• Title/Summary/Keyword: 견관절 환자

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The Diabetic Frozen Shoulder: Arthroscopic Release (당뇨병성 동 견관절의 관절경 하 박리술)

  • Han Chang-Whan;Kim Jin-Young;Kim Weon-Yoo;Sung Jin-Hyung;Yoo Jae-Duk;Rho Sang-Hyun
    • Clinics in Shoulder and Elbow
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    • v.2 no.1
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    • pp.74-83
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    • 1999
  • In diabetics, the frozen shoulder has been difficult to treat. They tend to respond poorly to manipulation. In this report we present the rationale and results of arthroscopic selective capsular release for those patients. Nine patients, who were diabetics, developed frozen shoulders which failed to respond to conservative management. They had persistent pain, stiffness, and limited function. An arthroscopic release was performed by progressively releasing the anterior structures from superior to inferior. Postoperatively physiotherapy was carried out daily to maintain the range of movement. At a follow up of 12 to 37 months the patients were assessed using the American Shoulder Society scheme. In addition, the patients were assessed preoperatively and postoperatively on four criteria: pain, external rotation, abduction and function. We found that the patients were statistically significantly improved in all four categories. Three of the nine patients had no pain, full range of motion compared with the opposite side and full function. There was one poor result of no improvement. The remaining five patients had improved but still had residual abnormalities. We consider arthroscopic release to be an effective treatment for the resistant diabetic frozen shoulder.

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Glenoid lesion in Traumatic Anterior Instability of Shoulder (견관절 외상성 불안정성 관절와 병변)

  • Lee, Seoung-Joon;Park, Jin-Young;Keum, Jung-Sup;Ye, Meng
    • Clinics in Shoulder and Elbow
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    • v.10 no.1
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    • pp.23-26
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    • 2007
  • 관절와 병변은 급성 외상으로 인한 골절뿐 아니라 불안정성으로 인한 골 침윤으로 정의할 수 있으며, 이는 통상의 방사선학적 검사를 통하여 진단을 하지 못하는 경우도 있다. 전방 탈구와 동반된 전방 관절와 골절의 빈도는 5.4%에서 32%까지 보고되었다. Hovelius 등이 226명의 탈구환자를 대상으로한 연구에서 8%의 관절와 골절이 있었다고 보고하였고, 노령의 환자에서 약간의 빈도가 증가한다고 하였다. 또한 Rowe는 전방 관절와 골절이 있는 27명의 환자에서 기계적 안정성의 결함으로 62%의 재발성 탈구가 있었다고 보고하였다. 보다 최근의 방카르트 술기에 대한 보고에서 수술적 처치를 한 환자중 44%가 관절와 골절을 동반하였다고 보고하였다. Rowe 와 Zarins는 다발성 전방탈구 환자에서 관절와 병변이 잘 치료되었는지 여부에 따라 다른 결과를 낸다고 보고하였다. 전자에 따르면, 관절와 병변을 진단하는 것은 중요하며 환자의 최종적 예후는 이를 어떻게 치료했는지 여부에 따라 결정된다고 하였다. 관절와 상완관절의 불안정성에서 동반된 관절와 병변의 진단은 보존적 치료시나 수술적 치료 시 모두 중요한 인자라고 하겠다.

Normal Glenoid Size of the Korean in 7th and 8th Decades (한국인 60~70대의 정상 견갑골 관절와의 크기)

  • Moon, Young-Lae;Ha, Sang-Ho;Noh, Kyung-Hwan
    • Clinics in Shoulder and Elbow
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    • v.11 no.1
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    • pp.37-40
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    • 2008
  • Purpose: We wanted to evaluate the normal glenoid size of Koreans in their 7th and 8th decades by conducting Computed tomographic (CT) studies. Materials and Methods: The CT images were obtained from the normal scapulae of the patients (mean age: 68.8) who had humeral fracture. A display workstation version 2.0.73.315 was used to measure the scans to determine the maximal superoinferior (SI) and anteroposterior (AP) diameters of the glenoid vault. Results: The average diameters of curvature of the glenoid were 31.2 mm (range: 27 to 34 mm) in the superior-inferior direction and 26.1mm (range: 22 to 31mm) in the anterior-posterior direction. Conclusion: This study showed the normal glenoid size of Koreans and it is different from the size that the international literature reported. It should be an important factor for the treatment of fracture or in designing arthroplasty implants.

Arthroscopic Bankart Repair using Suture Anchors (봉합나사를 이용한 Bankart 병변의 관절경적 봉합술)

  • Kim, Kyung-Taek;Kim, Chul-Hong;Shin, Sang-Howa;Kwak, Jong-Ill
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.173-177
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    • 2006
  • Purpose: To evaluate the efficacy of arthroscopic Bankart repair using suture anchors for treatment of traumatic anterior instability of shoulder joint. Materials and Methods: We performed arthroscopic Bankart repair using suture anchor in 90 cases and evaluated the results with the functional grading system of Rows and Zarins after patients were followed up for more than 24 months. Results: Combined pathologies identified under arthroscopy were Hill-sachs lesion in 46 cases, SLAP lesion in 12 cases, Rotate cuff lesion in 7 cases. The results were excellent or good in 82(91.1%) cases and redislocation was happened only 3 cases. Conclusion: We concluded that arthroscopic Bankart repair with suture anchors is one of the reliable and effective method for recurrent shoulder dislocation with Bankart lesion.

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견관절 불안정성 진단 및 치료방침의 결정

  • Choe, Chang-Hyeok
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2007.11a
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    • pp.104-109
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    • 2007
  • 외상성 전방탈구의 경우 일차성 탈구이거나 일상생활에 큰 불편을 호소하지 않는 불안정성이 있을 경우 및 비외상성 다방향 불안정성의 경우 보존적 치료가 바람직하며, 10대 및 20대의 재탈구로 인한 불안정성이 유발될 경우 관절경적 혹은 개방성 Bankart 술식을 통하여 관절순의 해부학적 정복 및 술 후 잘 조절된 재활치료를 시행할 경우, 좋은 결과를 얻을 수 있다. 치료 방법의 선택 시 가장 중요한 요소는 환자의 원하는 결과를 만족 시켜줄 수 있는 치료 방법을 선택하는 것이며, 이는 불안정성의 원인, 정도, 탈구의 횟수, 환자의 활동도 및 재활 의지등을 종합적으로 감안하여 결정되어야 한다.

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Current Concept of Anterior Shoulder Instability Repair (견관절 전방 불안정성의 봉합술에 대한 최신 지견)

  • Kim, Young-Kyu
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.1-7
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    • 2006
  • 견관절 전방 불안정성의 관절경적 치료는 환자 개개인의 병리 상태를 잘 파악하여 적절한 복원술을 시행함으로써 보다 좋은 결과를 기대할 수 있다. 현재 관절경적 Bankart 복원술시 봉합 나사못이 가장 이상적인 봉합기구로 알려져 있으며 여러 병리 상태를 고려하여 관절경적 복원술을 시행한 결과 여러 학자들이 과거에 비해 좋은 결과를 보고하고 있다(Table 2). 따라서 술기상으로 보다 숙련된 술식을 통해 재발율을 낮출 수 있으며 보다 좋은 결과를 얻기 위하여 수술 후 적극적인 재활 프로그램이 요할 것으로 생각된다.

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Investigation for Shoulder Kinematics Using Depth Sensor-Based Motion Analysis System (깊이 센서 기반 모션 분석 시스템을 사용한 어깨 운동학 조사)

  • Lee, Ingyu;Park, Jai Hyung;Son, Dong-Wook;Cho, Yongun;Ha, Sang Hoon;Kim, Eugene
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.68-75
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    • 2021
  • Purpose: The purpose of this study was to analyze the motion of the shoulder joint dynamically through a depth sensor-based motion analysis system for the normal group and patients group with shoulder disease and to report the results along with a review of the relevant literature. Materials and Methods: Seventy subjects participated in the study and were categorized as follows: 30 subjects in the normal group and 40 subjects in the group of patients with shoulder disease. The patients with shoulder disease were subdivided into the following four disease groups: adhesive capsulitis, impingement syndrome, rotator cuff tear, and cuff tear arthropathy. Repeating abduction and adduction three times, the angle over time was measured using a depth sensor-based motion analysis system. The maximum abduction angle (θmax), the maximum abduction angular velocity (ωmax), the maximum adduction angular velocity (ωmin), and the abduction/adduction time ratio (tabd/tadd) were calculated. The above parameters in the 30 subjects in the normal group and 40 subjects in the patients group were compared. In addition, the 30 subjects in the normal group and each subgroup (10 patients each) according to the four disease groups, giving a total of five groups, were compared. Results: Compared to the normal group, the maximum abduction angle (θmax), the maximum abduction angular velocity (ωmax), and the maximum adduction angular velocity (ωmin) were lower, and abduction/adduction time ratio (tabd/tadd) was higher in the patients with shoulder disease. A comparison of the subdivided disease groups revealed a lower maximum abduction angle (θmax) and the maximum abduction angular velocity (ωmax) in the adhesive capsulitis and cuff tear arthropathy groups than the normal group. In addition, the abduction/adduction time ratio (tabd/tadd) was higher in the adhesive capsulitis group, rotator cuff tear group, and cuff tear arthropathy group than in the normal group. Conclusion: Through an evaluation of the shoulder joint using the depth sensor-based motion analysis system, it was possible to measure the range of motion, and the dynamic motion parameter, such as angular velocity. These results show that accurate evaluations of the function of the shoulder joint and an in-depth understanding of shoulder diseases are possible.