at the 6 months follow-up. Conclusions: Although arthroscopic capsular release yielded favorable outcome at the mean 24 months follow-up, pain and motion limitations at 6-month postoperatively persisted in more than 50% of our patients. While combined pathologies were commonly encountered during arthroscopy, although their effects on surgical outcome in adhesive capsulitis remains unclear in this study.

• The Journal of Korean Medicine
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• v.44 no.1
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• pp.117-127
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• 2023

Objectives: The purpose of this study is to report the effect of hominis placenta pharmacopuncture and chuna manual therapy in patients with frozen shoulder. Methods: Frozen shoulder was treated with hominis placenta pharmacopuncture and chuna manual therapy, and the overall shoulder pain was measured by visual analog scale (VAS), and the range of motion (ROM) of shoulder movement was evaluated by measuring passive abduction and external rotation and active hand to shoulder blade test. Results: After the treatment, overall shoulder pain was reduced, and ROM of passive abduction and external rotation was increased. Conclusions: The above results show that hominis placenta pharmacopuncture and chuna manual therapy can be used as an effective treatment for frozen shoulder.

• Clinics in Shoulder and Elbow
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• v.24 no.3
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• pp.178-182
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• 2021

A 50-year-old woman who had been previously diagnosed with systemic lupus erythematosus consulted our clinic for pain and weakness in her right shoulder. On examination, she had an atrophied deltoid muscle, a painful right shoulder on movement, and a tender mass in the deltoid area. The patient was diagnosed with corticosteroid-induced deltoid myopathy, shoulder pain, and loss of range of motion that did not resolve with conservative treatment. We decided to perform reverse shoulder arthroplasty. No complications were observed at the last follow-up visit at 3 years postoperative. Unlike deltoid insufficiency that results from axillary nerve injury, deltoid myopathy due to corticosteroid use contains intact fibers,. Therefore, we increased the effectivity of the remaining deltoid fibers by extending the moment arm of the anterior fibers using reverse shoulder arthroplasty and achieved reliable improvements in clinical symptoms and function without increasing the risk of dislocation.