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Pectoralis Major Tendon Transfer for Refractory Winged Scapula - A Case Report -

난치성 익상 견갑의 대흉근 이전술 - 증례 보고 -

  • Ko, Sang-Hun (Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Cho, Sung-Do (Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Lee, Ki-Jae (Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Lee, Chae-Chil (Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine)
  • 고상훈 (울산대학교 의과대학 울산대학교병원 정형외과학교실) ;
  • 조성도 (울산대학교 의과대학 울산대학교병원 정형외과학교실) ;
  • 이기재 (울산대학교 의과대학 울산대학교병원 정형외과학교실) ;
  • 이채칠 (울산대학교 의과대학 울산대학교병원 정형외과학교실)
  • Published : 2009.12.15

Abstract

Purpose: We wanted to evalulate the clinical results of pectoris major tendon transfer for a neglected winged scapula that was caused by paralysis of the serratus anterior due to injury to the long thoracic nerve. Materials and Methods: A patient had neglected winged scapula that followed an arthroscopic operation for multi-directional instability of the shoulder joint, which was caused by traumatic dislocation. The patient was treated with pectoralis major tendon transfer using the modified Eden-Lange procedure. The range of a motion was improved from forward flexion $90^{\circ}$ and external rotation $70^{\circ}$ to $170^{\circ}$ and $150^{\circ}$ respectively. Results and Conclusion: There were no complications or recurrence and the patient's psychological satisfaction was also high. If the shoulder girdle muscles are intact, except for the serratus anterior, then pectoralis tendon transfer is a satisfactory method that can provide normal scapulo-thoracic motion.

목적: 저자들은 장흉 신경 손상에 의한 전거근 마비로 발생한 진구성 익상 견갑에서 대흉근 이전 술 시행 시 유용성과 임상적 결과를 평가하고자 하였다. 대상 및 방법: 외상 성 탈구로 야기된 견관절 불안정성에 대해 관절경 수술을 시행 후 발생한 진구성 익상 견갑 환자1예를 대상으로 Modified Eden-Lange 술식을 이용한 대흉근 이전술을 시행하였고, 술 전 전방 거상 90도, 외전 70 도에 비해 술 후 전방 거상 170도, 외전 150 도로 술후 향상된 관절운동 범위와 합병증 및 익상 견갑의 재발은 보이지 않았으며, 환자의 술 후 심리적 만족도 또한 높게 나타났다. 결과 및 결론: 장흉 신경에 의한 전거근 마비로 발생한 익상 견갑의 경우 다른 견갑대의 근육, 신경의 이상이 동반되지 않았을 때 대흉근 근육 이전술은 정상적인 견갑흉곽 운동을 제공할 수 있는 만족스러운 치료법 중 하나로 생각된다.

Keywords

References

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