• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2004년도 연수강좌
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• pp.176-179
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• 2004

Arthroscopy of the stiff elbow joint is a technically difficult procedure because of the decreased joint space of the elbow joint. even to experienced surgeons. Problems encountered include limited access of instrument to the intra-articular ,pace and an increased risk of cartilage injury in the contracted elbow joint. This study describes a novel transarticular approach for elbow arthroscopy that allow, the safe and effective creation of the proximal medial and lateral portals.

• Clinics in Shoulder and Elbow
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• 제8권1호
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• pp.14-18
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• 2005

Purpose: Limitation of motion of the elbow joint due to stiffness affect on life quality of the patients. So contracture of the elbow should be treated as soon as possible. Among the many treatment modalities, we described the result of arthroscopic treatment. Materials and Methods: From Mar. 2000 to Mar. 2003, 40 patients, who received the arthroscopic treatment by author for contracted elbow, were the subjects. We estimated the range of motion (ROM) of elbow joint before and after surgery by goniometer. The clinical result was evaluated by Severance elbow scoring system. The final ROM was evaluated at the point of no further increasement of joint motion. Male ware 30 cases, female ware 7 cases, average 42.6 years old and mean follow up period were 31 months. During arthroscopic treatment we had done release of the joint capsule or resection, synovectomy, removal of loose bodies. We used traditional portals. Results: The avarage preoperative ROM of elbow joint was 72.5 degree(range, 5 - 132 degree) and the increasement of ROM was totally 49.3 degree in flexion 26.5 degree and extension 22.8 degree. There was no other complication. Conclusion: Arthroscopic treatment for contracted elbow permit early joint ROM and it decrease the secondary injury to the elbow joint. Also there are few complications. It is thought to be a good treatment modality in contracted elbow joint.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 1999년도 학술대회
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• pp.38-40
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• 1999

$\cdot$ Arthroscopic management is the effective method with acceptable results for coronoid impingement of stiff elbow contributing to the functional improvement and pain relief. $\cdot$ The functional improvement and pain relief seem to be affected by the severity of a degenerative change of the elbow joint. $\cdot$ Excision of coronoid process is required in a marked limitation of further flexion in addition to deeping of the coronoid fossa and anterior capsular release. $\cdot$ Excision of olecranon tip or posterior capsular release are effective method in severe flexion contracture.

• Clinics in Shoulder and Elbow
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• 제8권1호
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• pp.49-56
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• 2005

Purpose: To review the surgical results of stiff elbow using the posterior extensile approach which provides a wide surgical view with a single posterior skin incision. Materials and Methods: From February 1999 to May 2002, we performed 6 surgical correction of stiff elbow using posterior extensile approach and followed the patients more than 1 year. In order to get better result, we performed cadaver study (four elbows of two fresh cadavers). Average duration of follow up was 15.7 months $(14{\sim}21)$. Functional results was analyzed using Brobery and Morrey analysis scale. Results: The approach through the plane between the extensor carpi radialis longus and the extensor carpi radialis brevis was ideal, because it preserves normal anatomy and provides a wide surgical view of the anterior joint. The posterior joint could be approached directly between the medial head of the triceps brachii and brachialis medially, the lateral head of triceps brachii and brachioradialis laterally. In all patients, an improved ROM was obtained with intra and extra-articular adhesiolysis: an average $61.7^{\circ}$ improvement $(50{\sim}75)$. Functional results were as follows: five excellent, one good. In addition, the patients' satisfaction was high since the scar from the operation was only a single line at the posterior surface of the elbow. Conclusion: In the treatment of stiff elbow, posterior extensile approach is thought to be useful because this method provides wide anterior and posterior surgical view.

• Clinics in Shoulder and Elbow
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• 제1권2호
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• pp.242-249
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• 1998

Stiffness of the elbow joint is relatively common after trauma, ectopic ossification, bum, postoperative scar, and etc. Mild flexion deformity can be reduced by use of active or passive motion exercise, dynamic sling, hinged distractor device, or turnbuckle orthosis. But these methods have disadvantages of difficulty in gaining acceptable range of motion only with stretching exercise, re-contracture after conservative managements and poor results that flexion contracture remained. The common described operative exposures for treatment of the stiff elbow are anterior, lateral, posterior, and medial approach. Through Anterior, lateral and medial approach each has not access to all compartments of the elbow. But, posterior approach has benefits that access to posterior, medial and lateral aspects of the elbow and as needed, fenestration to the olecranon fossa that produces a communication between the anterior and posterior compartments of the elbow are possible. From June 1991 through April 1997, 11 patients who had posttraumatic stiff elbow, were treated with debridement arthroplasty through the posterior approach. The purpose of this study are to introduce technique of the debridement arthroplasty and to evaluate final outcomes. With regarding to preoperative pain degree, mild degree matches to 3 cases, moderate to 3 cases, and severe to 2 cases. In preoperative motion, flexion was average 85° and extension was 30°. Postoperatively nine patients had got the complete relief of pain and two patients continued to have mild pain intermittentely. Postoperative flexion improved to 127° and extension to 2°, so that elbow flexion had improved by an average of 42° and elbow extension by 28°. On the objective scale all patients had good or excellent results and they all felt that they were improved by operation. Debridement arthroplasty is one of excellent procedures for the intractable stiff elbow if it is not unstable or it has not incongrous. But it need a meticulous operative technique and a well-programmed rehabilitation.

• Clinics in Shoulder and Elbow
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• 제13권2호
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• pp.286-292
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• 2010

목적: 관절의 적절한 기능을 위해서는 관절의 안정성과 운동 범위의 유지가 필요하다. 주관절과 연관된 환자의 주소의 대부분이 주관절의 강직이다. 최근 보고들에서 주관적의 강직에 대한 치료에서 우수한 결과가 보고되고 있다. 그러나 어떠한 술식을 선택하여야 하는 것은 결정하기 어렵다. 대상 및 방법: Morrey 등은 기능적인 운동 범위를 30-130도의 굴곡-신전 범위, 50도 회내전 및 50도 회외전이라고 하였다. 이 범위에서 일상 생활의 약 90%가 이루어 진다. 주관절 강직은 원인이 되는 외상과 주 병변의 위치에 따라서 분류할 수 있다. 관절 내 원인으로는 심각한 관절 내 불일치, 관절 내 유착 또는 관절 내 연골의 소실, 골극 형성에 의한 기계적 제한, 관절 내 유리체, 활액막의 과다 증식이 해당된다. 관절 외 원인으로는 외상 또는 탈구에 의한 심한 관절막의 유착, 측부 인대 또는 근육의 구축이 해당된다. 결과 및 결론: 신전 제한의 주 원인은 전방 관절막의 섬유화에 의한 구축이다. 이러한 병변은 전방 관절막 절제술이 도움이 된다. 굴곡 제한의 주 원인은 내측부 인대의 후방대의 구축이다.

• Clinics in Shoulder and Elbow
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• 제13권2호
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• pp.293-298
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• 2010

목적: 주관절은 굴곡 구축 40도 이상 굴곡 제한 105도 이하일 경우 일상 생활에 상당한 장애를 일으킬 수 있는 관절로 그 치료의 정도 및 시기를 결정하기가 상당히 어려운 것으로 알려져 있다. 이에 이 종설에서는 현재까지 인정된 주관절 구축의 수술적 접근법에 대하여 고찰하여 보도록 하겠다. 대상 및 방법: 환자의 병력을 포함하여 충분한 임상적 조사를 하는 것이 중요하다. 그리고 방사선학적 방법을 이용하여 환자의 주관절 구축에 대한 원인 및 상태를 정확히 파악하고 그에 적합한 수술법을 선택한다. 수술법으로는 관절경적 유리술 (arthroscopic release) 및 관혈적 유리술 (Open release), 견인 관절 성형술 (Distraction Arthroplasty), 인공관절 치환술 (Total elbow replacement)이 있으며 관혈적 유리술은 4가지 기본 도달법 -전방 도달법 (anterior approach), 내측 도달법 (medial "over the top" approach), 제한된 외측 도달법 (limited lateral approach: column procedure) 광범위 후방 도달법 (posterior extensile approach)-으로 분류될 수 있다. 결과 및 결론: 현재 주관절 구축의 수술은 관절경의 발달로 인한 최소 침습적인 방법이 대두되고 있으나 그 경과의 판정은 아직 미미하며 그에 대한 문헌 보고가 많지 않은 상태로 고식적인 개방성 접근법을 이용하는 것을 원칙으로 하고 있으며 접근법에 따른 분류를 사용하고 있다.

• Clinics in Shoulder and Elbow
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• 제17권1호
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• pp.44-47
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• 2014

Typically, massive rotator cuff tears have stiff and retracted tendon with poor muscle quality, in such cases orthopaedic surgeons are confronted with big challenging to restore the cuff to its native footprint. Furthermore, even with some restoration of the footprint, it is related with a high re-tear rate due to less tension free repair and less tendon coverage. In this tough circumstance, the partial repair has yielded satisfactory outcomes at relatively short follow-up by re-creating the transverse force couple of the rotator cuff. Through this partial repair, the massive rotator cuff tear can be converted to the "functional rotator cuff tear" and provide improvement in pain and functional outcomes in patient's shoulder.

• 셀메드
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• 제12권3호
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• pp.14.1-14.2
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• 2022

Currently, a 70-year-old woman started suffering from S.I joint pain from 1973 and had severe pain in the S.I joint, wrist, and elbow from 1975 to 1977, and was diagnosed with spinal tuberculosis at a general hospital. From 1978 to 1987, she suffered from chronic fatigue and insomnia, and since January 1, 1988, she was unable to get up while lying down, suffering from whole body joint, muscle pain, and fibromyalgia. In May 1989, she was also diagnosed with ankylosing spondylitis through genetic testing at the Catholic St. Mary's Hospital Rheumatology Department in Korea, and was treated with sulfasalazine, analgesic, and immunosuppressant, methotrexate, for 12 years until 1999, but none of the drugs eliminated the pain. She was hospitalized and discharged repeatedly, and continued to receive salt water poultice and exercise therapy at home, but was unable to move at all. In 2000, after biologic treatment with Remicade injection (Remsima®), she was able to walk and move, and after that, she was continuously prescribed biologics. From 2015 to 2019, Enbrel® (Etanercept) injection was prescribed once a week, but the symptoms such as severe pain (joint and muscle, fibromyalgia), scleroderma, Sjogren's syndrome (dryness of eyes, nose and mouth), difficulty swallowing, chronic fatigue, and stiff body appeared. Around January 2018, hepatic indicators were high and lymphocytes became enlarged. However, most serious injuries were highly improved after the OCNT combination therapy using active phytonutrients, anthocyanin-fucoidan nanocomplex. Therefore, for patients with such experiences, OCNT treatment is proposed as an alternative.

• 동의생리병리학회지
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• 제29권4호
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• pp.337-346
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• 2015

Sprain is the injury of meridian-muscle, and is caused by qi and blood obstruction or regional stagnation of qi and blood. So we take the channel points where pain flows. If we take the locations that feel pain, those locations are treatments points and ashi points. So we searched over the ashi points appearing on the patients with wrist sprain. Ashi points appeared on LI5, TE4, SI5 around wrist joints, LI10, LI11, LU6 around elbow joints, LI14, LU3, LU4, PC2 around upper arm. Also, ashi points appeared much on ST17, KI23, PC1, SP18, ST18 around thoracic region, and, on BL15, BL44, BL13 around anterior and thoracodorsal region, in order stated. Ashi points of the highest frequency appeared on LI14 around upper arm, and on LI5, TE4 around wrist joint, and SI5, ST17, KI12, PC1, SP18 appeared with second highest frequency. And ashi points on elbow points and thoracodorsal region appeared with the same frequency. Therefore, it is possible for us to know that the pain location appears in order of upper arm, anterior thoracic region, elbow joint region, and, thoracodorsal region, in treating wrist joints. There was a tendency that pain and movement disturbance recovered more quickly, depending on the pain reduction, as we found out the ashi points closely from stagnated qi and blood caused by wrist arthritis, and relaxed the stiff location. Rubbing treatments in treating pain ashi points is considered to play an important role to reduce pain effectively, so it is necessary to make a further study.