Anterior shoulder dislocation is a common injury among athletes, particularly during resistance training, where muscle resistance can complicate reduction procedures. In muscular patients, traditional reduction techniques may be challenging due to increased muscle tone and resistance. This case report describes a 29-year-old male patient who suffered an anterior shoulder dislocation while performing bench press exercises. Ultrasound-guided brachial plexus block (BPB) was used, resulting in effective pain relief and muscle relaxation, enabling successful reduction without sedation or general anesthesia. This report highlights the utility of BPB in managing difficult reductions, particularly in patients with significant muscle mass.

Rotator cuff tears are common shoulder injuries, particularly in older adults. Arthroscopic rotator cuff repair (ARCR) is the preferred treatment due to its successful outcomes, but complications like suture knot impingement may arise.Knot impingement, although rare, can lead to subacromial bone erosion and persistent pain. The condition remains under-reported, and direct evidence linking knot impingement to subacromial erosion is scarce. A 63-year-old woman presented with progressively worsening shoulder pain and restricted range of motion, 10 years after undergoing ARCR. Clinical assessment indicated subacromial impingement with positive Neer, Hawkins test results and reduced shoulder mobility. Arthroscopic evaluation revealed suture knots embedded in the subacromial bone, directly causing erosion. This is the first case to confirm through arthroscopy that subacromial bone erosion resulted from knot impingement. This case emphasizes the importance of follow-up and highlights the need to consider alternative suture techniques to avoid complications like knot impingement. Surgeons should be vigilant in minimizing risks associated with suture materials and techniques to improve long-term outcomes for patients undergoing ARCR.

Achilles tendon injuries frequently lead to postsurgical complications, including tendon tightness and discomfort. This case report describes a 28-year-old male with Achilles tendon tightness following tendon repair surgery, effectively treated with focused extracorporeal shockwave therapy (ESWT). Ultrasound imaging confirmed symptomatic and structural improvements, expanding ESWT indications in postsurgical tendon complications.

Purpose: Persistent postoperative stiffness is a common complication after arthroscopic rotator cuff repair (ARCR).We hypothesized that a subacromial steroid injection (SAI) may improve the early outcomes in patients with persistent stiffness without increasing steroid-associated complications. Therefore, we evaluated the effectiveness and safety of SAI in patients with persistent stiffness 3 months after ARCR. Methods: We retrospectively analyzed 300 ARCR cases performed between January 2012 and May 2014, in which repair integrity was confirmed at postoperative 3 months. Patients were divided into SAI and control groups. The SAI group received a single SAI (triamcinolone 40 mg and ropivacaine 52.5 mg) to address postoperative stiffness, with no additional SAI thereafter. The control group did not receive any injections until the final follow-up. Functional and radiological outcomes were compared between the two groups. Results: The mean follow-up period was 18.1±4.7 months (range, 12.1–37.2 months), with no difference between groups (p=0.731). At the time of injection, the range of motion was significantly lower in the SAI (all p＜0.001). However, functional outcomes were comparable between the two groups at 3 months after injection and the final follow-up (all p＞ 0.05). The healing failure rate at the final follow-up also did not differ between the SAI and control groups (14.9% vs. 13.2%, p=0.671). Conclusion This short-term follow-up study suggests that the administration of a single SAI to treat persistent stiffness at 3 months after ARCR may improve functional recovery without increasing the risk of healing failure.

Purpose: Arm wrestling is a common strength competition, particularly among young men, including military personnel.While previous studies have examined humeral shaft fractures from arm wrestling or in soldiers, no research has focused on both. This study evaluates the outcomes of dual plating fixation via the anterolateral approach for arm wrestling-induced fractures in soldiers. Methods: This retrospective study included 18 male patients (mean age, 21.7 years) treated at the Armed Forces Daejeon Hospital (May 2022–December 2023). Data on rank, radial nerve injury, fracture type (AO-OTA classification), and clinical outcomes (union time, radial nerve recovery, DASH score) were analyzed. Results: The cohort included 12 soldiers, two non-commissioned officers, and four officers. Common fracture types were A1 and B1, with four cases of radial nerve palsy. Union occurred at 12.5 weeks, and nerve recovery averaged 15 weeks. No cases of non-union or persistent nerve damage were observed. Conclusion Arm wrestling carries a high risk of humeral fractures in soldiers. Awareness and preventive measures should be emphasized. The dual plating fixation technique via the anterolateral approach is highly effective, demonstrating excellent union and recovery outcomes.

Purpose: The purpose of this study is to compare scapular alignment, muscle strength around the scapula and neck according to the classification of forward head posture (FHP), round shoulder posture (RSP) and forward head with round shoulder posture (FHRSP). Methods: Scapular alignment, muscle strength around the scapula, and neck strength were measured according to the FHP and RSP alignment classification for male college students. Scapular alignment was confirmed by measuring acromial depression, scapular lateral displacement, and scapular acromion distance. Muscle strength was measured during isometric contraction of upper trapezius (UT), middle trapezius (MT), lower trapezius (LT), and neck muscles. Results: Acromial depression was significantly greater in the FHP (7.20±1.02 cm) than in the RSP group (5.60±1.26 cm) and FHRSP (5.26±1.75 cm) (p＜0.05). The strength of the UT was significantly greater in the FHRSP (1.12±0.12 N/BW) than in the FHP (0.87±0.19 N/BW), and the strength of the LT was significantly greater in the control group (0.20±0.04 N/BW) than in the FHP (0.15±0.03 N/BW) and RSP (0.15±0.04 N/BW) (p＜0.05). The LT:UT ratio was significantly greater in the control group (0.20±0.05) than in the FHRSP (0.15±0.02) (p＜0.05). Conclusion UT strength was higher in RSP subjects with scapular elevation accompanied by FHP than in those with FHP alone. And LT strength and the LT:UT ratio were higher in subjects withno abnormalities in postural alignment. We suggest that these results can serve as a reference for evaluation and intervention according to postural alignment in clinical practice.

Purpose: The aim of this study was to examine whether a combined exercise (EX), including aerobic, resistance, and inspiratory muscle training, reduces fatigue and dyspnea, improves physical fitness, and if increased physical fitness after exercise is associated with attenuating symptoms in young adults with mild long coronavirus disease (COVID) symptoms. Methods: Twenty-eight young adults (aged 23±4 years) with long COVID were randomly assigned to either the EX group (n=14), which underwent aerobic, resistance, and inspiratory muscle training three times per week for 8 weeks, or the control (CON) group (n=14). Symptoms of dyspnea and fatigue were assessed using self-report questionnaires.Cardiorespiratory fitness was directly measured during cardiopulmonary exercise testing, while muscle strength was measured by isokinetic muscle testing. These variables were measured before and after the exercise intervention. Results: Compared to the CON group, the EX group showed improvements in symptoms of fatigue and dyspnea, maximal oxygen consumption (VO2peak ), and peak torque, with significant interaction effects observed (p＜ 0.05). The EX group exhibited a mean difference of 2.9 mL/kg/min in VO2peak (95% confidence interval [CI], 1.8−4.0) and 13.0 Nm (95% CI, 6.1−19.8) in peak torque compared to the CON group (p＜0.05). Improvements in VO2peak were negatively associated with attenuations in both fatigue and dyspnea after the exercise intervention (p＜0.05). Conclusion These findings indicate that EX training can effectively alleviate symptoms and improve physical fitness in young adults with mild long COVID. Structured exercise training may serve as an effective intervention to improve the health of those with long COVID.