Traumatic forequarter amputation is an extremely rare and life-threatening injury. It is caused by blunt trauma or tremendous traction force, and the prognosis is very poor because of the involvement of massive associated injury. Traumatic forequarter amputation has been rarely reported in the English language clinical literature, but has never been reported in Korea. We report a case of traumatic forequarter amputation caused by a conveyor belt that was treated with emergency resuscitation and surgery, with an accompanying review of the literature.
Amputation ; Emergencies ; Korea ; Prognosis ; Resuscitation ; Traction

Isolated acromial fracture is not common and it frequently accompanies fractures to the coracoid process and glenoid bone and also injuries to the acromioclavicular joint. Furthermore, most of these combined acromial fractures have minimal displacement, which needs no additional treatment other than protection for a certain period of time. We have experienced a case of isolated fracture of the posterolateral angle of the acromion, which we reduced and fixated using K-wire and cannulated screws. We report on the technical aspects and clinical results of this reduction and fixation, along with a review of the literature.
Acromioclavicular Joint ; Acromion ; Displacement (Psychology)

Tuberculous arthritis on the sternoclavicular joint is an uncommon disease and a delayed diagnosis can be due to the obscure clinical symptoms. We should suspect tuberculous arthritis in patients with slowly progressive pain, swelling, mild fever and a previous history of tuberculosis. Early diagnosis is important through conducting a thorough physical examination and performing laboratory tests and radiologic study. Tuberculous arthritis on the sternoclavicular joint should be treated with a combination of systemic antituberculous agents and thorough surgical debridement in marked damaged joints. When performing this operation, it is important not only to minimized the injury of the costoclavicular ligament, but also to avoid injury to the surrounding the vital structures such as the mediastinum and pleura after aggressive resection or radical debridement. We describe here 2 cases of the tuberculous arthritis on the sternoclavicular joint: one case had a good result after surgical debridement with using an anti-tuberculous agent, and the other had fatal complications such as mediastinal abscess and pleural effusion after the operation.
Abscess ; Arthritis ; Debridement ; Delayed Diagnosis ; Early Diagnosis ; Fever ; Humans ; Joints ; Ligaments ; Mediastinum ; Physical Examination ; Pleura ; Pleural Effusion ; Sternoclavicular Joint ; Tuberculosis

Periarticular cysts in the shoulder joint are relatively rare. The most common are paralabral cysts, which can cause suprascapular nerve entrapment syndrome. Acromioclavicular juxtaarticular cysts have been described in association with full-thickness rotator cuff tears and a degenerated acromioclavicular joint. Intramuscular cysts of the rotator cuff are a relatively rare and unknown type of periarticular cyst. We report a case of an intramuscular cyst of the rotator cuff that was associated with a tear of the rotator cuff.
Acromioclavicular Joint ; Nerve Compression Syndromes ; Rotator Cuff ; Shoulder Joint

PURPOSE: This study examined the outcomes of reconstruction of the coracoclavicular ligaments with using two suture anchors and performing coracoacromial ligament transfer in patients with acromioclavicular dislocation. MATERIAL AND METHODS: Forty patients with complete acromioclavicular dislocation were included in this study. According to the preoperative radiographs, 5 patients with AC dislocations were diagnosed as type III, 4 patients as type IV and 31 patients as type V. Two 3.5mm suture anchors with four strands of nonabsorbable sutures were separately placed on the anterolateral and posteromedial portion of the base of the coracoid process to stabilize the distal clavicle. The coracoacromial ligament was then transferred to the undersurface of the distal end of the clavicle for augmentation. RESULTS: At a mean follow-up of 28 months, the average Constant score improved to 97 points. All the patients returned to normal life at an average of 3.2 months postoperatively. At the last follow-up, 37 patients achieved anatomical reduction and three patients showed complete redislocation. However, the clinical results of the patients with redislocation were satisfactory. CONCLUSION: Anatomical coracoclavicular reconstruction using two suture anchors and coracoacromial ligament transfer for treating complete acromioclavicular dislocation is a safe, effective procedure for restoring a physiologically stable acromioclavicular joint.
Clavicle ; Dislocations ; Follow-Up Studies ; Humans ; Ligaments ; Suture Anchors ; Sutures

PURPOSE: To review the clinical and radiological results after an open reduction and internal fixation with a T-shaped LCP for unstable distal clavicle fractures. MATERIALS AND METHODS: From February 2005 to June 2006, ten patients with distal clavicle Neer type II fractures were treated with an open reduction and internal fixation with a T-shaped LCP. Bony union was identified by plain radiography. The clinical results were analyzed according to the UCLA scoring system. RESULTS: The mean time to fracture union was 9weeks and union was achieved in all cases. The mean UCLA score was 33.4 (30-35); excellent in 8 cases and good in 2 cases. In one case, loosening of one distal screw was occured and mild AC joint subluxation was observed in another case. CONCLUSION: 3.5 mm T-shaped LCP fixation is a useful technique for treating unstable distal clavicle fractures. This procedure provide stable fixation with no further AC joint injury.
Clavicle ; Humans ; Joints

PURPOSE: We wanted to evaluate the normal glenoid size of Koreans in their 7th and 8th decades by conducting Computed tomographic (CT) studies. MATERIALS AND METHODS: The CT images were obtained from the normal scapulae of the patients (mean age: 68.8) who had humeral fracture. A display workstation version 2.0.73.315 was used to measure the scans to determine the maximal superoinferior (SI) and anteroposterior (AP) diameters of the glenoid vault. RESULTS: The average diameters of curvature of the glenoid were 31.2 mm (range: 27 to 34 mm) in the superior-inferior direction and 26.1mm (range: 22 to 31mm) in the anterior-posterior direction. CONCLUSION: This study showed the normal glenoid size of Koreans and it is different from the size that the international literature reported. It should be an important factor for the treatment of fracture or in designing arthroplasty implants.
Arthroplasty ; Humans ; Humeral Fractures ; Scapula ; Shoulder

PURPOSE: The purpose of this study is to compare the results of using a locking compression plate and an unlocked plate for treating proximal humeral fractures. MATERIALS AND METHODS: This study was based on 20 patients who underwent plate fixation for proximal humeral fractures out of the 87 patients with proximal humeral fractures and who were admitted from 2003 to 2007 in our hospital. Of the 20 patients, 10 were treated with a locking compression plate and the other 10 were treated with an unlocked plate. Each group was evaluated according to the humeral neck shaft angle, the period until bony union, the complications and the Constant score. The humeral neck shaft angle was based on plain x-rays taken immediately after the operation and at 6 months postoperatively. The Constant score was evaluated on the last visit to our clinic. RESULTS: There was no significant statistical difference between the two groups in terms of the neck shaft angle, the period until bony union and the Constant score. Yet, there were three cases of screw migration in the unlocked plate group. CONCLUSION: There was no significant difference between the two groups in terms of the neck shaft angle, the period until bony union and the Constant score. The locking compression plate is considered to achieve more effective fixation for proximal humerus fractures because there were less complications such as screw migration.
Humans ; Humerus ; Neck ; Shoulder Fractures

PURPOSE: To evaluate the clinical and radiographic results of the treatment of a proximal humerus fracture with a locking compression plate(LCP). MATERIALS AND METHODS: This study reviewed the results of 24 cases of a proximal humerus fracture treated with a LCP from January 2005 to April 2007, after a follow up of more than 12 months. There were 8 males and 16 females with a mean age of 68.9(33-90) years. The clinical results were evaluated using the Neer's evaluation criteria, and the radiographic results were evaluated using the bone union time and Paavoleinen method. RESULTS: The mean time for bone union was 11.9 weeks. Using the Neer's functional evaluation, 21 cases of the 24 patients (87%) showed excellent or satisfactory results. Twenty two cases (91%) showed good results according to the Paavoleinen method. The complications encountered were metal failure (1 patient), AVN of the humeral head (1 patient) and joint stiffness (1 patient). CONCLUSION: The LCP demonstrated good results in the treatment of a proximal humerus fracture and has relatively fewer complications than other internal fixators.
Female ; Follow-Up Studies ; Humans ; Humeral Head ; Humerus ; Joints ; Male

PURPOSE: Parsonage-Turner syndrome is a rare disorder with sudden onset of severe pain around the shoulder girdle, followed by weakness of the shoulder muscles. The purpose of the current study was to describe the clinical features associated with this condition and to review the literature. MATERIALS AND METHODS: A retrospective study of the Parsonage-Turner syndrome was carried out for 6 patients seen from December 2005 to July 2008. The clinical and radiographic data was collected by medical records and telephone interviews. Five patients were males and one was female with ages ranging between 20-68 years (mean, 43.5). The mean follow-up period was 19.1 months (range, 14-27 months). RESULTS: The intense pain around shoulder continued for 1 day to 3 weeks and decreased spontaneously at a mean of 3.3 weeks (range, 2-5 weeks) after onset of pain. Weakness in the involved muscles had developed at a mean of four weeks (range, 2-7 weeks). At the end of follow-up, five patients had an improvement of their strength and one patient had regained full strength. Electromyography was the most helpful in diagnosis. CONCLUSION: Parsonage-Turner syndrome is a self-limited disorder with a good outcome. Understanding of the course will assist in the diagnosis and treatment.
Brachial Plexus Neuritis ; Electromyography ; Female ; Follow-Up Studies ; Humans ; Interviews as Topic ; Male ; Medical Records ; Muscles ; Retrospective Studies ; Shoulder