• Title/Summary/Keyword: 견관절와

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Bony Bankart lesion (골성 Bankart 병변)

  • Lee, Seung-Jun;Park, Jin-Young
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.1
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    • pp.50-54
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    • 2011
  • A growing number of people are enjoying sports activity with a rise in national income. In this current, many patients complain of traumatic shoulder dislocation and chronic instability with bony Bankart lesion. Computed tomography arthrography is good diagnostic modality for bony Bankart lesion. It is important to consider the patients' factors such as occupation, sports activity, size of preoperative glenoid bone loss before decision of treatment. As development of arthroscopic treatment, there is no significant difference in the result of bony Bankart repair between arthroscopic surgery and open surgery. However, open surgery should be considered for patients with preoperative glenoid bone loss more than 25% or in need of collision sports activity.

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Ultrasound Related Anatomy and Biomechanics of Shoulder Joint (초음파 영상과 관련된 견관절 해부학 및 생역학)

  • Kim, Yang-Soo;Lee, Jae-Young
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.1 no.2
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    • pp.112-116
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    • 2008
  • Ultrasonography of shoulder joint recently enlarges its utility since the knowledge of the shoulder disease is increased by numerous researches. Ultrasonography is not only noninvasive, safe, and relatively cheap, but also an unique modality that can monitor tendon movement during shoulder motion. Sonographic examination generally starts from the front side of the shoulder joint and finishes at back side in sitting position. Many structures in shoulder joint such as muscles, ligaments, glenoid labrum, bone, and especially rotator cuff tendon can be examined by ultrasonography. The rotator cuff is a motion unit consisted with subscapularis, supraspinatus, infraspinatus, and teres minor muscles. It functions as fulcrum and compresses the humeral head onto the glenoid, and steers for shoulder joint.

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Rehabilitation after Bankart and SLAP Repair (Bankart 병변과 SLAP 병변 수술 후 재활)

  • Kim, Yang-Soo
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.2
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    • pp.75-81
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    • 2008
  • 견관절의 안정요소 중 정적 안정요소는 관절와 상완 연골 인대 복합체나 관절 일치성 등으로서 재활 과정 중 신장 운동에 관여하며, 회전근 개 근육과 각 관절 사이의 운동 조화 등으로 이루어진 동적 안정요소는 근력 강화 운동으로 재활이 이루어진다. 견관절 불안정성에 대한 수술 후 재활은 복원된 조직을 보호하면서 동시에 주위 조직과의 유착을 방지하고 관절 운동 범위를 향상하기 위해 통증을 유발하지 않는 범위 내에서 부드러운 수동 관절 운동을 먼저 실시한다. 능동적 관절운동은 수술한 조직이 치유될 충분한 시간이 경과되었거나 환자가 통증없이 독립적인 견관절 운동이 가능할 때 실시한다. 견갑와 상완 관절뿐만 아니라 견갑 흉곽 운동과 견갑골 부착 근육에 대한 재활이 제대로 이루어져야 수술 후 만족할 만한 결과를 얻을 수 있다. 끝으로 본문에 상술한 모든 재활 프로그램은 환자의 개개인의 특성에 맞춰 운동 내용과 시기를 조정하여 개별화해야 효과적인 재활이 이루어질 수 있다.

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Remplissage Procedure (관절경하 극하건 고정술)

  • Kim, Young-Kyu
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.3
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    • pp.169-174
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    • 2010
  • 대다수의 견관절 전방 불안정성에서 관절와에 골 소실이 큰 경우는 Bankart 복원술을 튼튼하게 하였을지라도 상완골두를 지탱할 관절 궁이 감소되어 골에 의한 버팀이 줄어들므로 Bankart 복원이 실패할 가능성이 높다. 따라서 관절와 결손이나 상완골 두 결손이 큰 경우 정확한 측정으로 결손의 범위를 파악하여야 하며, 관절와 결손이 25% 이상이거나 상완 골 두 결손이 30% 이상인 경우 추가적인 수술적 처치가 요하여 최근 보고되고 있는 Latarjet 술식이나 관절경적 Remplissage 술식을 시행하는 것이 바람직하다.

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Measurement of shoulder motion fraction and motion ratio (견관절 운동 분율의 측정)

  • Kang, Yeong-Han
    • Journal of radiological science and technology
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    • v.29 no.2
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    • pp.57-62
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    • 2006
  • Purpose : This study was to understand about the measurement of shoulder motion fraction and motion ratio. We proposed the radiological criterior of glenohumeral and scapulothoracic movement ratio. Materials and Methods : We measured the motion fraction of the glenohumeral and scapulothoracic movement using CR(computed radiological system) of arm elevation at neutral, 90 degree, full elevation. Central ray was $15^{\circ},\;19^{\circ},\;22^{\circ}$ to the cephald for the parallel scapular spine, and the tilting of torso was external oblique $40^{\circ},\;36^{\circ},\;22^{\circ}$ for perpendicular to glenohumeral surface. Healthful donor of 100 was divided 5 groups by age(20, 30, 40, 50, 60). The angle of glenohumeral motion and scapulothoracic motion could be taken from gross arm angle and radiological arm angle. We acquired 3 images at neutral, $90^{\circ}$ and full elevation position and measured radiographic angle of glenoheumeral, scapulothoracic movement respectively. Results : While the arm elevation was $90^{\circ}$, the shoulder motion fraction was 1.22(M), 1.70(W) in right arm and 1.31, 1.54 in left. In full elevation, Right arm fraction was 1.63, 1.84, and left was 1.57, 1.32. In right dominant arm(78%), $90^{\circ} and Full motion fraction was 1.58, 1.43, in left(22%) 1.82, 1.94. In generation 20, $90^{\circ} and Full motion fraction was 1.56, 1.52, 30' was 1.82, 1.43, 40' was 1.23, 1.16, 50' was 1.80, 1.28, 60' was 1.24, 1.75. There was not significantly by gender, dominant arm and age. Conclusion : The criterior of motion fraction was useful reference for clinical dignosis the shoulder instability.

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Isolated Middle Glenohumeral Ligament Tear - A Case Report - (중관절와상완 인대의 단독파열 - 증례보고 -)

  • Choi, Chang-Hyuk;Kwun, Koing-Woo;Kim, Shin-Kun;Lee, Sang-Wook;Jang, Ho-Sun
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.1
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    • pp.101-106
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    • 1998
  • 일반적으로 견관절의 전방안정력은 하관절와상완인대에서 주역할을 하며, 불안정성으로 인한 병변은 관절순과 골관절와사이의 분리(Bankart lesion)로 나타난다고 한다. 중관절와상완인대는 특히 중등도의 외전위치에서 견관절의 전방안정성에 중요한 역할을 하는 정적 안정물로써, 다른 관절와상완인대의 동반손상없이 단독으로 파열된 례는 문헌고찰상 보고된 바가 없었다. 본 증례의 경우 특별한 외상력없이 내원 1년전부터 우측 견관절의 전방 불안정성과 동통성운동제한의 소견을 보였으며 상기 증상은 3개월 전부터 점차 악화되었다. 관절경 소견상 관절와순 부착부위에서 파열된 중관절와상완인대를 확인할 수 있었으며 동반된 관절와순의 부분파열 및 관절와관절면의 미란을 확인할 수 있었다. 파열된 중관절와상완인대와 비후된 활막을 변연절제 후 8개월 정도의 단계적 재활운동을 시행하였으며 동통과 관절운동의 회복소견을 볼 수 있었다. 본저자들은 관절경검사상 중관절와상완인대의 단독파열소견을 보인 39세의 여교사를 치료하였으며 그 결과를 문헌고찰과 함께 보고하는 바이다.

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Review in Remplissage on Anterior Shoulder Instability with Huge Hill-Sachs Lesion (전방 견관절 불안정성의 Hill-Sachs 병변의 치료에서 Remplissage의 Review)

  • Ko, Sang-Hun;Lee, Chae-Chil;Park, Han-Chang
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.134-139
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    • 2011
  • Purpose: We wanted to review the arthroscopic Remplissage technique and introduce our experiences with it for treating recurrent shoulder instability with a large Hill-Sachs lesion. Materials and Methods: The arthroscopic Remplissage technique with Bankart repair is performed in patients with no osteoarthritis, no fracture around the shoulder, a history of recurrence more than 10 times, a large Hill-Sachs lesion more than 30 to 40% of the humeral articular surface and glenoid bone loss less than 20%. Results and Conclusion: For recurrent shoulder instability with a large Hill-Sachs lesion, the Remplissage technique resulted in a good outcome for the shoulder stability, and good clinical and functional results.

Posterior Internal Impingement of the Shoulder in Baseball Players -Preliminary Report of 5 Cases Study- (야구 선수에서의 견관절 내부 후방 충돌 -5예에 대한 예비보고-)

  • Kim, Young-Kyu;Choi, Kwang-Woon
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.4 no.1
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    • pp.36-42
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    • 2005
  • Purpose: To investigate the arthroscopic findings, and to evaluate the clinical outcomes of the treatment of posterior internal impingement of the shoulder in baseball players. Materials and Methods: We followed up 5 cases who were diagnosed as posterior internal impingement for the mean 15 months. All of the cases complained of the pain in the posterior shoulder at late cocking, and were positive in the relocation test added by hyper-horizontal abduction at $120^{\circ}$ abduction of the arm. We sutured posterior labral tear and SLAP lesion arthroscopically, and conducted debridement for rotator cuff. Three cases were performed of anterior capsular plication and the other two were performed of thermal capsular shrinkage. Pain, range of motion, and level of return to sports activity were assessed for the results. Results: As to the arthroscopic findings, all the five cases showed the fraying in posterosuperior labrum, and two of them was accompanied with the flap tear in posterosuperior labrum and the other one was accompanied with type 2 SLAP lesion. All the cases showed the fraying in supraspinatus, and one case showed partial tear. Meanwhile, in all the cases, the rotator cuff was impinged to the labrum at $90^{\circ}{\sim}120^{\circ}$ of abduction and external rotation. As to the postoperative results, all the cases did not complain of pain or instability while pitching, and the competition was recovered to be the mean 88%($80{\sim}100%$) of that before the injury. Conclusion: Definite diagnosis for the posterior internal impingement would be possible through arthroscopic examination. Favorable outcomes could be obtained with capsular plication or shrinkage for anterior microinstability and stretching exercise for posterior capsule tightness inducing the internal impingement.

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Accuracy of the Glenohumeral Joint Injection According to the Approach (도달 방법에 따른 관절와상완 관절내 주사의 정확도)

  • Choi, Nam Yong;Lee, Kang Wook;Kim, Hyung Seok;Song, Hyun Seok
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.6 no.2
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    • pp.45-52
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    • 2013
  • Purpose: We wanted to compare the accuracy between the blind anterior approach and ultrasound guided posterior approach, which are preferred in the present clinical practice for the glenohumeral joint injection. Materials and Methods: The consecutive 95 cases were included in that the glenohumeral joint injection was done in the university hospital and the medical record and ultrasonography were available. There were 52 cases which were injected by blind anterior approach (group I) and 43 cases who were injected by ultrasound guided posterior approach (group II). The injection was decided as accurate if the fluid was visualized in the posterior joint under the ultrasound. We evaluated the range of motion before and after 2 weeks of injection. A subjective satisfaction of the patients was interviewed at the 2 weeks after injection. Results: The accuracy of the glenohumeral joint injections of the group I and group II was 80.8% and 90.7%, respectively. The range of motion was improved for the all cases regardless of the approaches. At the 2 weeks after injection, the subjective satisfaction (better than good) was achieved in 73.7%. Conclusion: The accuracy of the blind anterior approach for the glenohumeral joint injection was 80.8%. The accuracy of the ultrasound guided posterior approach was 90.7%. In this comparative study by the one physician, the ultrasound guided posterior approach showed the better accuracy.

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