Clinics in Shoulder and Elbow

대한견·주관절의학회 (Korean Shoulder and Elbow Society)
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60세 이상 환자에서 발생한 외상성 견관절 전방 탈구

Traumatic Anterior Shoulder Dislocation in Patients Older than 60 Years of Age

  • 하종경 (적십자병원 정형외과학교실) ;
  • 유재두 (이화의대 목동병원 정형외과학교실) ;
  • 박성필 (이화의대 목동병원 정형외과학교실) ;
  • 신상진 (이화여자대학교 의과대학부속 목동병원 정형외과학교실)
  • Ha, Jong-Kyoung (Department of Orthopedic Surgery, Red-Cross Hospital) ;
  • Yoo, Jae-Doo (Department of Orthopedic Surgery, College of Medicine, Ewha Womans University, Mok-Dong Hospital) ;
  • Park, Sung-Pil (Department of Orthopedic Surgery, College of Medicine, Ewha Womans University, Mok-Dong Hospital) ;
  • Shin, Sang-Jin (Department of Orthopedic Surgery, College of Medicine, Ewha Womans University, Mok-Dong Hospital)
  • 발행 : 2006.06.30
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초록

Purpose: This study evaluated clinical results, and recommended treatment protocol of traumatic anterior shoulder dislocation in the patients older than 60 years of age. Materials and Methods: Thirty-eight patients with first traumatic anterior shoulder dislocation aged over 60 years were included. The average age was 69.4 (range, 60 to 87 years). There were 8 men (average age of 71.6) and 30 women (average age of 69). Most common cause of injuries was a fall on the outstretched hand. The additional injuries were evaluated using MRI or CT arthrogram in the patients with significant pain and weakness while movements after 2 weeks sling immobilization. Results: Fifteen patients (39%) had rotator cuff tears and 5 patients (14%) had greater tuberosity fractures. The sizes of rotator cuff tears were diverse; 2 partial tears, 1 small tear, 4 medium tears, 3 large tears and 5 massive tears. Among 5 massive cuff tears, 3 patients revealed cuff arthropathy after reduction. 4 patients (11%) had recurrent dislocation more than one time during 1 month after the first dislocation. Bankart lesions revealed in 5 patients and three of them had associated rotator cuff tears. 3 out of 5 patients with Bankart lesions, 13 out of 15 patients with rotator cuff tears and 3 patients with displaced greater tuberosity fracture had operations. Conclusion: The injury mechanism of shoulder dislocation in patients older than 60 years of age seems to have either anterior or posterior mechanism. The diagnosis and treatment should be approached 2 weeks after dislocation.

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참고문헌

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