• Title/Summary/Keyword: 상완골두

Search Result 36, Processing Time 0.03 seconds

Acute Osteomyelitis of the Humeral Head after Arthroscopic Rotator Cuff Repair (관절경적 회전근 개 봉합술 이후 발생한 상완골두의 급성 골수염)

  • Shin, Sang-Jin;Jeong, Byoung-Jin;Kook, Seung Hwan;Shin, Sung-Joon
    • Clinics in Shoulder and Elbow
    • /
    • v.16 no.2
    • /
    • pp.141-147
    • /
    • 2013
  • A 57-year-old man who simultaneously underwent an operation for repair of rotator cuff and a revision operation for nonunion of a Pilon fracture presented with osteomyelitis of the humeral head on the $19^{th}$ day after surgery due to MRSA (Methicillin-resistant Staphylococcus aureus) infection. Infection was controlled after administration of appropriate intravenous antibiotic therapy and performance of several surgical procedures. However, devastating defects at the humeral head and the rotator cuff remained. No case of short term MRSA induced osteomyelitis has been reported.

Humeral Head Decentralization of Preoperative Magnetic Resonance Images and the Treatment of Shoulder Dislocations in Large to Massive Rotator Cuff Tears in Elderly over 65 Years Old (65세 이상 고령의 회전근 개 대파열 및 광범위 파열에 동반된 견관절 탈구의 치료 및 술 전 자기공명영상의 상완골두 탈중심화)

  • Lee, Bong-Ju;Song, In-Soo;Cha, Kihun
    • Journal of the Korean Orthopaedic Association
    • /
    • v.54 no.5
    • /
    • pp.418-426
    • /
    • 2019
  • Purpose: This study analyzed the features of humeral head decentralization in large to massive rotator cuff tears with a shoulder dislocation in the elderly. Moreover, shoulder instability and treatment were reviewed. Materials and Methods: From May 2005 to February 2017, Group A containing 45 cases (45 patients) over 65 years old accompanied by a large or massive rotator cuff tear with a shoulder dislocation and Group B containing 45 cases (45 patients) without a shoulder dislocation were enrolled. The mean ages in Groups A and B were 73.2 and 72.1 years old, and the mean follow-up periods were 30.7 and 31.3 months, respectively. Twenty-one cases (46.7%) in Group A underwent rotator cuff repair, and 8 cases (17.8%) underwent concomitant rotator cuff repair with Bankart repair. Sixteen cases (35.6%) underwent reverse total shoulder arthroplasty for cuff tear arthropathy. 45 cases (100%) in Group B underwent rotator cuff repair. The off-the center and head elevation were measured in the preoperative magnetic resonance imaging (MRI) of Groups A and B. The preoperative and postoperative visual analogue scale (VAS) score, American Shoulder and Elbow Surgeons (ASES) score, and University of California Los Angeles (UCLA) score in Groups A and B were compared. Results: In Groups A and B, the mean off-the centers were posterior 7.41 mm and posterior 2.02 mm (p=0.03), and the mean head elevations were superior 6.66 mm and superior 2.44 mm (p=0.02), respectively. The mean ASES scores of Groups A and B were 32.8 and 33.4 before surgery, and 77.1 (p=0.02) and 78.1 (p=0.02) after surgery (p=0.18), respectively. The mean UCLA scores of Groups A and B were 13.1 and 12.8 before surgery, and 28.9 (p=0.02) and 29.5 (p=0.01) after surgery (p=0.15), respectively. Conclusion: Patients over 65 years old with a shoulder dislocation in large to massive rotator cuff tears had higher off-the center and head elevation on the preoperative MRI than those without a shoulder dislocation. This measurement can help predict preceding shoulder instability. Early rotator cuff repairs should be performed and other treatments, such as Bankart repair and reverse total shoulder arthroplasty, should also be considered.

Arthroscopic assisted Core Decompression of Humeral Head Osteonecrosis - Technical Note - (상완 골두 골괴사증에서의 관절경하 핵심 감압술 - 수술 술기 -)

  • Cho, Chul-Hyun;Sohn, Sung-Won;Bae, Ki-Cheor;Kim, Dong-Hoo
    • Journal of the Korean Arthroscopy Society
    • /
    • v.13 no.2
    • /
    • pp.174-178
    • /
    • 2009
  • Purpose: We introduce arthroscopic assisted core decompression for humeral head osteonecrosis. Operative technique: After diagnostic shoulder arthroscopy is performed using posterior and anterior portal, we make a 2 cm lateral skin incision approximately 3 cm distal to 1/3 of lateral margin of the acromion and place short gray cannula to prevent adjacent soft tissue injury when insert guide pin. Under C-arm fluoroscopic and arthroscopic guidance, 3 to 4 guide pins are inserted toward the necrotic area. Then we perform drilling using 7.0 mm reamer. Conclusion: We believe this technique is a less invasive approach and avoids the complications comparing to deltopectoral approach. Arthroscopic assisted core decompression is an effective procedure in management of early stage of the humeral head osteonecoris.

  • PDF

Preoperative Shoulder MRI Findings to Predict Subscapularis Tendon Tear Requiring Surgical Repair (수술이 필요한 견갑하건 파열을 예측하기 위한 수술 전 어깨 MRI 소견)

  • Ji-hoon Jung;Young-Hoon Jo;Yeo Ju Kim;Seunghun Lee;JeongAh Ryu
    • Journal of the Korean Society of Radiology
    • /
    • v.85 no.1
    • /
    • pp.171-183
    • /
    • 2024
  • Purpose This study aimed to investigate which indirect parameters on preoperative MRI were the principal predictors of subscapularis tendon tears (STTs) requiring surgical repair. Materials and Methods Preoperative MRI scans of 86 patients were retrospectively reviewed for visual assessment of the STT, pathology of the long head of the biceps tendon (LHBT), posterior decentering (PD) of the humeral head, humeral rotation, fatty degeneration, and subscapularis muscle atrophy. To evaluate atrophy, visual grading using the anatomical line connecting the coracoid tip to the glenoid base, designated as the base-to-tip line (BTL), and thickness measurements were performed in the en-face view. Results Arthroscopically, 31 patients (36%) exhibited Lafosse type III or IV STT and underwent surgical repair. LHBT pathology (p = 0.002), PD of the humeral head (p = 0.012), fatty degeneration (p < 0.001), and BTL grade (p = 0.003) significantly correlated with STT. In the multivariate analysis, PD of the humeral head (p = 0.011, odds ratio [OR] = 5.14) and fatty degeneration (p = 0.046, OR = 2.81) were independent predictors of STT. Conclusion PD of the humeral head and fatty degeneration of the subscapularis can help to diagnose clinically significant STT. Interpretation of these findings may contribute to the planning of an optimal surgical strategy.

Remplissage Procedure (관절경하 극하건 고정술)

  • Kim, Young-Kyu
    • Journal of the Korean Arthroscopy Society
    • /
    • v.14 no.3
    • /
    • pp.169-174
    • /
    • 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.

  • PDF