Clinics in Shoulder and Elbow

대한견·주관절의학회 (Korean Shoulder and Elbow Society)
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봉합이 불가능한 회전근 개 광범위 파열에 대한 건 이전 수술

Tendon Transfer for Irreparable Massive Rotator Cuff Tear

  • 염재광 (인제대학교 상계백병원 정형외과학교실) ;
  • 이희성 (인제대학교 상계백병원 정형외과학교실) ;
  • 박성범 (인제대학교 상계백병원 정형외과학교실)
  • Yum, Jae-K. (Department of Orthopaedic Surgery, Sang-gye Paik Hospital, Inje Univ.) ;
  • Lee, Hee-Sung (Department of Orthopaedic Surgery, Sang-gye Paik Hospital, Inje Univ.) ;
  • Park, Sung-Bum (Department of Orthopaedic Surgery, Sang-gye Paik Hospital, Inje Univ.)
  • 투고 : 2010.05.10
  • 심사 : 2010.06.16
  • 발행 : 2010.06.15
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초록

목적, 대상 및 방법: 봉합이 불가능한 회전근 개 광범위 파열에 대한 치료로는 보존적 치료, 변연절제술, 부분 봉합술, 건 이전술, 인공 건 이식술 및 역행성 견관절 전치환술 등이 있으나 비교적 젊은 연령이거나 활동성이 높은 환자에서는 견관절의 생역학적 재건으로 force couple을 향상시켜서 견관절의 기능을 호전시키는 건 이전술이 보다 효과적인 치료로 사료된다. 결과 및 결론: 따라서 저자들은 봉합이 불가능한 회전근 개 광범위 파열에서 후상방형 결손에 대해서는 광배근 이전술을 그리고 견갑하건 결손에 대해서는 대흉근 이전술을 소개하고자 한다.

Purpose: Irreparable massive rotator cuff tears pose a distinct clinical challenge for the orthopaedist and non-surgical treatment has had inconsistent results and proven unsuccessful for chronic symptoms, while surgery, including debridement and partial and complete repairs have had varying degrees of success. Materials and Methods: For rotator cuff tears that are deemed irreparable, treatment options are limited. Results and Conclusion: The use of tendon transfers (latissimus dorsi for posterosuperior type cuff defects and pectoralis major for subscapularis defects) in younger patients to reconstruct rotator cuffs and re-establish function and restore shoulder kinematics can be useful in solving this difficult problem.

키워드

참고문헌

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