1.Adrenal Insufficiency in Patients with Rotator Cuff Tear: Prevalence, Risk Factors and Influence on Outcome.
Clinics in Shoulder and Elbow 2015;18(2):80-85
BACKGROUND: This study measured the rate of adrenal insufficiency among rotator cuff tear patients, and determined the roles of steroid treatment and herbal medicine as specific risk factors of adrenal insufficiency. METHODS: We prospectively evaluated the 53 patients who agreed to participate in the study and underwent arthroscopic rotator cuff repair due to a chronic full-thickness tear from March 2012 to September 2013. The diagnosis of adrenal insufficieny was made by rapid adrenocortical hormone test before the operation. We collected information regarding their history of steroid and herbal medicine treatment within the last 12 months. RESULTS: The rate of adrenal insufficiency among the rotator cuff tear patients in our study was 18.9% (10 of 53 patients). Steroid treatment (p=0.034), frequency of local steroid injection (p=0.008), and herbal medicine treatment (p=0.02) showed significant association with the risk of adrenal insufficiency. CONCLUSIONS: In this study, careful taking of a patient's medical history, such as the use of steroids and herbal medicine, is important when investigating adrenal function before surgery.
Adrenal Insufficiency*
;
Diagnosis
;
Herbal Medicine
;
Humans
;
Prevalence*
;
Prospective Studies
;
Risk Factors*
;
Rotator Cuff*
;
Steroids
2.Clinical and Radiological Outcome after Surgical Treatment in Displaced Clavicular Midshaft Fracture.
Clinics in Shoulder and Elbow 2016;19(2):73-77
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° 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.
California
;
Classification
;
Clavicle
;
Elbow
;
Follow-Up Studies
;
Fractures, Closed
;
Humans
;
Preoperative Period
;
Range of Motion, Articular
;
Retrospective Studies
;
Shoulder
;
Treatment Outcome
3.Clinical and Radiological Outcomes of Hook Plate Fixation in the Lateral End Fracture of the Clavicle and Acromioclavicular Dislocation.
Young Kyoung MIN ; Jung Han KIM ; Heui Chul GWAK
Clinics in Shoulder and Elbow 2016;19(4):209-215
BACKGROUND: The purpose of this study was to identify the clinical and radiological outcomes of hook plate fixation for lateral end fracture of the clavicle and acromioclavicular dislocation. METHODS: There were a total of 20 cases with lateral end fracture of the clavicle and 16 cases with acromioclavicular dislocation. All patients were evaluated for range of motion, functional score by using Constant score, and American Shoulder and Elbow Surgeons shoulder index at just before implant removal and at final follow-up. Coracoclavicular distance was measured in acromioclavicular dislocation and bony union was evaluated in the lateral end fracture of the clavicle. RESULTS: The clinical outcomes and range of motion were increased at the final follow-up compared with just before implant removal in both the lateral end fracture of the clavicle and acromioclavicular dislocation. In acromioclavicular dislocation, all cases—except one—showed maintenance of reduction after implant removal. Moreover, in the lateral end fracture of the clavicle, all cases—except one—showed bony union. CONCLUSIONS: Hook plate fixation in the lateral end fracture of the clavicle and acromioclavicular dislocation resulted in good clinical and radiological results.
Clavicle*
;
Dislocations*
;
Elbow
;
Follow-Up Studies
;
Humans
;
Range of Motion, Articular
;
Shoulder
;
Surgeons
4.Clinical and Radiologic Results Comparing the Periarticular Proximal Humerus Locking Plate and Polarus Nail for Displaced Proximal Humerus Fractures.
Young Kyoung MIN ; Seung Jun LEE ; Heui Chul GWAK ; Sang Woo KANG ; Kuen Tak SUH
Clinics in Shoulder and Elbow 2017;20(4):208-216
BACKGROUND: This study compared the clinical and radiological outcomes of the single calcar screw plate and Polarus nail techniques for the treatment of the proximal humerus fractures. METHODS: Seventy-two patients diagnosed with displaced proximal humerus fracture were enrolled for the study. Of these, 50 patients underwent the locking plate surgery with a single calcar screw (plate group), whereas 22 patients underwent the Polarus nail surgery (nail group). The plate group was further divided into plate 1 group (with medial support), and plate 2 group (without medial support). The radiological and functional results of both groups were compared to the nail group. RESULTS: The α angle 1 year after surgery was significantly different between plate 1 and plate 2, and plate 2 and nail groups (p=0.041, p=0.043, respectively). The ratio that does not satisfy the reference value of γ angle was 2.8% in plate 1, 7.1% in plate 2 and 22.7% in nail group (p=0.007); there was a significant difference between plate 1 and nail group, and plate 2 and nail group (p=0.014, p=0.033, respectively). CONCLUSIONS: No significant differences were observed in the clinical results between locking plate and Polarus nail. However, in the plate 2 group and nail group, the rate of failure to maintain reduction during the 1-year period after surgery was statistically and significantly higher than the plate 1 group (level of evidence: level IV, case series, treatment study).
Humans
;
Humeral Fractures
;
Humerus*
;
Reference Values
5.Premature Peripheral Arterial Disease with the 5th Toe Necrotizing Lesion after Workout: A Case Report
Heui-Chul GWAK ; Jun-Min YOON ; Dae-Yoo KIM
The Korean Journal of Sports Medicine 2022;40(4):259-262
Premature peripheral arterial disease is characterized by onset of peripheral arterial occlusion before age of 50 years. Its prevalence is rare. To the best of the authors’ knowledge, there is rare research of premature peripheral arterial disease in Korea. The authors encountered a case of necrotic toe caused by premature peripheral arterial disease after soccer workout. This paper reports this case with a review of the relevant literature.
6.Operative Treatment of Osteochondral Lesion of the Talus: Arthroscopic Bone Marrow Stimulation (Multiple Drilling or Microfracture)
Journal of Korean Foot and Ankle Society 2020;24(2):48-54
Osteochondral lesion of the talus (OLT) is a broad term used to describe an injury or abnormality of the talar articular cartilage and adjacent bone. Various terms are used to describe this clinical entity, including osteochondritis dissecans, osteochondral fractures, and osteochondral defects. Several treatment options are available; the choice of treatment is based on the type and size of the defect and the treating clinician’s preference. Arthroscopic microfracture (a bone marrow stimulation technique) is a common and effective surgical strategy in patients with small lesions or in those in whom non-operative treatment has failed. This study had the following aims: 1) to review the historical background, etiology, and classification systems of OLT; 2) to describe a systematic approach to arthroscopic bone marrow stimulation for OLT; and 3) to determine the characteristics that are useful for assessing osteochondral lesions, including age, size, type (chondral, subchondral, cystic), stability, displacement, location, and containment of the lesion.
7.Rupture of Achilles Tendon after Steroid Injection in Achilles Tendinitis (A Report of Five Cases).
Jeon Gyo KIM ; Heui Chul GWAK ; Jong Min BAIK
Journal of Korean Foot and Ankle Society 2013;17(4):309-315
PURPOSE: The purpose of the study was to investigate five cases with chronic Achilles tendon rupture that occurred after steroid injections. MATERIALS AND METHODS: In our hospital, we experienced five cases of chronic Achilles tendon rupture from September 2010 to March 2012. All patients had got steroid injection for Achilles tendinitis at the other hospitals, and their heel pain was aggravated when they visited our outpatient department. After treatment, signs and symptoms of Achilles tendon rupture were developed and the diagnosis was confirmed by ultrasonography or magnetic resonance imaging (MRI). Surgical treatment was done for Achilles tendon rupture. RESULTS: There was difference between intra-operative findings of Achilles tendon rupture and usual chronic Achilles tendon rupture. Unlike usual findings of chronic Achilles tendon rupture whose scar tissue or tissue attenuation are found around the defect area of Achilles tendon, there were partial necrosis of tendon severe adhesion with surrounding tissue, extensive defect and longitudinal rupture on ruptured area. Also, severe inflammation of paratenon, granulation and fibrinoid deposit were found on biopsy findings in four cases. CONCLUSION: Based on review of data about relative risk and benefit of local corticosteroid injection to inflammatory lesion in Achilles tendon, it requires more attention to Achilles tendon rupture following local corticosteroid injection.
Achilles Tendon*
;
Biopsy
;
Cicatrix
;
Diagnosis
;
Heel
;
Humans
;
Inflammation
;
Magnetic Resonance Imaging
;
Necrosis
;
Outpatients
;
Rupture*
;
Tendinopathy*
;
Tendons
;
Ultrasonography
8.A Osteochondroma of Calcaneus with Gouty Arthritis of the Subtalar Joint (A Case Report).
Journal of Korean Foot and Ankle Society 2012;16(4):280-285
Osteochondroma, which is an osteocartilaginous exostosis, is essentially the most common primary bone tumor. These benign neoplasms are generally asymptomatic and have a relatively small potential for adverse effects. Calcaneal osteochondroma is rare, furthermore osteochondroma accompanying with gouty arthritis is very rare. Also, the subtalar joint is not a classic site of acute gout. In this report, we report the case of a patient who experienced an unusual calcaneal osteochondroma with undiagnosed gouty arthritis of the subtalar joint.
Arthritis, Gouty
;
Calcaneus
;
Gout
;
Humans
;
Osteochondroma
;
Subtalar Joint
9.Ankle Syndesmotic Injury.
Heui Chul GWAK ; Young wook KWON
Journal of Korean Foot and Ankle Society 2011;15(4):187-194
Ankle injuries may involve the distal tibiofibular syndesmosis and can be associated with a variable degree of trauma to the soft tissue and osseous structures that play an important role in ankle joint stability. Ankle syndesmotic injury may occur solely as a soft tissue injury or in association with variable ankle fractures. Ankle syndesmotic injury does not necessarily lead to ankle instability; however, the coexistence of deltoid ligament injury critically destabilizes the ankle joint. The prevalence of these injuries may be higher than previously reported. The diagnosis of syndesmotic injury as not always easy because isolated ankle sprains may be missed in the absence of a frank diastasis and syndesmotic instability may be unnoticed in the presence of bimalleolar ankle fractures. Controversies arise at almost every phase of treatment includings : type of fixation(screw size, type of implant), number of cortices required for fixation and of need for hardware removal. Regardless of controversies, the most important goal should be restore and maintain the normal tibiofibular relationship to allow for healing of the ligamentous structures of the syndesmosis.
Animals
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Ankle
;
Ankle Injuries
;
Ankle Joint
;
Ligaments
;
Prevalence
;
Soft Tissue Injuries
;
Sprains and Strains
10.Cause of Metatarsalgia.
Journal of Korean Foot and Ankle Society 2017;21(3):79-82
Metatarsalgia is one of the most common causes of patients complaining of pain in their feet. This pain is the plantar forefoot, including the second to fourth metatarsal heads and arises from either mechanical or iatrogenic causes. On the other hand, it is frequently accompanied by a deformity of the toes as well as of the first and fifth rays. The pain has a variety of causes, and sometimes the cause is difficult to distinguish. The variability of possible causative factors necessitates an individualized approach to treatment. To determine these causes, this paper presents an overview of the gait mechanics, plantar pressure, and the classification according to the etiology.
Classification
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Congenital Abnormalities
;
Foot
;
Gait
;
Hand
;
Head
;
Humans
;
Mechanics
;
Metatarsal Bones
;
Metatarsalgia*
;
Toes