팔꿈치보호대와 키네시오 테이핑 처치가 내측상과염 시니어 여성 골프선수의 통증, 손목 ROM 및 골프수행능력에 미치는 영향

이승재 대한체육학회 2022 대한스포츠융합학회지 (jcses) Vol.20 No.2

The purpose of this study was to examine the effects of elbow sleeve and kinesiology taping (KT) treatment on pain, wrist joint ROM, and golf performance in senior female golf player with medial epicondylitis. The study subjects were 11 female senior club golf players diagnosed with medial epicondylitis (61.7±2.8 years old). As a randomized cross-over design, this study was classified into a elbow sleeve group (TES group), a hard type elbow sleeve group (HTES group), a placebo elbow sleeve group (PES group), and a KT group. For the elbow protector, fortium taping elbow sleeve pro developed by Fortium (Co., Ltd.) and hard type fortium elbow sleeve ex1 were used. As a result, the TES group, the HTES group, and the KT group showed that there was no difference in the subject's grip strength, pain scale, wrist ROM, and golf performance. It is thought that the effect of the elbow sleeve could be expected as much as the effect of the KT treatment, which is useful for medial epicondylitis. Therefore, wearing an elbow sleeve for senior female golf player with medial epicondylitis suggested its potential use in the future along with KT treatment for golf performance and pain prevention.

테이핑이 내측 상과염 환자의 통증에 미치는 효과

서영교,김기철,이재홍,최정희,김신균,이수진,Seo, Young-Gyo,Kim, Ki-Chul,Lee, Jae-Hong,Choi, Jeong-Hee,Kim, Shin-Gyun,Lee, Su-Jin 대한고유수용성신경근촉진법학회 2012 PNF and Movement Vol.10 No.4

Purpose : The Purpose of this study was to investigate the effects of taping on the pain decrease in patient with medial epicondylitis. Methods : A total of 20 patients participated in this study. Group 1 of 10 subjects performed taping intervention three times a week. Group 2 of 10 subjects only therapeutic modalities for 30 minutes. We analyzed the descriptive statistics and one-way ANOVA by SPSS 12.0 for windows. Results : In comparison of VAS between pre and post value, the decrease of pain was significant in the experimental and control group(p<.05). In comparison of the difference of VAS score between the groups was significant difference at (p<.05). Conclusion : Taping techniques helped to lower VAS score in patients with medial epicondylitis. Further tirials, which give attention to these parts, are needed before any firm conclusions may be made.

Evaluation of the ulnar nerve with shear-wave elastography: a potential sonographic method for the diagnosis of ulnar neuropathy

김수진,이근영 대한초음파의학회 2021 ULTRASONOGRAPHY Vol.40 No.3

Purpose: This study was designed to verify whether shear-wave elastography (SWE) can be used to differentiate ulnar neuropathy at the cubital tunnel from asymptomatic ulnar nerve or medial epicondylitis. An additional aim was to determine a cut-off value to identify patients with ulnar neuropathy. Methods: This study included 10 patients with ulnar neuropathy at the cubital tunnel as confirmed with electromyography (three women and seven men; mean age, 51.9 years), 10 patients with medial epicondylitis (nine women and one man; mean age, 56.1 years), and 37 patients with asymptomatic ulnar nerve and lateral epicondylitis (21 women and 16 men; mean age, 54.0 years). Each patient underwent SWE of the ulnar nerve at the cubital tunnel, distal upper arm, and proximal forearm. Results: Patients with ulnar neuropathy at the cubital tunnel exhibited significantly greater mean ulnar nerve stiffness at the cubital tunnel (66.8 kPa) than controls with medial epicondylitis (21.2 kPa, P=0.015) or lateral epicondylitis (33.9 kPa, P=0.040). No significant differences were observed between patients and controls with regard to ulnar nerve stiffness at the distal upper arm or the proximal forearm. A stiffness of 31.0 kPa provided 100% specificity, 80.0% sensitivity, 100% positive predictive value, and 83.3% negative predictive value for the differentiation between ulnar neuropathy and medial epicondylitis. Conclusion: Cubital tunnel syndrome is associated with a stiffer ulnar nerve than lateral or medial epicondylitis. SWE seems to be a new, reliable, and simple quantitative diagnostic technique to aid in the precise diagnosis of ulnar neuropathy at the cubital tunnel.

Effectiveness of Initial Extracorporeal Shock Wave Therapy on the Newly Diagnosed Lateral or Medial Epicondylitis

Sang Seok Lee,Sangkuk Kang,Noh Kyoung Park,Chan Woo Lee,Ho Sup Song,손민균,조강희,Jung Hwan Kim 대한재활의학회 2012 Annals of Rehabilitation Medicine Vol.36 No.5

Objective To evaluate the effectiveness of initial extracorporeal shock wave therapy (ESWT) for patients newly diagnosed with lateral or medial epicondylitis, compared to local steroid injection.Method An analysis was conducted of twenty-two patients who were newly confirmed as lateral or medial epicondylitis through medical history and physical examination. The ESWT group (n=12) was treated once a week for 3 weeks using low energy (0.06-0.12 mJ/mm2, 2,000 shocks), while the local steroid injection group (n=10) was treated once with triamcinolone 10 mg mixed with 1% lidocaine solution. Nirschl score and 100 point score were assessed before and after the treatments of 1st, 2nd, 4th and 8th week. And Roles and Maudsley score was assessed one and eight weeks after the treatments.Results Both groups showed significant improvement in Nirschl score and 100 point score during the entire period. The local steroid injection group improved more in Nirschl score at the first week and in 100 point score at the first 2 weeks, compared to those of the ESWT group. But the proportion of excellent and good grades of Roles and Maudsley score in the ESWT group increased more than that of local steroid injection group by the final 8th week.Conclusion The ESWT group improved as much as the local steroid injection group as treatment for medial and lateral epicondylitis. Therefore, ESWT can be a useful treatment option in patients for whom local steroid injection is difficult.

주관절 내상과염과 동반된 척측 측부 인대 파열

구정회 ( Jung Hoei Ku ),조형래 ( Hyung Lae Cho ),진홍기 ( Hong Ki Jin ),김지언 ( Ji Un Kim ) 대한스포츠의학회 2017 대한스포츠의학회지 Vol.35 No.2

Medial epicondylitis, also known as “golfer`s elbow,” is a common overuse syndrome of the elbow and predominantly affects the origin of the common flexor tendon. We report two unique cases of medial epicondylitis complicated by chronic complete tear of the ulnar collateral ligament and common flexor tendon origin. Physical examination showed a focal huge swelling of medial epicondylar region of the dominant elbow and magnetic resonance imaging revealed complete tear of the ulnar collateral ligament and common flexor tendon and extravasation of intra-articular effusion. Satisfactory results were achieved with ulnar collateral ligament reconstruction and simultaneous repair of the common flexor tendon origin.

Treatment of Medial Epicondyle Fracture without Associated Elbow Dislocation in Older Children and Adolescents

박건보,곽윤해 연세대학교의과대학 2012 Yonsei medical journal Vol.53 No.6

Purpose: Displaced medial humeral epicondyle fractures with or without elbow dislocation have been treated with open reduction and fixation using K-wires or screws. The purpose of this study is to evaluate the clinical and radiological outcomes of surgical treatments of medial humeral epicondyle fracture without elbow dislocation according to the fixation methods. Materials and Methods: Thirty-one patients who had undergone open reduction and fixation of the displaced medial humeral epicondyle fracture without elbow dislocation were included. Group I consisted of 21 patients who underwent fixation with K-wires, and Group II comprised 10 patients who underwent fixation with cannulated screws. Immediate postoperative, final follow-up and normal anteroposterior radiographs were compared and the clinical outcome was assessed using the final Japanese Orthopaedic Association (JOA) elbow assessment score. Results: On the immediate postoperative radiographs, the distal humeral width in Group II was larger than that in Group I. On the final follow-up radiographs,the epicondylar position in Group I was lower than that in Group II. There was no significant difference in the distal humeral width, epicondylar position and joint space tilt between the immediate postoperative, final follow-up radiographs and the normal side within each group. There was no significant difference in the final JOA score between groups. Conclusion: Open reduction followed by K-wire fixation or screw fixation of the displaced medial humeral epicondyle fracture without elbow dislocation in older children and adolescents resulted in improved radiologic outcome and good elbow function in spite of diverse radiologic deformities.

K-강선 교차고정을 이용한 전위된 상완골 내측상과 골절의 수술적 치료

허윤무(Youn Moo Heo),김상범(Sang-Bum Kim),이진웅(Jin Woong Yi),이재익(Jae Ik Lee),유현진(Hyun Jin Yoo),김태균(Tae Gyun Kim) 대한정형외과학회 2015 대한정형외과학회지 Vol.50 No.6

목적: 전위된 상완골 내측상과 골절의 K-강선 교차고정을 이용한 수술 후 임상 결과에 대해 알아보고자 한다. 대상 및 방법: 탈구 여부에 관계없이 전위된 상완골 내측상과 골절로 정복 술 및 K-강선 교차고정술을 시행받은 17명을 대상으로 하였다. 남녀 각각 12예, 5예로 평균 나이는 12.7세였으며 임상적 결과는 Elbow Assessment Score of the Japanese Orthopedic Association을 사용해 평가하였다. 측정된 점수와 나이, 형태, 탈구여부, 전위 정도, 술 후 1년째 건 측과의 내상과 크기 차이를 통계적으로 비교 평가하였다. 결과: Elbow Assessment Score의 평균 점수는 98점이었고 형태는 type I: 2, type II: 9, type IV: 6예였으며, 탈구가 동반된 경우는 6예가 있었다. 평균 골절편 전위는 11.6 mm였으며 술 후 1년째 원위 상완골 내측 길이는 28.6 mm로 건측 28.1 mm에 비해 증가해 있었다. 점수와 유의성을 보인 것은 골절편의 전위뿐이었다(p=0.011). 결론: 소아 청소년에 있어 전위된 상완골 내측상과 골절에 대하여 K-강선을 이용한 교차 고정 및 정복은 주관절의 불안정이나 후유증 없이 양호한 임상적 결과를 얻을 수 있다. Purpose: The aim of this study was to investigate the clinical and radiological outcomes following reduction of displaced medial humeral epicondyle fracture with a K-wire cross-fixation. Materials and Methods: Seventeen patients (mean age, 12.7 years; 12 boys and 5 girls) who underwent cross-fixation using K-wires in displaced medial epicondyle fracture, regardless of dislocation, were included. Surgical outcomes were estimated using the Elbow Assessment Score of the Japanese Orthopaedic Association. Statistical significance between the elbow assessment score and age, fracture type, dislocation, displacement width, and size difference between bilateral medial epicondyles was estimated 6 weeks after surgery. Results: The mean elbow assessment score among the patients was 98 points (range, 94-100 points). Displaced medial epicondyle fractures were radiologically classified according to 3 groups: minimally displaced (2 cases), entrapped (9 cases), and associated with dislocation (6 cases). The mean displacement width of the fracture fragment was 11.6 mm. At 6 weeks postoperatively, the medial length of the distal humerus (28.6 mm) was greater compared to that of the contralateral side (28.1 mm). Displacement of the fracture fragment was statistically related to the elbow assessment score (p=0.011). The other assessed values did not show statistical meaning. Conclusion: Open reduction of the displaced medial humeral epicondyle fracture using K-wire cross-fixation in children and adolescents showed favorable clinical results with no instability or elbow complications.

Operative Treatment of Medial Epicondylitis

Sang Jin Cheon,Woong Ki Jeon 대한견주관절의학회 2015 대한견주관절의학회지 Vol.18 No.4

Background: The The purpose of this study was to make a comparative analysis of the clinical outcomes after the operative treatment of refractory medial epicondylitis between the suture anchor group and the non-suture anchor group. Methods: We enrolled 20 patients (7 men and 13 women) with recalcitrant medial epicondylitis who were able to receive operative treatment in a minimum of an 18-month follow-up. The mean age was 48.6 years (range, 36–59 years). The patients were allocated into either the suture anchor group (7 patients) or the non-suture anchor group (13 patients). We evaluated clinical outcomes using the visual analog scale (VAS), the pain grading system of Nirschl and Pettrone, and postoperative grip strength. Results: The VAS score decreased from 8.8 to 2.0 for the suture anchor group and from 8.6 to 1.3 for the non-suture anchor group(p=0.16). The postoperative grip strength was 95%, 93% of the non-treated arm in both groups (p=0.32). The postoperative satisfaction level was good in 5 patients and fair in 2 for the suture anchor group and excellent in 5 patients, good, in 4, and fair, in 4 for the nonsuture anchor group (p=0.43). The clinical outcomes did not show a statistically significant difference between the two groups. Conclusions: We found that patients with recalcitrant medial epicondylitis were treated reliably with satisfactory clinical outcomes whether or not suture anchors were used. We believe the use of suture anchors when more than 50% of the tendon origin is affected provides an effective and favorable treatment modality.

Heterotopic Ossification of the Elbow after Medial Epicondylectomy

Jae Hong Ha(하재홍),Hyun Sik Gong(공현식),Goo Hyun Baek(백구현) 대한정형외과학회 2015 대한정형외과학회지 Vol.50 No.1

주관절의 골절이나 인대/건 손상에 대한 수술 후 발생하는 이소성 골화는 잘 알려져 있다. 그러나 내상과 절제술 후 발생한 주관절의 이소성 골화는 드물다. 저자들은 각각 내상과염과 주관 증후군의 치료로 시행한 내상과 절제술 후 발생한 이소성 골화 2예를 보고한다. 수술 전 환자들은 내상과 주위에 석회 침착 소견을 보였었다. 이 증례들은 석회 침착이 있는 환자에서 내상과 절제술은 술 후 주관절의 이소성 골화 가능성을 높일 수 있을 것을 시사한다. Postoperative heterotopic ossification of the elbow after surgery for treatment of acute trauma such as fractures and ligament/tendon ruptures has been well-documented. However, literature concerning heterotopic ossification after medial epicondylectomy is scarce. We report on two cases of heterotopic ossification that occurred following medial epicondylectomy for medial epicondylitis and for cubital tunnel syndrome. Preoperatively, calcifications around the medial epicondyle were observed in both patients. These cases suggest that medial epicondylectomy, in the presence of pre-existing calcifications, may pose an increased risk of postoperative heterotopic ossification of the elbow.

Heterotopic Ossification of the Elbow after Medial Epicondylectomy

하재홍,공현식,백구현 대한정형외과학회 2015 대한정형외과학회지 Vol.50 No.1

Postoperative heterotopic ossification of the elbow after surgery for treatment of acute trauma such as fractures and ligament/tendon ruptures has been well-documented. However, literature concerning heterotopic ossification after medial epicondylectomy is scarce. We report on two cases of heterotopic ossification that occurred following medial epicondylectomy for medial epicondylitis and for cubital tunnel syndrome. Preoperatively, calcifications around the medial epicondyle were observed in both patients. These cases suggest that medial epicondylectomy, in the presence of pre-existing calcifications, may pose an increased risk of postoperative heterotopic ossification of the elbow.