Journal of Korean Orthopaedic Sports Medicine (대한정형외과스포츠의학회지)

Korean Orthopaedic Society for Sports Medicine (대한정형외과스포츠의학회)
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Inferior Capsular Shift Procedure using Splitting Subscapularis and Capsule for Instability of the Shoulder

견관절 불안정성의 견갑하근 및 관절 낭 수평 분할을 이용한 하방 관절 낭 이동술

  • Park Jin-Young (Department of Orthopedic Surgery, Dankook University College of Medicine) ;
  • Lim Soo-Taek (Department of Orthopedic Surgery, Seoul National University College of Medicine) ;
  • Yoo Moon-Jib (Department of Orthopedic Surgery, Dankook University College of Medicine) ;
  • Lyu Suk-Joo (Department of Orthopedic Surgery, Dankook University College of Medicine)
  • 박진영 (단국대학교의과대학정형외과학교실) ;
  • 임수택 (서울대학교의과대학정형외과학교실) ;
  • 유문집 (단국대학교의과대학정형외과학교실) ;
  • 유석주 (단국대학교의과대학정형외과학교실)
  • Published : 2002.03.01
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Abstract

Purpose: The aim of this retrospective study were to report the short-term results of inferior capsular shift procedure using splitting subscapularis and capsule for the patients who had shoulder instability and were apt to recur after arthroscopic stabilization procedure. Materials & Methods : Fifteen cases of instability of the shoulder were included with an average follow-up of 2 years (range: 1$\~$3 years). There were 13 men and 2 women with an average age of 27years. Multidirectional instability was found in 4 cases, voluntary instability in 3 cases, bony Bankarte lesion in 2 cases and 6 cases were contact sportmen. Thirteen shoulders underwent the inferior capsular shifts and Bankart repairs and 2 shoulders without Bankart lesion underwent the inferior capsular shift only. Average 19 mm of shift (range: 10$\~$25 mm) was done. Results : Fourteen patients showed good and excellent results with one subluxation and one positive apprehension test. Postoperative ranges of motions did not change in forward elevation, external rotation at side and external rotation at 90$^{\circ}$ abduction (p>0.05). Conclusion : Inferior capsular shift procedure using splitting subscapularis and capsule can be helpful in shoulder instability patients who were high-risk group of recurrence with arthroscopic procedure.

목적 : 견관절 불안정성의 관절경적 수술로 재발의 가능성이 높은 환자에 대해견갑하근 및 관절낭 수평 분할을 이용한 하방관절낭이동술을시행하고이에대한결과를분석하고자하였다. 대상및방법 : 1994년부터 1999년까지수술을시행한환자중1년이상추시(평균: 2년, 범위: 1$\~$3년)가가능한 15례를대상으로하였다. 남자가13례여자가2례이었으며평균연령은27 이었다. 질환은다방향성불안정성4례, 수의성불안정성3례, 골성Bankart 병변이있는전방불안정성2례, 접촉성운동선수의전방불안정성6례였다. 13례는관혈적봉합술과하방관절낭이동술을 동시에 시행하였고, Bankart 병변이없던2례는하방관절낭이동술만 시행하였다. 관절낭중첩 정도는평균 19 mm (범위: 10$\~$5 mm)였다. 결과 : 14례에서우수혹은양호의결과를보였으며술후1례에서아탈구되었고, 1례에서전방염려검사에양성소견을보였다. 술후전방거상과팔을체간에붙인외회전, 90$^{\circ}$ 외전에서의외회전의운동범위는술전과통계학적인차이가없었다. 결론 : 견갑하근및관절낭수평분할을이용한하방관절낭이동술은관절운동범위의감소없이과잉관절낭과Bankart 병변을치료할수있어관절경적치료로재발의가능성높은환자에서권장될치료법으로사료되었다.

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