• The Academic Congress of Korean Shoulder and Elbow Society
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• 2009.03a
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• pp.131-131
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• 2009

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2006.03a
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• pp.15-15
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• 2006

• Clinics in Shoulder and Elbow
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• v.6 no.2
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• pp.127-130
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• 2003

Arthroscopy of the elbow is a very precise and demanding procedure due to the closeness of the recommended portals to neurovascular structures and complexity of articular geometry. So to establish safe portal is not always reproducible especially in case of stiff elbow, even for the experienced arthroscopist. We described new tip of elbow arthroscopy using a new starting portal. This procedure is almost always reproducible even in stiff elbow, and minimizes risk of damage to neurovascular structures.

• Clinics in Shoulder and Elbow
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• v.7 no.1
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• pp.41-45
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• 2004

In adhesive capsulitis of the shoulder of no response to nonoperative treatment, an arthroscopic capsular release and manipulation improves range of motion and pain relief. We performed an arthroscopic examination in the stiff shoulder, of which she had no response to nonoperative treatment, after the conservative treatment of a clavicular shaft fracture by motorcycle-driver traffic accident. We found the intra-articular 'rotator interval bridging scar adhesion' between subscapularis tendon and antero-superior glenoid fossa under the rotator interval which was no adhesion and contracture itself. We performed the scar adhesion removal and synovectomy, maintaining the rotator interval. We recommended nonsteroidal anti-inflammatory drug for postoperative pain relief and continuous active and passive range of motion (ROM) exercise to gain motions. Preoperatively, active and passive range of motion were 70° for forward elevation, 60° for abduction and especially 0° for external rotation. After postoperative 2 months, active ROM were 150° for forward elevation, 130° for abduction and 80° for external rotation. After postoperative 6 months, passive and active ROM were full. UCLA score improved from preoperative 9 points to postoperative 29 points.

• Journal of the Korean Society of Physical Medicine
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• v.2 no.2
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• pp.219-228
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• 2007

Objective : The purpose of this study was conducted to find treatment of forward head posture and shoulder instability with proprioceptive neuromuscular facilitation concept. Methods : This is literature study with books, seminar note and international course. Results : Forward head posture and shoulder instability has related each other. Forward head posture will make muscle instability, weakness and stiffness on neck and shoulder girdle. It will make pain also. Important muscle are suboccipital muscle, omohyoid muscle, sternoclaidomastoid muscle, scaleni, pectoralis minor, levator scapular and digastric. Conclusion : Treatment of the forward head posture and shoulder instability is provided. It is that treatment of stiff muscle with eccentric muscle work, muscle elongation, muscle strengthening at the structure level and at the functional level for daily activities.

• PNF and Movement
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• v.5 no.2
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• pp.1-10
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• 2007

Purpose : The purpose of this study was conducted to find treatment of forward head posture and shoulder instability with proprioceptive neuromuscular facilitation concept. Methods : This is literature study with books, seminar note and international course. Results : Forward head posture and shoulder instability has related each other. Forward head posture will make muscle instability, weakness and stiffness on neck and shoulder girdle. It will make pain also. Important muscle are suboccipital muscles, omohyoid muscle, sternoclaidomastoid muscle, scaleni, pectoralis minor, levator scapular and digastric. Conclusion : Treatment of the forward head posture and shoulder instability is provided. It is that treatment of stiff muscle with eccentric muscle work, muscle elongation, muscle strengthening at the structure level and at the functional level for daily activities.

• Clinics in Shoulder and Elbow
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• v.1 no.2
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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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• v.8 no.1
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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.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2004.11a
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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.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2004.03a
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• pp.54-54
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• 2004