The purpose of this study was to measure intra-rater and inter-rater reliability and range of motion for measurement of passive shoulder internal rotation range of motion and to compare anterior glide distance of humeral head in three methods. Fifty healthy subjects and fifty patients with shoulder musculoskeletal pain were recruited for this study. The subjects' passive shoulder internal rotation range of motion was measured by visual estimation, manual stabilization, and pressure biofeedback unit methods. In two trials, measurements were performed on each subject by two examiners. Intraclass correlation coefficient (ICC(3,1)) was used to determine the reliability of each measurement. The intra-rater reliability of the three methods was excellent (ICC=.77~.93) in both groups. The inter-rater reliability of the visual estimation method was poor (ICC=.20, .29), the manual scapular stabilization method was poor and fair (ICC=.09, .50), and the pressure biofeedback unit method was excellent (ICC .86, .75) in the experimental and control groups. In the experimental group, the difference of examined range of motion by each examiner was significant in the visual estimation method and manual scapular stabilization method, but there was an insignificant difference between the groups is the pressure biofeedback unit method. This result suggests that the intra-rater and inter-rater reliability of a pressure biofeedback unit was better than the other methods. The difference in distance of the anterior glide of humeral head was insignificant among all the methods. The pressure biofeedback unit method was the most reliable method, so it is proposed to be a new and reliable method to measure internal rotation range of motion.

This manuscript is reporting the usefulness and treatment results of internal fixation with PHILOS plate in proximal humerus fractures with osteoporosis. Sixteen cases of proximal humerus fractures with osteoporosis were surgically treated with PHILOS plate and followed up for an average 11 months (8-23 months). Mean age was 63 years old (range, 47-88 years old). The functional results were assessed by Neer’s evaluation criteria, Constant evaluation criteria and Korea shoulder scoring system. And the radiological results were assessed by Paavolainen’s method. The mean BMD T- score is -3.5, the mean bone union periods were 15.9 weeks. Functional satisfactory results were thirteen cases in Neer’s evaluation criteria, good results were fourteen cases in Constant evaluation criteria and the mean score is eighty-nine points in Korea shoulder scoring system. Radiologic good results were noted in thirteen cases and fair results were noted in one case. One case showed screw loosening in complication. Internal fixation using PHILOS plate for proximal humerus fractures with osteoporosis makes good functional and radiologic results, so that is considered as a good method.