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회전근 개 대파열 및 거대 파열에서 상완 이두 근 장두를 포합한 회전근 개 봉합술의 중기 추시 결과

Mid-term Results of Biceps Incorporating Suture Without Deteaching the Biceps Tendon from the Flenoid in the Large or Massive Cuff Tear

  • 지종훈 (가톨릭대학교 대전성모병원 정형외과학교실) ;
  • 박상은 (가톨릭대학교 대전성모병원 정형외과학교실) ;
  • 김영율 (가톨릭대학교 대전성모병원 정형외과학교실) ;
  • 김원유 (가톨릭대학교 대전성모병원 정형외과학교실) ;
  • 권오수 (가톨릭대학교 대전성모병원 정형외과학교실) ;
  • ;
  • 문창윤 (가톨릭대학교 대전성모병원 정형외과학교실)
  • Ji, Jong-Hu (Department of Orthopedic Surgery, Daejeon St. Mary's Hospital, College of Medicine, the Catholic University of Korea) ;
  • Park, Sang-Eun (Department of Orthopedic Surgery, Daejeon St. Mary's Hospital, College of Medicine, the Catholic University of Korea) ;
  • Kim, Young-Yul (Department of Orthopedic Surgery, Daejeon St. Mary's Hospital, College of Medicine, the Catholic University of Korea) ;
  • Kim, Weon-Yoo (Department of Orthopedic Surgery, Daejeon St. Mary's Hospital, College of Medicine, the Catholic University of Korea) ;
  • Kewon, Oh-Su (Department of Orthopedic Surgery, Daejeon St. Mary's Hospital, College of Medicine, the Catholic University of Korea) ;
  • Jang, Dong-Gyun (Department of Orthopedic Surgery, Daejeon St. Mary's Hospital, College of Medicine, the Catholic University of Korea) ;
  • Moon, Chang-Yun (Department of Orthopedic Surgery, Daejeon St. Mary's Hospital, College of Medicine, the Catholic University of Korea)
  • 발행 : 2008.12.15

초록

서론: 관절경하 회전근개 봉합 시 상완 이두 근 장두를 회전근 개 건 결손부위에 포함한 봉합법의 임상적 결과에 대하여 평가하는 것이다. 재료 및 방법: 2005년 1월부터 2007년 1월까지 대파열 또는 거대파열의 회전근개 완전 파열을 가진 환자 총 21명을 대상으로 상완 이두 근 장두를 포함하여 관절경하 회전근 개 봉합술을 시행하였다. 남자 9명, 여자 12명이었으며 평균 나이는 60.3세(47~73세)이었다. 평균 추시 기간은 23개월(6~48)이었으며, 추시 된 모든 환자에게 University of California Los Angeles (UCLA), the shoulder index of the American Shoulder and Elbow Surgeons (ASES)와 simple shoulder test (SST)를 이용하여 술 전과 마지막 추시 시 점수를 비교하였다. 결과: 마지막 추시(평균 23개월)에서 VAS 점수, ASES, UCLA점수와 SST 점수는 통계적으로 의미 있게 향상되었다(p<0.05). 초음파와 MRI를 이용하여 추시 한 9예 중에서 2예 에서는 부분 파열의 소견을 보이며 건의 연결성이 관찰되었으나 나머지 7예에서는 모두 완전 파열된 소견이 관찰되었다. 결론: 회전근 개 대파열이나 광범위 파열 환자에서 상완 이두 근 장두를 관절와에서 분리시키지 않고, 회전근 개 봉합술을 시행하는 방법은 권장할 만한 술식으로 사료된다.

Purpose: The aim of this study is to analyze the clinical results of using the technique of rotator cuff repair without parting the biceps long head from the glenoid for large or massive tear of the rotator cuff. Material and Methods: Form January 2005 to January 2007, we performed the arthroscopic biceps repair with incorporating suture to the rotator cuff for 21 patients with large or massive rotator cuff tear. The mean follow up period was 23 months (range: 6-48months). The number of males and females was 9 and 13, respectively. The age distribution ranged from 47 to 73 years with a mean age of 60.3 years. We compared the preoperative score with the postoperative scores using the University of California Los Angeles (UCLA) score, the shoulder index of the American Shoulder and Elbow Surgeons (ASES) and a simple shoulder test (SST). Results: The improvement in the VAS, ASES and the UCLA and SST scores was statistically significant at the final follow up (average follow-up 23 months) (p>0.05). Two of nine cases were found to have partial tear with continuity but seven cases were found to have complete tear according to the ultrasonography and MRI. Conclusion: The technique of rotator cuff repair without parting the biceps long head from the glenoid for large or massive tear of the rotator cuff is considered to be recommendable.

키워드

참고문헌

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