Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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Acromion Morphology in Coronal and Sagittal Plane; Correlation with Rotator Cuff Syndrome

관상면과 시상면에서의 견봉 형태와 회전근개 파열의 연관성

  • Jo, Chris H. (Department of Orthopedic Surgery, Seoul National University Boramae Hospital) ;
  • Kim, Jung-Taek (Department of Orthopedic Surgery, Seoul National University Boramae Hospital) ;
  • Yoon, Kang-Sup (Department of Orthopedic Surgery, Seoul National University Boramae Hospital) ;
  • Lee, Ji-Ho (Department of Orthopedic Surgery, Seoul National University Boramae Hospital) ;
  • Kang, Seung-Baek (Department of Orthopedic Surgery, Seoul National University Boramae Hospital) ;
  • Lee, Jae-Hyup (Department of Orthopedic Surgery, Seoul National University Boramae Hospital) ;
  • Han, Hyuk-Soo (Department of Orthopedic Surgery, Seoul National University Boramae Hospital) ;
  • Rhee, Seung-Whan (Department of Orthopedic Surgery, Seoul National University Boramae Hospital)
  • 조현철 (서울대학교 보라매병원 정형외과학교실) ;
  • 김정택 (서울대학교 보라매병원 정형외과학교실) ;
  • 윤강섭 (서울대학교 보라매병원 정형외과학교실) ;
  • 이지호 (서울대학교 보라매병원 정형외과학교실) ;
  • 강승백 (서울대학교 보라매병원 정형외과학교실) ;
  • 이재협 (서울대학교 보라매병원 정형외과학교실) ;
  • 한혁수 (서울대학교 보라매병원 정형외과학교실) ;
  • 이승환 (서울대학교 보라매병원 정형외과학교실)
  • Published : 2009.12.15
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Abstract

Purpose: We evaluated the correlation of the anatomic parameters of the acromion those represent on the magnetic resonance image (MRI) of impingement syndrome. Materials and Methods: From June, 2004 to December, 2005, 71 cases were surgically proven to be impingement syndrome, and the anterior acromial hooking angle, the lateral acromial hooking angle (AAHA and LAHA) and the acromial hooking index (AHI: the sum of the AAHA and LAHA) were compared to 16 control cases. At the same period, 55 cases were surgically proven to be partial or full thickness rotator cuff tear, and age, gender and twelve anatomic parameters, including the acromial type, the acromial angle, the anterior covering, the acromial slope, the AAHA, the lateral acromial angle, the acromial torsional angle, the lateral acromial angulation, the LAHA, the lateral covering, the acromiohumeral distance and the AHI were assessed. Results: The AAHA and AHI were increased as impingement syndrome proceeded. The acromial type and acromial angle, and the AAHA, LAHA and AHI showed significant differences between the controls and the rotator cuff tear patients on univariant analysis. On multivariant analysis, gender was most strongly correlated with rotator cuff tear. Age, AAHA and the acromial angle showed similar correlation, respectively. Conclusion: The coronal acromial shape is correlated with rotator cuff tear, and it is important to correct the lateral acromial shape when performing acromioplasty.

목적: 견관절 자기 공명 영상에서 전방 및 외측 견봉 갈고리각을 측정하고 기존의 견봉 지표들과 비교하였다. 대상 및 방법: 2004년 6월에서 2005년 12월까지 수술을 통해 진단된 충돌증후군 환자를 대상으로, 동일한 시기에 충돌증후군 관련질환 이외의 원인으로 자기공명영상을 촬영한 대조군으로 선정하였다. 충돌증후군 환자군의 자기공명영상에 전방 견봉 갈고리각 (AAHA)과 측방 견봉 갈고리각 (LAHA), 그리고 견봉 갈고리지수 (AHI)를 측정하고 회전근개 파열환자군에 대해, 견봉형태, 견봉각, 전방덮임정도, 견봉경사, AAHA, 외측견봉각, 견봉염전각, 외측견봉굴곡각, LAHA, 외측덮임정도, 견봉상완거리, 견봉갈고리지수를 측정하여 대조군과 비교하였다. 결과: 충돌증후군 환자에서 단계가 진행할수록 AAHA, AHI는 증가하였다. 회전근개 파열환자에서 AAHA와 LAHA는 증가해 있었다. 단변량 분석에서는 견봉유형, 견봉각과 AAHA, LAHA, AHI가 회전근개 파열환자에서 대조군과 차이를 보였다. 다변량 분석에서는 성별, 연령, AAHA, 견봉각이 유의한 변수로 분석되었고 성별이 가장 큰 연관성이 있으며 연령, AAHA, 견봉각은 유사한 연관성을 보였다. 결론: 견봉의 형태는 사관상면의 특징이 회전근개 파열과 연관성을 가지므로 견봉성형술에서 견봉 측방 성형도 중요하다.

Keywords

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