Clinics in Shoulder and Elbow

대한견·주관절의학회 (Korean Shoulder and Elbow Society)
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40세 이상 재발성 견관절 탈구 환자에서 관절내 병변에 대한 관절경적 연구

Arthroscopic Evaluation on Intra-Articular Pathology in Recurrent Shoulder Dislocation Aged Over 40 Years

  • 민우기 (경북대학교 의과대학 정형외과학교실) ;
  • 김주은 (경북대학교 의과대학 정형외과학교실) ;
  • 조환성 (경북대학교 의과대학 정형외과학교실) ;
  • 김풍택 (경북대학교 의과대학 정형외과학교실) ;
  • 전인호 (경북대학교 의과대학 정형외과학교실)
  • Min, Woo-Kie (Department of Orthopedic Surgery, Kyung Pook National University Hospital) ;
  • Kim, Ju-Eun (Department of Orthopedic Surgery, Kyung Pook National University Hospital) ;
  • Cho, Hwan-Seong (Department of Orthopedic Surgery, Kyung Pook National University Hospital) ;
  • Kim, Poong-Taek (Department of Orthopedic Surgery, Kyung Pook National University Hospital) ;
  • Jeon, In-Ho (Department of Orthopedic Surgery, Kyung Pook National University Hospital)
  • 발행 : 2009.12.15
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초록

목적: 40대 이상의 환자의 외상성 견관절 재발성 전방 탈구에서 관절 내 병변 구조물을 조사하고, 그 발병 기전 및 향후 치료 방침을 정하는데 임상적 의의를 제공하고자 한다. 대상 및 방법: 2001년 1월부터 2009년 5월까지 재발성 견관절 전방 탈구로 본원에서 수술적 치료를 받은 환자 중 수술 당시 나이가 40세 이상인 16명의 환자 (평균 나이 52.7세)를 조사하였다. 모든 환자에서 관절경을 이용하여, 관절와 순, 관절막, 회전근 개, 골병변 등의 관절 내 구조물에 대한 관절경적 소견을 조사하였다. 결과: 조사한 16례의 모든 환자들에서 상완 골두의 Hill-Sachs 병변이 보였으며, 골성 Bankart 병변 3례 (19%), 관절와 순 파열 6례 (38%), 관절막 파열은 15례 (94%)에서 발견 되었다. 12례 (75%)의 환자에서 극상건 파열이 발견되었고, 견갑하근 파열은 5례 (31%)에서 발견되었다. SLAP 병변은 1례 (6%)에서 관찰되었다. 결론: 40세 이상 견관절 재발성 탈구 환자에서는 관절막 및 회전근 개 파열의 빈도가 상대적으로 많이 나타났다. 따라서 청소년기와 달리, 장년층 이상의 환자에서는 관절막 및 회전근 개 손상에 대한 수술 전 대비가 요구된다.

Purpose: This study is to analyze the prevalence of various intra-articular lesions in patients with traumatic recurrent anterior dislocation of shoulder over 40 years and suggest clinical implications for treatment. Materials and Methods: We retrospectively studied 16 cases that underwent surgical treatment for recurrent anterior dislocation of shoulder from January 2001 to May 2009. There were 9 males and 7 females, and the mean age was 52.7years. We carried out arthroscopic exam for all patients based on standard protocol, which included labrum, capular lesion, cuff, bony lesions. Results: All 16 cases showed Hill-Sachs lesion, 3 patients (19%) had bony Bankart lesion, 6 patients (38%) had labral tear. Capsular tear were found 15 patients (94%). Twelve (75%) had ruptured supraspinatus and 5 (31%) had subscapularis tear. Only one (6%) had SLAP lesion. Conclusion: There was relatively higher incidence of capsular and rotator cuff tears in patients over age 40 years. Preoperative planning to address these lesions is highly recommended.

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참고문헌

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