Clinics in Shoulder and Elbow

대한견·주관절의학회 (Korean Shoulder and Elbow Society)
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견갑골 체부 골절의 수술적 치료

Surgical Treatment of the Fracture of the Scapular Body

  • 류인혁 (포항세명기독병원 정형.성형센터) ;
  • 서보건 (포항세명기독병원 정형.성형센터) ;
  • 정재익 (포항세명기독병원 정형.성형센터) ;
  • 김경철 (포항세명기독병원 정형.성형센터)
  • Rhyou, In-Hyeok (Upper Extremity and Microsurgery Center, Department of Orthopedic Surgery, Semyeong Christianty Hospital) ;
  • Suh, Bo-Gun (Upper Extremity and Microsurgery Center, Department of Orthopedic Surgery, Semyeong Christianty Hospital) ;
  • Chung, Chae-Ik (Upper Extremity and Microsurgery Center, Department of Orthopedic Surgery, Semyeong Christianty Hospital) ;
  • Kim, Kyung-Chul (Upper Extremity and Microsurgery Center, Department of Orthopedic Surgery, Semyeong Christianty Hospital)
  • 발행 : 2008.12.15
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초록

목적: 견갑골 체부 골절의 수술적 치료 결과를 분석하고자 하고자 한다. 대상 및 방법: 7명의 환자를 대상으로 수술적 치료를 시행하였다. 견갑골 외측 경계가 100% 전위된 경우, 관절와가 $25^{\circ}$ 각변형 되거나 1 cm 이상 내측 전위된 경우, 견갑골 체부와 쇄골 골절이 동반된 경우를 수술적 치료의 대상으로 삼았다. 남자가 5명 여자가 2명, 평균 나이는 49(40~58)세, 평균 추시는 11(6~24)개월 이였다. 두 명은 다발성 늑골 골절과 척추 골절을 동반하였다. 기능적 평가를 위해 UCLA score 와 Korean shoulder score, 술 후 주관적인 만족도를 이용하였다. 결과: UCLA score는 평균29(17~33)점 이었고 평균 Korean shoulder score는 86(63~94)점이었다. 환자의 주관적인 만족도는 10점 만점에 7.7(4~9)이었다. 합병증으로 정복된 골절의 소실 없는 나사못 이완이 1예에서 관찰되었으며 관절와로 돌출된 나사못으로 1예에서는 교환하여야 하였다. 결론: 심하게 전위된 견갑골 체부골절에서는 견관절 및 견갑흉곽관절의 생역학적 이상으로 인한 견관절의 운동 장애를 예방하기 위해 수술적 치료가 도움이 될 것으로 판단된다.

Purpose: We wanted to evaluate the results of surgical treatment for fracture of the scapular body. Materials and methods: The subjects of this study were seven patients with fracture of the scapular body and all these patients were managed surgically. We considered the operative indications as being 100% translation of the lateral border, or $25^{\circ}$ of angular deformity of the glenoid, or 1cm medialization or the variant of the double disruption of the superior scapular suspensory complex. There were five males and two females, and their ages ranged between 40 and 58 years (mean age: 49) with average follow up of 11 months (6~24 months). Two patients sustained multiple fractures of the ribs and spines. The surgical results were evaluated according to the subjective satisfaction, the UCLA score and the Korean shoulder score. Results: The mean UCLA score was 29 (17~33) and the mean Korean shoulder score was 86 (63~94). The self assessment for subjective satisfaction was 7.7 (4~9). There were two complications; one case of screw pull-out without the loss of the fracture fixation and the other case with screw penetration of the glenoid cavity. Conclusion: Surgical treatment may be effective for the management of severely displaced fracture of the scapular body in order to prevent the impairment of the shoulder function caused by the altered glenohumeral and scapulothoracic kinematics.

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참고문헌

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피인용 문헌

  1. Treatment of Anterior Glenoid Rim Fracture with Comminuted Fragment Using Arthroscopic Reduction and AO Headless Compression Screw Fixation - A Case Report - vol.14, pp.1, 2011, https://doi.org/10.5397/CiSE.2011.14.1.094