• Clinics in Shoulder and Elbow
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• v.17 no.3
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• pp.134-137
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• 2014

To report the fracture of proximal humerus in the lateral anchor site after suture bridge repair. A 57-year-old female patient with shoulder pain on the right-side was admitted through the emergency room following a car accident. Seven weeks before the accident, the patient had undergone surgery at a different hospital for the repair of supraspinatus tendon rupture on the right-side via suture bridge technique. Humerus surgical neck fracture was confirmed by X-ray, and proximal humerus fracture at the anchor site was confirmed by magnetic resonance imaging. Following 7 months of conservative treatment resulted in satisfactory bone union and motion of the shoulder joint. We report the need of close observation during and after the arthroscopic repair of the rotator cuff in patients with osteoporosis.

• Clinics in Shoulder and Elbow
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• v.7 no.2
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• pp.94-97
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• 2004

Herpes zoster presents clinically with cutaneous vesicular eruption and pain along the dermatome, but it can sometimes cause muscular paralysis. When the disease involves cervical root, it is included in the differential diagnosis of shoulder diseases. A sixty-six year old patient, complaining of severe pain and weakness of his left shoulder, was referred to the authors as having a partial tear of the supraspinatus tendon on MRI. However, the authors found out a paralysis of the sixth cervical root in the patient by electrophysiologic studies, noting that the patient had been affected with a herpes eruption in the neck and arm two months before. Zoster paresis has been reported to be associated with the cutaneous eruption within two weeks of its onset, making its diagnosis not so difficult. The authors report a case of delayed-onset muscular paralysis after cutaneous herpes zoster, which presented just like a rotator cuff tear.

• 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.

• 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.

• Clinics in Shoulder and Elbow
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• v.11 no.2
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• pp.96-103
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• 2008

Purpose: This study investigated the rate of retear and related factors after arthroscopic repair of rotator cuff tears involving more than one tendon. Materials & Methods: Arthroscopic repair of 22 rotator cuff tears (average size 3.2cm: average age 58 years old) involving the supraspinatus and part or all of the infraspinatus were investigated using MRI on average 10 months after repair. The status of the repaired cuff was investigated using Sugaya's classification, and the change in muscle was evaluated with Goutallier's classification. Results: Retear (Sugaya grade IV, V) was found in 7cases(32%). Tears larger than 3cm had a higher retear rate(67%) than smaller tears(8%). Retear cases had Goutallier grade II or higher muscle changes preoperatively and showed aggravation of muscle atrophy postoperatively. Even without retear, reversal of muscle change was not seen Conclusion: Rotator cuff tears not confined to the supraspinatus had a 32% retear rate after arthroscopic repair. The size of the tear was the most crucial factor influencing retear. Retear was frequent in tear over 3cm. Atrophy of the cuff muscle worsened when the repair failed but did not improve even without retear.

• Clinics in Shoulder and Elbow
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• v.2 no.2
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• pp.170-177
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• 1999

The electromyographic activity of four muscles(biceps, supraspinatus, infraspinatus and subscapularis) was mea­sured from non-dominant shoulders of 12 volunteers by six different provocative test for the biceps pathology. The provocative tests were Speed, Yergason, Ludington, Heuter, O'Brien and the abduction-extension test. Each test was performed in a force of 30% of maximal voluntary contraction. The levels of activity of the biceps were higher than those of the other rotator cuff muscles only in Speed's test: 28% in the biceps, 26% in the infraspinatus, 25% in the supraspinatus and 21 % in the subscapularis. The levels of activity of the biceps as a percent of MMT(maximal manual test) were higher in Speed's(42%) and O'Brien's test with the arm supinatecl(42%). Speed's test can isolate the activity of biceps better than the other tests but it is a nonspecific test by which the biceps tendon was also activated within other rotator cuff muscles.

• Clinics in Shoulder and Elbow
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• v.1 no.1
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• pp.19-25
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• 1998

Appropriate clinical examination and imaging may lead to early diagnosis and treatment of the shoulder impingement syndrome, thus preventing progressing to a complete tear of rotator cuff. The impingement syndrome was caused by repeated entrapment and compression of supraspinatus tendon between the proximal end of humerus inferiorly, particullary its greater tuberosity. and one or m <)re component of coracoacromial arch superiorly. The purpose of this study is to critically, evaluate the result of twenty-five consecutive subacromial decompression with impingement syndrome and to assess the diagnostic accuracy of MR imaging by using oblique coronal and oblique sagittal plan. These patients were treated by arthroscopic subacromial decompression after their pains failed to improve with conservative therapy over three month. The average follow up was 25 month(range, 12 to 50). The mean age was 43 year old. The results were rated based on subjective response and the UCLA shoulder rating scale of the result. Ten patients(40%) were rated as excellent, 11patients(44%) were good. while four patients(16%) were fair. Radiologic evaluation suggested that the oblique sagittal plan of MRI can be helpful in evaluation of bony and soft-tissue structure of the coracoacromial arch and determining depth of bony resection. There were no infection or neurovascular injury. In reviewing our result, it appears that the arthroscopic subacromial decompression can be successful sugery for shoulder impingement syndrome and diagnostic accuracy of supplimentary oblique sagittal view of MRI was relatively higher than oblique coronal view alone for apprqpriate surgical plan.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.7 no.2
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• pp.120-126
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• 2014

Acromioclavicular (AC) joint cyst is an uncommon presentation around the shoulder joint that is usually associated with chronic rotator cuff pathology and degenerative AC joint arthritis. Understanding the underlying pathophysiology of the shoulder joint is essential for appropriate interpretation of the AC joint cyst, assistance in determining the therapeutic strategy, and prevention of complications after treatment. We present a case of AC joint cyst with an aseptic fistula which was complicated by simple excision for recurred AC joint cyst after multiple aspirations. This case revealed a massive rotator cuff tear involving supraspinatus, infraspinatus, and subscapularis tendon on ultrasonography. We also reviewed the clinical approach and treatment options to be considered for its pathogenesis in the literature.

• The Journal of Korean Physical Therapy
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• v.12 no.2
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• pp.95-105
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• 2000

Glenohumeral internal and external rotation with shoulder abducted in the frontal plane often causes impingement of the supraspinatus tendon. whereas similar activity in scapular plane does not cause impingement. The Purpose of this study was to determine if assessment among the three positions as 30 degrees, 60 degrees, 90 degrees abduction in the sitting position of the scapular plane could be affected the comparison between intemal and external peak torque, total work, average power. In this study, Isokinetic shoulder rotational strength was evaluated in twenty healthy male university students, using the Cybex NORMTM System (CYBEX Division of LUMEX, Inc., Ronkonkoma, New York). Test data was gathered in the plane of the scapular, 30 degrees of horizontal flexion anterior to coronal plane, and the subjects performed the test with the arm 30, 60, and 90degrees abducted in the sitting position. also, test speed was set at deg/sec. Statistical analysis was performed using SPSS 7.5 for Windows software and mean and standard deviations were calculated. ANOVA was used to analyze the difference of the values in the three test positions. A paired t-test was used of examining the difference in the means peak torque between external and internal rotation. Not any significant difference was found among three abduction positions in scapular plane, even though there was a consistent pattern of greater strength in the abducted position of 60 degrees. Internal relation strength peak torque and total work were greater than those of external rotation in every test positions.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.1
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• pp.61-72
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• 2022

Purpose : This study was to verify the effect of eccentric training and suggest a specific application method by comparing the effects of acromohumeral distance (AHD), supraspinatus tendon thicknees (STT), pain intensity and functional performance after MWM and eccentric training (MWM-ET) or general exercise (MWM-GE) in chronic subacromial impingement syndrome (SAIS) patients. Methods : A total of 55 participants were randomly assigned to each group, and according to the intervention method, "MWM-ET group (n=28)" vs. "MWM-GE group (n=27)" was divided into two groups. AHD, STT, pain intensity, and functional performance were measured before intervention, and both groups were re-measured 3 times a week after 6 weeks of intervention in the same way. Results : The AHD was significantly increased in MWM-ET group compared to MWM-GE group. No significant difference was observed between the groups in the STT, but Pain intensity was significantly lower in MWM-ET group than in MWM-GE group, and functional performance was significantly increased in MWM-ET group compared to MWM-GE group. Conclusion : As a result of MWM-ET intervention that further increases AHD compared to MGE, it can be clinically presented as a more effective intervention method for faster recovery from injury due to pain reduction and smooth return to daily life due to improved functional performance.