Clinics in Shoulder and Elbow

대한견·주관절의학회 (Korean Shoulder and Elbow Society)
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상부 견갑하 건 완전파열의 관절경 하 봉합술과 변연절제술의 전향적 비교

Prospective Comparative Study of Arthroscopic Repair Versus Debridement for the Full-Thickness Tear of Upper Subscapularis

  • 고상훈 (울산대학교 의과대학 울산대학교병원 정형외과학교실) ;
  • 차재룡 (울산대학교 의과대학 울산대학교병원 정형외과학교실) ;
  • 이채칠 (울산대학교 의과대학 울산대학교병원 정형외과학교실) ;
  • 박한창 (울산대학교 의과대학 울산대학교병원 정형외과학교실) ;
  • 신승명 (울산대학교 의과대학 울산대학교병원 정형외과학교실)
  • Ko, Sang-Hun (Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Cha, Jae-Ryong (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) ;
  • Park, Han-Chang (Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Shin, Seung-Myeong (Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine)
  • 투고 : 2010.04.26
  • 심사 : 2010.05.10
  • 발행 : 2010.06.15
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초록

목적: 견갑하근 상부의 완전 파열 시 봉합나사를 이용한 파열 부 봉합술과 변연절제술을 비교하여 보고자 한다. 대상 및 방법: 2003년 5월부터 2007년 10월까지 본원에서 견갑하근 상부의 완전 파열에 대해 봉합나사를 이용한 관절경 감시하의 봉합술을 시행한 69예와 변연절제술을 시행한 30예의 환자를 대상으로 하였다. 견갑하근 손상의 범위는 상부 1/3인 경우를 대상으로 하였다. 결과의 판정은 최초 내원 시점과 최종 추시의 UCLA 와 ASES 중 일상생활지수 (ADL)과 통증 점수를 비교하였다. 결과: 1군과 2군 모두 UCLA, ASES score, ASES score 중 통증에 대한 VAS 점수, 5점을 만점으로 한 내 회전 근력평가평가에서 술 전 보다 술 후 결과가 향상되었다. 1군과 2군의 비교에서 술 후 UCLA 및 VAS 점수는 p>0.05로 차이가 없었고, ASES점수 및 내 회전 근력에 대한 평가는 p<0.05로 의미 있는 차이가 있었다. 결론: 견갑하근의 상부 완전파열 시 견갑하근 봉합술은 단순 변연절제술보다 좋은 치료방법으로 고려할 수 있다.

Purpose: To evaluate the results from arthroscopic repair versus debridement for full-thickness tears of the upper subscapularis tendon. Materials and Methods: Ninety-nine patient outcomes were evaluated and compared prospectively. Sixty-nine patients with full-thickness tears of the upper subscapularis tendon underwent arthroscopic repair (group I) and thirty patients underwent simple debridement (group II) between May 2003 and October 2007. In all patients, the tear was localized to the superior one third of the upper subscapularis tendon. The results of the treatment were assessed by evaluating the UCLA, ASES, and VAS for pain and internal rotation strength scores before and after the operation. Results: In groups I and II, UCLA, ASES, VAS, and internal rotation muscle power (perfect score = 5) scores were improved after surgery. In comparing group I and group II, the UCLA and VAS scores were not significantly different (p>0.05), while the ASES and internal rotation strength scores were significantly different (p<0.05). Conclusion: The arthroscopic repair of full-thickness tears of the upper subscapularis tendon was a better surgical method than simple debridement.

키워드

참고문헌

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피인용 문헌

  1. MR Evaluation of Tendinous Portions in the Subscapularis Muscle vol.14, pp.1, 2011, https://doi.org/10.5397/CiSE.2011.14.1.035