• 제목/요약/키워드: Shoulder Lesions

검색결과 149건 처리시간 0.021초

Iliac Bone Graft for Recurrent Posterior Shoulder Instability with Glenoid Bone Defect

  • Ko, Sang-Hun;Cho, Yun-Jae
    • Clinics in Shoulder and Elbow
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    • 제17권4호
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    • pp.190-193
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    • 2014
  • Recurrent posterior shoulder instability is a debilitating condition that is relatively uncommon, but its diagnosis in young adults is increasing in frequency. Several predisposing factors for this condition have been identified, such as the presence of an abnormal joint surface orientation, an osteochondral fracture of the humeral head or glenoid cavity, and a postero-inferior capsuloligamentary deficit, but their relative importance remains poorly understood. Whilst, conservative treatment is effective in cases of hyperlaxity or in the absence of bone abnormality, failure of conservative treatment means that open or arthroscopic surgery is required. In general, soft-tissue reconstructions are carried out in cases of capsulolabral lesions in which bone anatomy is normal, whereas bone grafts have been required in cases where posterior bony Bankart lesions, glenoid defects, or posterior glenoid dysplasia are present. However, a consensus on the exact management of posterior shoulder instability is yet to be reached, and published studies are few with weak evidence. In our study, we report the reconstruction of the glenoid using iliac bone graft in a patient suffering recurrent posterior shoulder instability with severe glenoid bone defect.

40세 이하에서 견관절 전방 탈구가 동반된 상완골 대결절 골절에서 관절내 병변 및 임상 결과 (Accompanying Lesions and Clinical Results in the Greater Tuberosity Fracture of the Humerus with Anterior Shoulder Dislocation Under the Age of Forty)

  • 김두섭;윤여승;이동규;박현국;박장희;신존정헌
    • Clinics in Shoulder and Elbow
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    • 제14권1호
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    • pp.20-26
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    • 2011
  • 목적: 상완골 대결절 골절에서 견관절 탈구가 동반된 경우 동반 병변을 조사하고 임상적 결과를 알아보고자 한다. 대상 및 방법: 2005년 5월부터 2008년 11월까지 견관절 탈구가 동반된 상완골 대결절 골절 환자 중 40세 이하의 30명을 대상으로 관절경을 시행하였다. 동반 병변을 확인한 후 도관나사 고정 또는 봉합나사를 이용하여 고정을 시행하였다. Constant 점수와 Rowe 점수를 조사하였다. 결과: Bankart 병변 2예, 골성 Bankart 병변 4예, Perthes 병변 4예, free ALPSA 병변 2예, GLAD 병변 3예, 관절낭 파열 6예 관찰되었고, 회전근 개 부분 파열 5예 (16.7%), SLAP type I 2예 (6.7%), SLAP type II 병변 1예 (3.3%), 이두장건 파열 1예 (3.3%)가 관찰되었다. Constant 점수는 술 전 평균 56.30${\pm}$11.83점에서 술 후 평균 94.43${\pm}$7.82점으로 증가하였고 (p=0.034), Rowe 점수는 52.56${\pm}$9.96점에서 91.76${\pm}$9.56점으로 증가하였다 (p=0.026). 결론: 견관절 전방 탈구를 동반한 대결절 골절에서 관절경을 이용한 동반 병변 확인과 골절 치료로 우수한 임상 결과와 골유합을 보였다. 2차 관절경 검사상 Perthes 병변, Free ALPSA 병변, GLAD 병변 및 관절낭 파열은 봉합술을 시행하지 않았지만 자연 치유되거나 더이상 손상의 범위가 증가되지 않았고 술 후 이차적인 불안정성을 유발하지 않았다.

상지말단부의 테이핑요법이 견관절 통증에 미치는 영향 (An influence Taping therapy toward upper limb end part having on shoulder pain)

  • 양경한;이윤미
    • 대한물리치료과학회지
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    • 제13권2호
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    • pp.47-55
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    • 2006
  • This study was executed in order utilized five typical taping therapy spending on upper limb end part, and to grasp an influence on shoulder pain of upper limb part among spiral balance taping therapy of Danaca. This study was performed at Physical therapy Dept. of Gyeongbuk H orthopedics until 2005 November 4 from 2005 October 4th. This study appealed for a shoulder pain, and visited all 25(15 Non capsular lesions, 10 capsular lesions) patients to the objects. We executed study to the objects to a patient to agree with us after explaining a purpose and object of this study. Urged warning, and all executed eight times over about the patient who executed taping therapy for five weeks so as not to be able to get other therapy treatment. Application way of taping therapy applied all once at random generally five taping therapy to apply to limbs end of upper at clinical so far. Operated on the results about pain decrease, and we calculated as compared before and after five taping therapy. Also, operated again on them in a taping therapy judged that there was pain decrease, and we returned them to home. We make a comparative analysis for a pain after and before a treatment as we use the VAS which is evaluation of a pain in this study. The results of this study are as follows. Appeared so as operated, and a pain decrease change of Non capsular lesions became lower with a the average of 2.3 after a taping therapy in the average of 6.4s former a treatment, and to note statistically later Taping therapy of upper limb end part.(P<0.01). The pain decrease change of capsular lesions of a shoulder joint pain index decreased with the average of 4.0 after a taping therapy treatment in the average of 6.0 former a treatment after Taping therapy of upper limb end part, but were not able to note statistically.(P>0.05) Taping therapy of upper limb end part is positive to pain decrease of shoulder joint in the above-mentioned study can affect, and can especially get the effective conclusion that was able to affect from pain decrease of Non capsular lesions.

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A Comparison between Arthroscopic Biceps Tenodesis and Arthroscopic Repair in Isolated Type 2 Superior Labrum Anterior and Posterior Lesions

  • Hong, Kyung-Jin;Kim, Doo-Sup;Shin, Ji-Su;Kang, Sang-Kyu
    • Clinics in Shoulder and Elbow
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    • 제20권1호
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    • pp.24-29
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    • 2017
  • Background: The purpose of this study was to compare the clinical outcome in patients aged less than 55 years who underwent arthroscopic tenodesis and arthroscopic repair for type 2 superior labrum anterior and posterior (SLAP) lesions. Methods: Between April 2008 and December 2014, surgery was performed on a total of 45 patients with isolated type 2 SLAP lesions. Arthroscopic repair was performed in 22 patients and arthroscopic tenodesis was performed in 23 patients. In both groups, the clinical outcomes at follow-ups were evaluated using the University of California at Los Angeles (UCLA) score, American Shoulder and Elbow Surgeons (ASES) score, and visual analogue scale (VAS) score. Results: In both groups, the VAS scores for pain had improved significantly throughout the postoperative follow-up period. The VAS score showed a statistically significant difference at postoperative 3 and 6 months (p<0.05); however, there was no statistically significant difference between preoperative and postoperative results at 12 months (p>0.05). In both groups, the functional outcome was statistically improved postoperatively. In a comparison of the UCLA and ASES scores between the two groups, there was a statistically significant difference at postoperative 3 and 6 months (p<0.05), but there was no statistically significant difference between preoperative and postoperative results at 12 months (p>0.05). Conclusions: Based on the results of this and other studies, patients with isolated type 2 SLAP lesions showed better short-term clinical outcome with tenodesis than with repair. However, there was no difference between the two groups at the final follow-up.

Arthroscopic Capsular Release for Painful Throwing Shoulder With Posterior Capsular Tightness

  • Yoneda, Minoru;Nakagawa, Shigeto;Mizuno, Naoko;Fukushima, Sunao;Hayashida, Kenji;Mae, Tatsuo;Izawa, Kazutaka
    • 대한관절경학회:학술대회논문집
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    • 대한관절경학회 2006년도 제15차 추계학술대회 심포지움
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    • pp.35-39
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    • 2006
  • Posterior capsular tightness with glenohumeral internal rotation deficit is usually considered to be an acquired condition of the throwing shoulder and is usually treated conservatively. However, because posterior capsular tightness is sometimes irreversible, we have performed arthroscopic capsular release for painful throwing shoulder with posterior capsular tightness. The true loss of internal rotation and posterior stiffness was confirmed by examination with the patient under anesthesia, and contracture of the posterior capsule and the posterior band of the inferior glenohumeral ligamant was observed arthroscopically. Because an extensive adhesion between the capsule and the fascia of the external rotators was noted, a capsular release was performed from 6 o'clock to 11 o'clock (in the right shoulder) to completely expose the muscle belly of the external rotators. Of the first 16 consecutive patients, 4 had no concomitant lesions and underwent posterior capsular release alone. With a minimum of 2 years' follow-up, it was ascertained that the throwing pain completely disappeared in 14 patients and improved in 2. In all, 11 patients returned to their preinjury performance level, and 5 returned to a lower level of function. In the 4 patients who had no concomitant lesions, throwing pain completely disappeared, and all were able to return to their preinjury performance level.

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Clinical Results of the Arthroscopic "Multiple Pulled Suture" Technique for Large or Comminuted Bony Bankart Lesion

  • Lee, Byung-Ill;Kim, Byoung-Min;Kho, Duk-Hwan;Kim, Hyeung-June
    • Clinics in Shoulder and Elbow
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    • 제20권3호
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    • pp.138-146
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    • 2017
  • Background: Arthroscopic fixations for large and comminuted bony Bankart lesions are technically difficult. We developed an arthroscopic multiple pulled suture (MPS) technique to restore large and comminuted bony Bankart lesions. Methods: Ten patients (mean age, 49.8 years; range, 31-79 years) underwent bony Bankart repair using the illustrated MPS technique and were then followed for a mean of 27.3 months. A plain radiograph series and three-dimensional computed tomography scans were taken at the initial clinical evaluation and 3 months postoperatively. Outcome measurements included the American Shoulder and Elbow Surgeons (ASES) score, Rowe score, University of California at Los Angeles (UCLA) score, and subjective patient satisfaction, along with surgical complications. Results: Union of an osseous fragment with the glenoid rim was confirmed in all patients on a computed tomography scan 3 months after operation. The osseous fragment was restored to proper articular congruence and reduction. The affected shoulder was stable in nine of the 10 patients. One patient presented with a redislocation after a sports injury 3 years postoperatively. The ASES, Rowe, and UCLA scores improved at the final evaluation, and median patient satisfaction at the final follow-up was 9 of 10 points (range, 6-10 points). Conclusions: The arthroscopic MPS technique for bony Bankart lesions with large or comminuted osseous fragments was a relatively easy and safe method for stable fixation of the osseous fragment. Therefore, the arthroscopic MPS technique resulted in good restoration of stability with high patient satisfaction and low complication rates.

회전근개 파열과 동반한 TypeⅡ SLAP 병변 (Type Ⅱ SLAP Lesion with the Rotator Cuff Tear)

  • 김진섭;황필성;유정한
    • Clinics in Shoulder and Elbow
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    • 제2권2호
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    • pp.115-119
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    • 1999
  • Purpose: We reviewed the SLAP lesions and associated injuries, also evaluated a hypothesis that the type II posterior SLAP lesion is related with posterior rotator cuff tear and gives rise to the postero-superior instability. Materials and Methods: The patient recording papers, MRI, video and operation sheets were reviewed with the 28 SLAP lesions confirmed by the arthroscopy among 242 cases. Among these SLAP lesions, type II was 22 cases and classified to the anterior, posterior(16 cases), combined subtype(6 cases) based on the main anatomic location. There were 14 cases of the type II accompanying rotator cuff tear. The average follow-up(13 months) results were evaluated with the ASES and Rowe rating score after repair or debridement of the SLAP lesions. Results: In the type II lesions accompanying the rotator cuff tears(14 cases), the posterior(l0 cases) and combined type(4 cases), cuff lesions were all existed posteriorly. Also We could confirm the drive-through sign in the eleven cases, though did not check the disappearance of this sign after repair because of retrospective study. We could followed up the 22 cases, 18 cases(77%) were excellent or good, fair 3 cases(14%) and poor 1 case(4%). Also, type II lesions with the rotator cuff tear(14 cases) were showed better results in the repair(8 cases) than the debridement(6 cases) of the unstable type II with the cuff repair. Conclusion: The type II lesions were frequently associated with the cuff tear in the specific location. We could presume the possibility of postero-superior instability in the SLAP lesion with the cuff injuries. Also, satisfactory results could be experienced when the unstable SLAP lesions with the cuff tear were repaired at the same time.

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