• Journal of the Korean Arthroscopy Society
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• v.10 no.2
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• pp.135-140
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• 2006

Diagnosis and treatment of the unstable shoulder is one of the more difficult problems in orthopaedic surgery. There is confusion between the normal laxity with translation and subluxation of the humeral head relative to the glenoid and an abnormal amount of laxity, leading to pain and dysfunction. Unfortunately, there is no single treatment that applied to all lesions that cause the instability. It is imperative, therefore, that an accurate diagnosis be made, including the directions and degree of shoulder instability as well as any coexisting problems. Anatomical defects must be defined. Common factors that could most readily compromised instability repair are examined. These include techniques for making an accurate diagnosis with identification of the precise anatomical pathology, and the rationale for appropriate surgical treatment with the avoidance of technical complication such as unnecessary hardware or exposures that might lead to residual instability, arthritis, and nerve or vascular injuries. Additional injuries may be prevented by careful rehabilitation postoperatively to restore shoulder stability, flexibility, and endurance prior to an individual's return to stressful sports or work.

• Clinics in Shoulder and Elbow
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• v.21 no.3
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• pp.169-175
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• 2018

Traumatic anterior dislocation of the shoulder is one of the most common directions of instability following a traumatic event. Although the incidence of shoulder dislocation is similar between young and elderly patients, most studies have traditionally focused on young patients due to relatively high rates of recurrent dislocations in this population. However, shoulder dislocations in older patients also require careful evaluation and treatment selection because they can lead to persistent pain and disability due to rotator cuff tears and nerve injuries. This article provides an overview of the nature and pathology of acute primary anterior shoulder dislocation, widely accepted management modalities, and differences in treatment for young and elderly patients.

• Journal of the Korean Society of Physical Medicine
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• v.19 no.2
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• pp.107-122
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• 2024

PURPOSE: This study examined sports injuries among national sitting volleyball players and to provide baseline data for the development of programs to prevent injuries and enhance performance. METHODS: The study surveyed 21 national team athletes (12 males and nine females) participating in the 4^th Hangzhou Asian Para Games. The questionnaire consisted of 17 items, including general information, type of disability, sites and types of sports injuries and their causes, the current state of sports injuries and the treatment and management of injuries. RESULTS: The survey results suggested that the most common injury sites were the finger, shoulder, and waist. The most frequent types of injuries were sprain, muscle cramp, and LBP. The causes were insufficient warm-up, playing unhealed and carelessness. Injuries were most prevalent during morning training and in the winter. Most injuries occurred in practice, and the actions most likely to cause injuries were blocking, spike and sitting movements. Ice and spray were the most common treatments, usually administered by the athletes themselves. Physical therapy was the most common post-injury management, and the most common sequelae involved continuing to use despite pain. CONCLUSION: Based on these results, systematic and individualized training and therapeutic support tailored to the characteristics of sitting volleyball and the types of disabilities are necessary to prevent and manage sports injuries among national players. Continuous injury management by medical staff, particularly physical therapists, is essential to maintain the health of disabled athletes.

• Journal of Korean Orthopaedic Sports Medicine
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• v.3 no.1
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• pp.22-24
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• 2004

Snowboarding has become one of the premier alpine sports. The past decade has seen the popularity of snowboarding increase dramatically and the recent Winter Olympic Game showcased the strong visual appeal of the sport and the youth-oriented lifestyle and culture that accompanies it. The injury profile of the sport has also undergone change along with technological advances in boot and binding systems and the changing demographics of the sports participants. Central to the development of injury-prevention strategies is knowledge of the profile of injuries that occur, understanding those who are at particular risk and, if possible, the biomechanical factors involved in each injury type. Snowboarding was initially considered a dangerous, uncontrolled, alpine sport - an opinion based on little or no scientific evidence. That evidence has rapidly grown over the past decade and we now know that snowboard injury rates are no different to those in skiing; however, the injury profile is different. The purpose of this review is to give some perspective to the current snowboard injury literature. It discusses not only the demographic profile of those injured and the type of injuries that occur, but also gives some insight into the progress that has occurred in determining the impact of specific prevention strategies, such as splints to prevent injuries to the wrist/forearm. As the literature indicates, however, some things will not change, e.g. injuries are more likely to occur in beginners and lessons need to be reinforced as a fundamental aspect of any injury-prevention strategy.

• 대한정형외과스포츠의학회:학술대회논문집
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• 2003.11a
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• pp.120-131
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• 2003

• Clinics in Shoulder and Elbow
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• v.19 no.2
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• pp.73-77
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• 2016

Background: The first purpose of this study is to compare the clinical and radiological outcomes of surgical treatment for displaced midshaft clavicle fracture (Robinson type 2B1 vs. 2B2) with 3.5-mm low profile clavicular locking compression plate. The second purpose is to evaluate the difference of the results depending on the presence of accompanying injuries. Methods: Forty-nine patients who underwent an operation for the fractures were reviewed retrospectively. Fracture patterns were classified according to group 2B1 and 2B2 using Robinson's classification. For radiological outcome, time to union after operation was evaluated and for clinical outcome, American Shoulder and Elbow Society (ASES) score, University of California in Los Angeles (UCLA) score, visual analogue scale (VAS), and range of motion (ROM) were evaluated from preoperative period to last follow-up period. Results: The mean time for union was not significantly different in the 2B1 group and 2B2 group (p=0.062). No statistically significant difference in ASES score, UCLA score, and VAS was observed between 2B1 and 2B2 (p=0.619, p=0.896, p=0.856, respectively). In ROM, significant higher mean forward flexion and abduction was observed in 2B2 (p=0.025, p=0.017, respectively) and there was no difference in external rotation and external rotation at shoulder $90^{\circ}$ abduction position (p=0.130, p=0.180, respectively). There was no significant difference in clinical outcomes according to the accompanying injuries. Conclusions: There was no difference in clinical and radiological outcome between Robinson 2B1 and 2B2 type fracture after the operation. Accompanying injuries may not affect the clinical result of displaced midshaft clavicle fractures.

• Clinics in Shoulder and Elbow
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• v.24 no.4
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• pp.209-214
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• 2021

Background: The treatment for acromioclavicular joint injuries (ACJI) ranges from a conservative approach to extensive surgical reconstruction, and the decision on how to manage these injuries depends on the grade of acromioclavicular (AC) joint separation, resources, and skill availability. After a thorough review of the literature, the researchers adopted a simple cost-effective technique of AC joint reconstruction for acute ACJI requiring surgery. Methods: This was a prospective single-center study conducted between April 2017 and April 2018. For patients with acute ACJI more than Rockwood grade 3, the researchers performed open coracoclavicular ligament reconstruction using synthetic sutures along with an Endobutton and a figure of 8 button plate. This was followed by AC ligament repair augmenting it with temporary percutaneous AC K-wires. Clinical outcomes were evaluated using the Constant Murley shoulder score. Results: Seventeen patients underwent surgery. The immediate postoperative radiograph showed an anatomical reduction of the AC joint dislocation in all patients. During follow-up, one patient developed subluxation but was asymptomatic. The mean follow-up period was 30 months (range, 24-35 months). The mean Constant score at 24 months was 95. No AC joint degeneration was noted in follow-up X-rays. The follow-up X-rays showed significant infra-clavicular calcification in 11 of the 17 patients, which was an evidence of a healed coracoclavicular ligament post-surgery. Conclusions: This study presents a simple cost-effective technique with a short learning curve for anatomic reconstruction of acute ACJI. The preliminary results have been very encouraging.

• Clinics in Shoulder and Elbow
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• v.9 no.1
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• pp.42-49
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• 2006

Purpose: This study evaluated clinical results, and recommended treatment protocol of traumatic anterior shoulder dislocation in the patients older than 60 years of age. Materials and Methods: Thirty-eight patients with first traumatic anterior shoulder dislocation aged over 60 years were included. The average age was 69.4 (range, 60 to 87 years). There were 8 men (average age of 71.6) and 30 women (average age of 69). Most common cause of injuries was a fall on the outstretched hand. The additional injuries were evaluated using MRI or CT arthrogram in the patients with significant pain and weakness while movements after 2 weeks sling immobilization. Results: Fifteen patients (39%) had rotator cuff tears and 5 patients (14%) had greater tuberosity fractures. The sizes of rotator cuff tears were diverse; 2 partial tears, 1 small tear, 4 medium tears, 3 large tears and 5 massive tears. Among 5 massive cuff tears, 3 patients revealed cuff arthropathy after reduction. 4 patients (11%) had recurrent dislocation more than one time during 1 month after the first dislocation. Bankart lesions revealed in 5 patients and three of them had associated rotator cuff tears. 3 out of 5 patients with Bankart lesions, 13 out of 15 patients with rotator cuff tears and 3 patients with displaced greater tuberosity fracture had operations. Conclusion: The injury mechanism of shoulder dislocation in patients older than 60 years of age seems to have either anterior or posterior mechanism. The diagnosis and treatment should be approached 2 weeks after dislocation.

• Clinics in Shoulder and Elbow
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• v.6 no.2
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• pp.99-107
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• 2003

Disorders of the shoulder in which conservative management is indicated as a primary treatment include idiopathic frozen shoulder, atraumatic instability. acute calcific tendinitis , subacromial impingement syndrome, partial thickness or small full thickness tear of the rotator cuff, and chronic rotator cuff tear in elderly population. Aside from medication and various physical modalities used for relief of pain, the mainstay of orthopaedic rehabilitation consists of stretching of the tendons and capsulologamentous complex, and strengtnening of rotator cuff muscles as well as surrounding muscles. However, orthopaedic rehabilitation in chronically painful conditions of the shoulder differs in detail according to the specific diseases or injuries, And it is important to make the rehabilitation program that can be undertaken by the patients rather than adhering to a fixed schedule. Also the program should be changed as the condition of the patient improves or deteriorates. Nevertheless there are basic rules of stretching and strengthening , which should always be observed in applying orthopaedic rehabilitation treatment.

• Therapeutic Science for Rehabilitation
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• v.12 no.3
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• pp.33-44
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• 2023

Objective : The purpose of this study was to identify the risk factors for shoulder pain in manual wheelchair users with spinal cord injuries and to explore the correlation between shoulder pain and quality of life. Methods : Out of 182 participants initially included, 168 were selected for analysis. The questionnaire had 41 questions, with 15 on the Wheelchair User's Shoulder Pain Index (WUSPI) and 26 on the World Health Organization Quality of Life-BREF (WHOQOL-BREF). Results : It was found that participants' scored 50.75 in the WUSPI, whereas they scored higher in mobility and overhead activity. In addition, participants' WHOQOL-BREF scored 70.48, with a mean score of 2.71, which was lower than ordinary adults' WHOQOL-BREF (mean: 3.11) and that of older people suffering from chronic musculoskeletal system pain (total score: 77.92). Conclusion : The participants' WUSPI showed negative correlations with all items, including the total scores on the WHOQOL-BREF. This suggests that the participants' shoulder pain had a negative impact on their quality of life. Therefore, clinical experts, including occupational therapists, should provide manual wheelchair users with spinal cord injuries with programs aimed at preventing and managing shoulder pain, thereby contributing to improving their quality of life.