Clinics in Shoulder and Elbow

대한견·주관절의학회 (Korean Shoulder and Elbow Society)
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통증성 Jerk 검사: 견관절 후하방 불안정성의 보전적 치료 결과의 예측

Painful Jerk Test: A Predictor of Success in Nonoperative Treatment of Posteroinferior Instability of the Shoulder

  • 김승호 (성균관대학교 의과대학 삼성서울병원 정형외과학교실) ;
  • 정웅교 (성균관대학교 의과대학 삼성서울병원 정형외과학교실) ;
  • 박재철 (성균관대학교 의과대학 삼성서울병원 정형외과학교실) ;
  • 박준식 (성균관대학교 의과대학 삼성서울병원 정형외과학교실) ;
  • 오일빈 (성균관대학교 의과대학 삼성서울병원 정형외과학교실)
  • Kim Seung-Ho (Department of Orthopaedic Surgery Sungkyunkwan University School of Medicine, Samsung Medical Center) ;
  • Jeong Woong-Kyo (Department of Orthopaedic Surgery Sungkyunkwan University School of Medicine, Samsung Medical Center) ;
  • Park Jae-Chul (Department of Orthopaedic Surgery Sungkyunkwan University School of Medicine, Samsung Medical Center) ;
  • Park Jun-Sic (Department of Orthopaedic Surgery Sungkyunkwan University School of Medicine, Samsung Medical Center) ;
  • Oh Irvin (Department of Orthopaedic Surgery Sungkyunkwan University School of Medicine, Samsung Medical Center)
  • 발행 : 2004.12.01
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초록

The purposes of this study were to evaluate the presence or absence of pain with the jerk test as a predictor of the success of nonoperative treatment for posteroinferior instability of the shoulder and to identify pathologic lesion responsible for the pain in the jerk test. Eighty-nine shoulders(81 patients), which had posteroinferior instability with positive posterior clunk in the jerk test, were nonoperatively treated. The patients were divided into two groups with respect to the presence of pain in the jerk test: painless jerk group(54 shoulders) and painful jerk group(35 shoulders). Response to the nonoperative treatment was evaluated after at least 6 months rehabilitation program. Patients who did not respond to the rehabilitation underwent arthroscopic examination to identify any pathologic lesion. The painful jerk group had higher failure rate with nonoperative treatment (p<0.001). In the painless jerk group, fifty shoulders (93%) responded to rehabilitation program after a mean of 4 months. Four shoulders(7%) were unresponsive to the rehabilitation. In the painful jerk group, five shoulders(16%) were successful with the rehabilitation while the other thirty shoulders(84%) failed. All 34 shoulders, which were unresponsive to the rehabilitation, had a variable degree of posteroinferior labral lesions. In conclusion, the jerk test is a hallmark for predicting the prognosis of nonoperative treatment in the posteroinferior instability. Shoulders with symptomatic posteroinferior instability and a painful jerk test have posteroinferior labral lesion.

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참고문헌

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