• Title/Summary/Keyword: 전방 탈구

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Stabilization in the Anterior Shoulder Instability' Where Do We Stand Today? (견관절 전방 불안정성에서 치료방침의 결정)

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    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2004.11a
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    • pp.112-116
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    • 2004
  • 전방 탈구인 경우 첫탈구이거나 생애에 몇번만 탈구를 경험하고 일상생활에 별 지장이 없다면 보존적으로 치료하는 것이 바람직하다. 다만 early surgey가 요구되는 경우는, 첫탈구가 teen aged이면 관절경적 수술을, 골편이 큰 Bankart병변이 있는 첫탈구는 수술하는 것이 좋다. 전방 불안정성인 경우, collision sports는 개방술로, non-athletes이거나 throwing 또는 contact sports는 관절경술로 시행해 주는 것이 바람직하다. 우리가 명심하여야 할 것은 전방 불안정성을 다루는데 환자의 입장에서 서야 한다는 것이다. 의사의 능력 정도나 욕망보다도 환자의 상태, 활동 정도와 환자의 요구에 맞추어 환자를 치료하여야 한다.

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Treatment of Traumatic Sternoclavicular Joint Anterior Dislocation with a Sternal Fracture (흉골 골절과 동반된 외상성 흉쇄관절 전방 탈구의 치료)

  • Choi, Sung;Shin, Dong-Ju;Hwang, Seong-Mun
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.76-81
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    • 2021
  • A traumatic dislocation of the sternoclavicular joint is a rare injury, and among them, anterior dislocation is more common than a posterior dislocation. Posterior dislocation is a potential risk by compressing the mediastinal structures, but an anterior dislocation has not been considered a risk. Traumatic sternoclavicular joint anterior dislocation associated with anterior angulation of a sternal fracture can develop mediastinal compression and have a risk in the same way as a posterior dislocation. This case report is about a traumatic sternoclavicular joint anterior dislocation with a sternal fracture accompanied by mediastinal compression that was treated surgically using a plate and showed relatively good clinical results. This rare case is reported along with a review of the relevant literature.

Recurrent Volar Rotatory Dislocation of the Proximal Interphalangeal Joint of the Finger in Judo Player - A Case Report - (유도 선수에서 발생한 수지 근위 지관절의 재발성 전방 회전 탈구 - 1례 보고 -)

  • Hwang, Jung-Chul;Chung, Duke-Whan;Han, Chung-Soo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.1
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    • pp.51-55
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    • 2009
  • Volar rotatory dislocation of the proximal interphalangeal joint(PIP) of the finger is rare. We report a female judo player who had volar rotatory dislocation of the PIP joint of the middle finger. She had dislocation of PIP joint total 4 times. At operation, the central tendon was identified as being distension, with the ulnar collateral ligament ruptured. The ruptured ulnar collateral ligament was interposed within the joint. The ruptured ulnar collateral ligament was repaired and extensor expansion was repaired. At last follow-up, she didn't have recurrent dislocation during judo. Accurate diagnosis, early intervention and progressive rehabilitation of this injury are very important as other dislocations.

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Glenoid lesion in Traumatic Anterior Instability of Shoulder (견관절 외상성 불안정성 관절와 병변)

  • Lee, Seoung-Joon;Park, Jin-Young;Keum, Jung-Sup;Ye, Meng
    • Clinics in Shoulder and Elbow
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    • v.10 no.1
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    • pp.23-26
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    • 2007
  • 관절와 병변은 급성 외상으로 인한 골절뿐 아니라 불안정성으로 인한 골 침윤으로 정의할 수 있으며, 이는 통상의 방사선학적 검사를 통하여 진단을 하지 못하는 경우도 있다. 전방 탈구와 동반된 전방 관절와 골절의 빈도는 5.4%에서 32%까지 보고되었다. Hovelius 등이 226명의 탈구환자를 대상으로한 연구에서 8%의 관절와 골절이 있었다고 보고하였고, 노령의 환자에서 약간의 빈도가 증가한다고 하였다. 또한 Rowe는 전방 관절와 골절이 있는 27명의 환자에서 기계적 안정성의 결함으로 62%의 재발성 탈구가 있었다고 보고하였다. 보다 최근의 방카르트 술기에 대한 보고에서 수술적 처치를 한 환자중 44%가 관절와 골절을 동반하였다고 보고하였다. Rowe 와 Zarins는 다발성 전방탈구 환자에서 관절와 병변이 잘 치료되었는지 여부에 따라 다른 결과를 낸다고 보고하였다. 전자에 따르면, 관절와 병변을 진단하는 것은 중요하며 환자의 최종적 예후는 이를 어떻게 치료했는지 여부에 따라 결정된다고 하였다. 관절와 상완관절의 불안정성에서 동반된 관절와 병변의 진단은 보존적 치료시나 수술적 치료 시 모두 중요한 인자라고 하겠다.

Delayed Diagnosis of Volar Dislocation of the Distal Ulna after Treatment of the Radial Shaft Fracture (요골 간부 골절 치료 후 지연 발견된 원위 척골의 전방 탈구)

  • Jeon, Suk Ha;Lee, Sanglim
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.5
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    • pp.427-432
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    • 2021
  • Delayed treatment of volar dislocation of the distal radioulnar joint can result in wrist pain, limited rotation of the forearm, and degenerative arthritis that could be managed only by salvage procedures. A 24-year-old male patient presented with wrist pain and a loss of forearm rotation after surgery for a radial shaft fracture. The shaft of the radius was fixed with a plate and screws with a volar angulation of 7°. The ulnar head was dislocated volar to the distal radius, and the bone defect in the ulnar head was impacted into the volar rim of the sigmoid notch of the radius, preventing the head from being reduced in the joint. Corrective osteotomy of the malunited radial shaft and sliding osteotomy of the proximal ulnar head were performed to fill the distal bone defect. Pain and range of the forearm rotation were improved at postoperative 19 months.

Arthroscopic Bankart Repair for Post-seizure Anterior Instabilities of Shoulder - 2 Cases Report - (전간 발작과 관련된 견관절 전방 불안정성 환자에서 시행한 관절경적 Bankart봉합술 - 2예 보고 -)

  • Moon, Young-Lae;Yang, Hun;Gorthi, Venkat
    • Clinics in Shoulder and Elbow
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    • v.12 no.1
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    • pp.98-101
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    • 2009
  • Purpose: These case reports have been prepared to highlight the uncommon occurrence of anterior shoulder dislocation after an epileptic seizure, the recognition of which is important as this type of injury is associated with bony lesions and a high incidence of recurrence. Materials and Methods: We report two cases of recurrent anterior dislocation of the shoulder due to grand mal epilepsy. These cases were treated as usual anterior dislocations of the shoulder, and were regularly followed to detect any recurrence of shoulder instability. Results: Outcome of the surgery in the two cases was different because of the differences in seizure control. In the patient in whom seizures were well-controlled, there was no recurrence of instability, while the patient with poorly controlled seizures developed a recurrence of the dislocation following shoulder repair. Conclusion: The authors emphasize the need to control seizures in order to prevent injury recurrence in this subset of patients.

Reconstruction of the Glenoid Using Iliac Bone Graft for Recurrent Anterior Shoulder Instability with Severe Glenoid Bone Defect - A Report of Two Cases - (관절와의 심한 골결손을 동반한 견관절 전방 불안정성에서 장골 이식술을 이용한 관절와 재건술 - 2예 보고 -)

  • Lee, Seong-Man;Jung, Won-Ju;Lee, Hyun-Joo;Jeon, In-Ho
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.117-122
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    • 2010
  • Purpose: The purpose of this report was to assess a surgical technique-using an autogenous tricortical iliac crest bone graft in patients with epilepsy-for anatomical glenoid reconstruction for recurrent anterior glenohumeral instability with severe glenoid deficiency. Materials and Methods: We studied two cases of recurrent anterior dislocation of the shoulder due to epilepsy. These cases were treated with anatomical glenoid reconstruction using an autogenous tricortical iliac crest bone graft. Results: Both cases achieved bone union in 5 months. There was no recurrence of instability and pain. Both cases had normal range of motion. Conclusion: Anatomical glenoid reconstruction for recurrent anterior glenohumeral instability with severe glenoid deficiency using an autogenous tricortical iliac crest bone graft is a successful surgical technique for achieving shoulder stability.

견관절 불안정성 진단 및 치료방침의 결정

  • Choe, Chang-Hyeok
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2007.11a
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    • pp.104-109
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    • 2007
  • 외상성 전방탈구의 경우 일차성 탈구이거나 일상생활에 큰 불편을 호소하지 않는 불안정성이 있을 경우 및 비외상성 다방향 불안정성의 경우 보존적 치료가 바람직하며, 10대 및 20대의 재탈구로 인한 불안정성이 유발될 경우 관절경적 혹은 개방성 Bankart 술식을 통하여 관절순의 해부학적 정복 및 술 후 잘 조절된 재활치료를 시행할 경우, 좋은 결과를 얻을 수 있다. 치료 방법의 선택 시 가장 중요한 요소는 환자의 원하는 결과를 만족 시켜줄 수 있는 치료 방법을 선택하는 것이며, 이는 불안정성의 원인, 정도, 탈구의 횟수, 환자의 활동도 및 재활 의지등을 종합적으로 감안하여 결정되어야 한다.

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