Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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The Operative Treatment of Scapular Glenoid Fracture

견갑골 관절와 골절의 수술적 치료

  • Kang, Ho-Jung (Department of Orthopaedic Surgery, Yonsei University College Medicine) ;
  • Jung, Sung-Hoon (Department of Orthopaedic Surgery, Kwangmyung Sung-Ae General hospital) ;
  • Jung, Min (Department of Orthopaedic Surgery, Yonsei University College Medicine) ;
  • Hahn, Soo-Bong (Department of Orthopaedic Surgery, Yonsei University College Medicine) ;
  • Kim, Sung-Jae (Department of Orthopaedic Surgery, Yonsei University College Medicine) ;
  • Kim, Jong-Min (Department of Orthopaedic Surgery, Kwangmyung Sung-Ae General hospital)
  • 강호정 (연세대학교 의과대학 정형외과학 교실) ;
  • 정성훈 (광명성애병원정형외과) ;
  • 정민 (연세대학교 의과대학 정형외과학 교실) ;
  • 한수봉 (연세대학교 의과대학 정형외과학 교실) ;
  • 김성재 (연세대학교 의과대학 정형외과학 교실) ;
  • 김종민 (광명성애병원 정형외과)
  • Published : 2007.12.15
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Abstract

Purpose: To determine the causes of the surgical treatment results in glenoid fracture by a retrospective analysis. Materials and methods: From March 1999 to February 2004, 9 patients who underwent an open reduction due to a glenoid fracture were reviewed. The modified Ideberg classification was used. There were 1, 3, 2, 1 and 2 cases of modified Ideberg type I, II, III, V, and VI, respectively. The internal fixators were a reconstruction plate, a small plate, a one-third tubular plate, a small screw, and a cannulated screw in 6, 1, 3, 3 and 1 case, respectively. The constant score and Adam's functional assessment method were used to evaluate the postoperative shoulder function. Results: The average time for fracture union was 7 weeks. The functional assessment was excellent in 4 cases, good in 3 cases, and fair in 2 cases. There were two complications related to surgery; articular screw encroachment, and inferior glenoid bone resorption without instability. Conclusion: A glenoid fracture with glenohumeral instability or displaced that was treated by open surgery showed good clinical results. Moreover, the more comminuted fracture had a lower functional score.

목적: 견갑골 관절와 골절의 치료로 관혈적 수술을 시행했던 예들을 후향적으로 분석하여 치료 결과에 미치는 요인을 알아보고자 하였다. 대상 및 방법: 1999년 3월부터 2004년 2월까지 관혈적 정복술을 시행한 관절와 골절 9예를 대상으로 하였다. 골절의 분류는 변형 Ideberg씨 분류를 이용하였으며 제 1형이 1예, 2형 3예, 3형 2예, 5형 1예, 6형 2예였다. 정복에 사용된 내고정물은 재건 금속판 6예, 소형 금속판 1예, 1/3 원통형 금속판 3예, 소형 나사 3예, 유관 나사 1예였다. 수술 후 견관절의 기능 평가는 Constant score 및 Adam의 기능 평가 방법을 이용하였다. 결과: 수술 후 평균 7주에 골유합 소견을 보였다. 임상적 평가에서 우수가 4예, 양호가 3예, 보통이 2예 였다. 수술 후 합병증으로 나사의 관절와 침범, 관절와 하방에 안정성에 지장이 없는 골소실이 각각 1예가 있었다. 결론: 관절의 불안정성이 있거나 골편의 전위가 큰 관절와 골절의 경우에 수술적인 치료로 양호한 결과를 얻을 수 있었고 골절 양상이 분쇄가 심할수록 나쁜 결과를 보였다.

Keywords

References

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