Yeo Seung Yoon

The Spectrum of Lesions and Clinical Results of Arthroscopic Stabilization of Acute Anterior Shoulder Instability

Purpose The purpose of this study is to investigate and analyze accom-panying lesions including injury types of anteroinferior labrum lesion in young and active patients who suffered traumatic anterior shoulder dislocation for the first time. Meterials and Methods The study used magnetic resonance angiography (MRA) to 40 patients with acute anterior shoulder dislocation from April 2004 to April 2008, and of those, 36 with abnormal MRA finding were treated with arthroscopy. Results There was a total of 25 cases of anteroinferior glenoid labrum lesions. A superior labrum anterior-posterior lesion (SLAP) lesion was observed in 8 cases. For bony lesions, 22 cases of Hill-sachs lesions, 4 cases of lesions in greater tuberosity fracture of humerus, and 4 cases of loose body were found. For lesions involving rotator cuff, partial articular side rupture was found in 2 cases and 2 cases were found to have a complete rupture. Conclusion Under MRA and arthroscopy performed on patients with acute anterior shoulder dislocation, it was observed to have varying types of anteroinferior labrum lesions such as Perthes, Bankart, ALPSA, and bony Bankart lesion. that MRA is a remar-kably useful tool to classify various lesions in acute anterior dislocation of the shoulder and to make a diagnosis, making it a useful tool to decide a treatment method while consulting patients and their families.

Comparison of early fixation and delayed reconstruction after displacement in previously nondisplaced acromion fractures.

Scapular fractures account for approximately 1% of all fractures, and 8% to 10% are acromion fractures. We compared the results of early and delayed treatment for nondisplaced and type III acromion fractures, respectively, to investigate an early treatment method for nondisplaced acromion fractures. Patients treated between March 1999 and March 2006 with 2-year follow-up were selected for the study. The early fixation group comprised 16 patients, and the delayed reconstruction group comprised 18 patients. Moreover, the delayed reconstruction group was further divided into 2 additional groups: delayed group B and delayed group N. Delayed group B comprised 7 cases receiving bone graft, and delayed group N comprised 11 cases not receiving bone graft. Mean Constant scores were significantly greater for the early fixation group (92+/-6.6; range, 64-98) than for both delayed groups N (86+/-7.8; range, 54-96) and B (81+/-9.4; range, 58-92) (P=.042 and .024, respectively). Mean pain score was 14+/-4.8 (range, 5-15) in the early fixation group, 12+/-7.4 (range, 5-15) in delayed group N, and 9+/-8.8 (range, 5-15) in delayed group B (P=.052 and .018, respectively). Mean daily activity score was also significantly greater in the early fixation group (19+/-6.4; range, 16-20) than in both delayed group N (14+/-6.2; range, 10-18) and delayed group B (10+/-4.4; range, 8-18) (P=.048 and .021, respectively). The P values for Constant, pain, and daily activity scores between delayed groups N and B were .048, .038, and .052, respectively. In cases of young patients with type IC acromion fractures at the time of injury, a high activity level, and the early need for crutches or a walker, early surgical treatment should be considered.

Chronic Irreducible Anterior Dislocation of the Shoulder without Significant Functional Deficit.

Shoulder dislocation is frequently encountered by orthopedists, and closed manipulation is often sufficient to treat the injury in an acute setting. Although most dislocations are diagnosed and managed promptly, there are rare cases that are missed or neglected, leading to a chronically dislocated state of the joint. They are usually irreducible and cause considerable pain and functional disability in most affected patients, prompting the need to find a surgical method to reverse the worsening conditions caused by the dislocated joint. However, there are cases of even greater rarity in which chronic shoulder dislocations are asymptomatic with minimal functional or structural degeneration in the joint. These patients are usually left untreated, and most show good tolerance to their condition without developing disabling symptoms or significant functional loss over time. We report on one such patient who had a chronic shoulder dislocation for more than 2 years without receiving treatment.