• The Journal of Korean Orthopaedic Ultrasound Society
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• v.7 no.1
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• pp.7-12
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• 2014

Purpose:The effectiveness of transdermal buprenorphine patch on the patients with frozen state of frozen shoulder was evaluated. Materials and Methods: Between March and September in 2013, 127 patients with pain and limited range of motion in shoulder joint over 6 months were included. Every patient was confirmed the diagnosis through MRI or ultrasonogram and each patient received intra-articular injection of steroid once. After 2~4 weeks, every patient was interviewed via telephone survey and finally 105 patients were included, 54 patients received only oral NSAIDs (NP group) while 51 patients received additional transdermal buprenorphine patch (BP group). Pain and functional visual analog scale (PVAS, FVAS), American Shoulder Elbow Society (ASES) score was checked. Results: Generally, every outcome variables showed improvements in both groups (p<0.001). PVAS score after treatment showed superior result in NP group but it was not significant (p=0.088). In ASES score, NP group had superior result than BP group and it had significant difference. Similarly in FVAS, NP group showed superior result but the data before treatment was significantly different (p=0.028) Conclusion: Transdermal buprenorphine patch didn't show superior treatment result in the patient with frozen state of frozen shoulder which was applied with oral NSAIDs after single intra-articular glenohumeral steroid injection in short-term follow-up.

• Journal of Acupuncture Research
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• v.24 no.4
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• pp.143-155
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• 2007

Objectives: To observe the effect of acupuncture and nerve block combination treatment on adhesive capsulitis patients. Methods : 59 voluntary patients were randomly assigned to acupuncture treatment group(E group, n=22), nerve block treatment group(W group, n=17) and acupuncture and nerve block combination treatment group(EW group, n=20). The E group received acupuncture treatment on LI15, $TE_{14}$, $GB_{21}$ and Master Dong's acupuncture points, Shin-gwan and Gyun-joong, twice a week for 4 weeks. The W group received suprascapular nerve block, subacromial injection and trigger point injection, twice a week for 4 weeks. The EW group received the same treatment as the W group and after 5minutes of rest, successively received the treatment identical to that of E group. All three groups were instructed to practice groups were instructed to practice self exercise during their daily lives. Evaluations were made before treatment and after 1, 2, 3 and 4week treatment. Constant Shoulder Assessment(CSA), Shoulder Pain and Disability Index(SPADI), Range of Motion(ROM), the patient's treatment satisfaction measured by Visual Analogue Scale(VAS) and Digital Infrared Thermographic Imaging(DITI) were used as assessment tools. The obtained data were analyzed and compared. Results : The E group showed significant improvement(p<0.05) on CSA, SPADI, VAS and DITI. As for ROM, Adduction and Extension improved significantly(p<0.05). The W group showed significant improvement(p<0.05) on CSA, SPADI, VAS and DITI. As for ROM, Abduction and Extension improved significantly. The EW group showed significant improvement(p<0.05) on CSA, SPADI and VAS. As for ROM, Adduction, Abduction, Extension and Flexion improved significantly. The improvement of CSA, VAS and Abduction ROM in the EW group was significantly(p<0.05) superior compared to the groups treated with single type of treatment. Conclusion : It is suggested that acupuncture and nerve block combination treatment for adhesive capsulitis patients is more effective than the two single treatments. Through further studies, the acupuncture and nerve block combination treatment model may be developed into East-West Collaboration Model in treating adhesive capsulitis.

• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.94-98
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• 2011

Purpose: We present a case of anterior glenoid rim comminuted fracture that was treated with arthroscopic reduction and an AO headless compression screw (HCS) fixation. Materials and Methods: A 31-year old man complained of left shoulder pain after falling down on stairs. The anterior glenoid comminuted fragments were arthroscopically reduced. Fixation with an AO HCS was done after placement of 1.1 mm Kirschner wire as a guide pin through a standard cannulated anterosuperior portal. Results: Twelve months after the operation, union of the fracture was achieved and the range of motion was fully recovered. He did not complain of any discomfort during his activities of daily living. Conclusion: An AO HCS had various screw sizes and this was good for fixation of a small glenoid fracture and a long drill bit and screw driver were useful for fixation of deep seated glenoid fracture. A short guide wire could be replaced by a 1.1 mm K-wire. An AO HCS was useful for fixation of an anterior glenoid rim comminuted fracture.

• Journal of Korean Orthopaedic Sports Medicine
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• v.5 no.1
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• pp.58-62
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• 2006

Purpose: To evaluate the result of operative treatment with plate and wire fixation for fractures of the distal clavicle. Materials and Methods: We assessed 9 cases of fractures of the distal clavicle that were treated by plate and wire fixation from March 2001 to July 2003 and followed up over 1year. We used the reconstruction plate as a buttress and performed cerclage wiring to fix comminuted fracture site. The functional result of shoulder was evaluated by the scoring system of Rowe. Results: The average periods of bony union was 9 weeks in all cases. According to Rowe scoring system, the functional result was exellent in 7 cases and good in 2 cases. There was no LOM of shoulder and traumatic arthritis in AC joint. But there was skin irritation in 1 case. Conclusion : The operative method by reconstruction plate and wire fixation for distal clavicular fracture was useful when there were comminuted fracture. This method seems to be simple and satisfactory in terms of improvement of range of motion of shoulder, restoration of function and rare complication.

• Clinics in Shoulder and Elbow
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• v.15 no.2
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• pp.138-142
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• 2012

Pigmented villonodular synovitis (PVNS) is a rare benign proliferative disorder that results in villous hyperplasia and nodule formation in the synovium, tendon sheath and bursa. That most commonly affects the knee and the hip joint in adult. PVNS of the hand, the wrist, the shoulder and the elbow is rare and that of the elbow in children is particularly rarer. An eight-year-old boy had his left elbow pain and a lesion like benign bone tumor in the left fossa olecrani on plain x-ray. During the operation, abnormal synovial hyperplasia in his left elbow joint led us to diagnose PVNS. Therefore, open curettage of the lesion and radical synovectomy was performed. The specimen of the synovectomized tissue revealed PVNS. The left elbow pain subsided after the operation and the child restored a full range of motion of his left elbow. We reported this rare case of PVNS in a child's elbow joint mimicking the bone tumor together with a review of the literature.

• Clinics in Shoulder and Elbow
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• v.10 no.2
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• pp.220-226
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• 2007

Purpose: The distal clavicle has a biomechanical structure different from that of the proximal or middle 1/3 clavicle, and delayed union or nonunion occurs frequently in a distal clavicle fracture. The authors obtained favorable results from an open reduction and bone grafting of the distal clavicle nonunion. We report the results together with review of the relevant literature. Materials and Methods: The subjects were 8 patients(average age, 38.9) who had undergone surgery for distal clavicle nonunion from August 2003 to May 2006. Nonunion occurred after surgical treatment in 4 cases, and after conservative treatment in the other 4. In all cases, the patients complained of pain. Results: The mean follow-up duration was 14 months, and radiological union was observed in 8 weeks on average. In all cases, the range of shoulder joint motion was normal at the end of the follow-up observation. In the functional evaluation, 7 cases showed excellent results and 1 case showed good results. Conclusion: Surgical treatment is a safe and reliable treatment for distal clavicle fracture nonunion because it can achieve early rehabilitation and union.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.1 no.2
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• pp.86-90
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• 2008

Purpose: To evaluate the differences between blindly and ultrasonography (US)-guided during multiple needling and dextrose injection technique for calcific tendinitis of shoulder. Materials and Methods: We chose 36 symptomatic calcific tendinitis patients, whose age ranged from 27 to 69. Our procedures were multiple needling and injection of dextrose over the lesion of calcific deposits. The bind injection group were 19 patients whose age ranged from 27 to 64-year-old (mean 52.2), and the US-guided injection group were 17 patients ranged from 31 to 69-year-old (mean 49.0). We compare these groups by VAS (visual analogue scale) and range of motion before and after procedures. Results: There is no difference between two groups in VAS and ROM before procedure (p>0.05). Two groups revealed significant improvement without limitation of shoulder function, however, the group under US-guided revealed better results than under blind (VAS:p=0.001, Flexion:p=0.000, Abduction:p=0.000, External rotation: p=0.016). Conclusion: Ultrasonography-guided procedure showed better results than blind, so the use of ultrasonography is more promising procedure.

• Clinics in Shoulder and Elbow
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• v.12 no.1
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• pp.1-6
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• 2009

Purpose: To evaluate and report the clinical and radiological outcomes of open reduction and internal fixation with a mini-T plate for unstable distal clavicle fractures. Materials and Methods: From December 2004 to July 2007, fifteen patients who had a fracture of the distal clavicle (Neer type II fracture) were treated with an open reduction and internal fixation using a mini-T plate. They were followed up for a minimum of one year and the clinical and radiological results were analyzed. Results: The average time to fracture union was 3.1(3~4) months. There were no complications, such as deep infection or fixation loss. The mean ASES score was 97 points (85~100points) at the last follow up period, and 14 patients had a full range of motion of the shoulder. Conclusion: Open reduction and internal fixation with a mini-T plate for unstable distal clavicle fracture is a good surgical method with good clinical and radiological results.

• Journal of Korean Neurosurgical Society
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• v.42 no.1
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• pp.16-19
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• 2007

Objective : This report describes the clinical study of the surgical method of lateral third infraclavicular implantation of vagal nerve stimulation (VNS) generator through the axillary wrinkle incision. Methods : In a retrospective study, the data for 20 patients with medically intractable epilepsy treated by this approach were examined. The mean age was 31.4 years (range : 14-50), and the mean follow-up period was 12.15 months (range : 4-21 months). The male to female ratio was 2.3 : 1. The subcutaneous pocket for the generator was located in the lateral third infraclavicular area through the axillary wrinkle. Our method was a modification of the standard VNS generator implantation in the mid-infraclavicular pocket through anterior axillary incision. Results : There were the excellent or good cosmetic satisfaction in 95% of the cases and fair in 5%. The generator was located outside the lung field in 15%, periphery of the lung field in 45%, and crossed over the lung field in 40%. Discomfort from shoulder motion occurred transiently in 35% of cases. Other complications were minimal. Conclusion : These results demonstrate that the lateral third infraclavicular apporach will offers cosmetic benefits and reduction of obscuration of the lung field without serious complications. Thus, this technique provides an attractive alternative among the surgical techniques for the vagal nerve stimulation.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.3 no.1
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• pp.21-25
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• 2010

Purpose: To evaluate efficacy of ultrasound guided prolotherapy in patients with persistant symptoms after rotator cuff repair. Materials and Methods: Between January and December of 2008, 90 patients who had persistant pain and shoulder adhesion 4 weeks after rotator cuff repair were treated with ultrasound guided prolotherapy. The mean age was 55.2 years. Visual analogue scale (VAS) and range of motion (ROM) before and after the procedure, complications related to the procedure were analyzed. Results: The average VAS score at 4 weeks follow up decreased to $2.5{\pm}2.304$ from $6.3{\pm}1.25$ before prolotherapy and forward flexion range at 4 weeks follow up increased to $143{\pm}26.63$ from $106{\pm}21.64.$ Four weeks after the ultrasound guided prolotherapy, 74 cases(82%) reported of improved pain and ROM, 13 cases(14%) reported of improvement after 2~5 days of the procedure and 3 cases(4%) had no improved in pain and ROM. No complications were encountered. Conclusion: The authors believe that ultrasound guided prolotherapy in repaired rotator cuff tear patients theoretically increased possibilities of healing and with relieving the pain of the patients results in increased possibility of rehabilitation effect.