• 제목/요약/키워드: Recurrent shoulder dislocation

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견관절 초기 전방 탈구와 재발성 전방 탈구 (Initial and Recurrent Anterior Dislocation in Shoulder)

  • 김영규;이재훈;김현민;이충훈
    • Clinics in Shoulder and Elbow
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    • 제8권2호
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    • pp.148-153
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    • 2005
  • 초기 탈구에서 시행한 조기 안정화 술식이 재발성 탈구의 Bankart 복원술 보다 좋은 결과를 나타내었으며 이는 관절경상 관찰되어진 관절낭 인대의 이완이나 관절와 연의 마멸이 결과에 영향을 미칠 수 있을 것으로 추정되었다. 또한 초기 탈구에서 발생된 Bankart 병변이 술기상으로 보다 쉽게 복원될 수 있으며 치유도 잘 되어 재발율이 감소될 것으로 생각되었고, 조기 수술적 치료를 통해 정상적인 일상 생활 및 스포츠 활동이 가능하리라 생각되었다. 따라서 활동력이 왕성하고 운동을 좋아하는 젊은 층이나 운동 선수에서는 문헌상에서 보고되고 있는 초기 탈구 후의 높은 재발율을 고려하여 초기 탈구 발생시 조기 안정화 술식이 유용할 것으로 사료되었다. 그러나 초기 탈구시 조기 안정화 술식을 시행할 지에 대해서는 보다 엄격한 적응이 요할 것으로 생각된다.

이두건 부하 검사(Biceps Load Test): 견관절 재발성 전방 탈구시 SLAP 병변 진단의 새로운 검사방법 (Biceps Load Test: A Test of SLAP lesion in the Recurrent Anterior Dislocation of the Shoulder)

  • 김승호;하권익;한계영
    • Clinics in Shoulder and Elbow
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    • 제1권1호
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    • pp.78-82
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    • 1998
  • The following will describe a method of evaluating the SLAP lesion in the recurrent anterior dislocation of the shoulder. We have named it the biceps load test. The biceps load test is performed with the patient in the supine position and the arm to be examined is abducted 90/sup°/, and the forearm is in the supinated position. First, the anterior apprehension test is performed. When the patient become apprehensive, the patient is allowed active flexion of the elbow, while the examiner resists elbow flexion. If the apprehension is relieved or diminished, the test is negative. If aggravated or unchanged, the test is positive. A prospective study was performed, in which 75 patients who were diagnosed as having recurrent unilateral anterior instability of the shoulder underwent the biceps load test and arthroscopic examination. The biceps load test showed negative results in 64 of these patients, of which the superior labral-biceps complex was intact'in 63 cases and only I shoulder revealed a type n SLAP lesion. E]even patients with a positive test were confirmed to have type n SLAP lesions. A positive biceps load test represents an unstable SLAP lesion in a patient with recurrent anterior dislocation of the shoulder. The biceps load test is a reliable test for evaluating the SLAP lesion in the recurrent anterior dislocation of the shoulder(sensitivity: ,9] .7%, specificity: 100%, positive predictive value: 1.00 and negative predictive value: 0.98). Biceps contraction increases the torsional rigidity ?of the glenohumeral joint and long head of biceps tendan act as internal rotator of the shoulder in the abducted and externally rotated position. These stabilize the shoulder in abduction and external rotation position in the biceps load test.

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견관절 습관성 탈구의 관혈적 관절막 전위술과 관절경적 Bankart 병변 수복술 (Open Capsular Shift versus Arthroscopic Bankart Repair for Recurrent Dislocation of Shoulder)

  • 김정만;서정태;장정호;김택수
    • Clinics in Shoulder and Elbow
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    • 제2권1호
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    • pp.47-52
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    • 1999
  • The results of open capsular shift(Group 1) and arthroscopic trans glenoid Bankart repair(Group 2) for the recurrent anterior dislocation of the shoulder were compared. During a 4-year period, 25 patients were surgically treated. Fourteen shoulders had open Bankart procedure and capsular shift, and II shoulders were treated arthroscopically. A Bankart lesion was found in 12 out of 14 patients in Group I and all 11 patients in Group 2. Average follow-up period was 46 months for Group 1 and 23.4 months for Group 2. Group 1 showed 71.4% good to excellent results with 1 recurrent dislocation. Group 2 showed 90.9% good to excellent results with no recurrent dislocation. The cause of less favorable results of Group I compared with Group 2 was loss of external rotation postoperatively. The study showed that the results of arthroscopic Bankart repair was comparable to the open capsular shift in terms of stability, and the postoperative function was better than open capsular shift.

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제 1형 신경 섬유종증 환자에서 발생한 재발성 견관절 탈구 및 근위 상완골 골절 - 1예 보고 - (Recurrent Shoulder Dislocation and Proximal Humerus Fracture in Neurofibromatosis Type I - A Case Report -)

  • 황태혁;조형래;왕태현;양희순
    • Clinics in Shoulder and Elbow
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    • 제16권2호
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    • pp.135-140
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    • 2013
  • 제 1형 신경 섬유종증 환자에서 발생한 재발성 견관절 탈구 및 동반된 근위 상완골 골절 1예를 보고하고자 한다. 제 1형 신경 섬유종증으로 진단된 20세 남자로 가벼운 외상 후 발생한 우측 견관절의 탈구와 근위 상완골 골절로 내원하였다. 수상측 주관절부에는 큰 망상형 신경 섬유종들이 있었으며 견관절 탈구는 재발성 병변이었다. 단순 방사선과 컴퓨터 단층 촬영 소견 상 상완골과 견갑골의 골성 변형을 보였고 자기 공명 영상 검사 상 삼각근과 회전근 개에 다발성 신경 섬유종성 변화가 관찰되었다. 관혈적 정복술 및 관절막 재건술을 시행하였으며 근위 상완골 골절은 재건 금속판을 이용하여 고정하였다. 골유합과 만족스런 기능 회복을 보였으며 수술 후 7개월 추시 상 견관절 탈구의 재발은 관찰되지 않았다. 제 1형 신경 섬유종증 환자에서 발생한 견관절 재발성 탈구와 근위 상완골 골절은 드문 합병증이나 질환의 정형외과적 접근 시 고려해야 할 것으로 사료된다.

Transient postoperative inferior subluxation of the shoulder after surgical stabilization of recurrent anterior dislocation in a patient with myasthenia gravis: a case report

  • Samuel Baek;Geum-Ho Lee;Myung Ho Shin;Tae Min Kim;Kyung-Soo Oh;Seok Won Chung
    • Clinics in Shoulder and Elbow
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    • 제26권3호
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    • pp.302-305
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    • 2023
  • The authors present a case of transient postoperative inferior subluxation of the shoulder after arthroscopic surgical stabilization for recurrent anterior dislocation. The patient was a 61-year-old woman with myasthenia gravis (MG). The first anterior shoulder dislocation occurred because of a fall to the ground. Despite a successful closed reduction, two more dislocations occurred in 3 weeks. Magnetic resonance imaging revealed an anterior labroligamentous periosteal sleeve avulsion (ALPSA) lesion, an engaging Hill-Sachs lesion, and large tears of the supraspinatus and infraspinatus tendons. The patient underwent arthroscopic rotator cuff repair and ALPSA repair with a remplissage procedure. Intraoperatively, no tendency for instability was found; however, a widened glenohumeral joint space and inferior subluxation of the humeral head without functional compromise was observed on the day after surgery and disappeared spontaneously on radiographs 2 weeks later. To the authors' knowledge, this is the first report documenting the occurrence of transient postoperative inferior subluxation of the shoulder in a patient with MG.

Management of the First-time Traumatic Anterior Shoulder Dislocation

  • Wang, Sung Il
    • Clinics in Shoulder and Elbow
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    • 제21권3호
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    • pp.169-175
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    • 2018
  • Traumatic anterior dislocation of the shoulder is one of the most common directions of instability following a traumatic event. Although the incidence of shoulder dislocation is similar between young and elderly patients, most studies have traditionally focused on young patients due to relatively high rates of recurrent dislocations in this population. However, shoulder dislocations in older patients also require careful evaluation and treatment selection because they can lead to persistent pain and disability due to rotator cuff tears and nerve injuries. This article provides an overview of the nature and pathology of acute primary anterior shoulder dislocation, widely accepted management modalities, and differences in treatment for young and elderly patients.

견관절 전방 재발성 탈구에 대한 관혈적 술식과 관절경적 술식의 결과 비교 (Open Versus Arthroscopic Technique in the Traumatic Recurrent Anterior Dislocation of the Shoulder)

  • 경희수;전인호;김성중;여준영
    • Clinics in Shoulder and Elbow
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    • 제5권2호
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    • pp.110-117
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    • 2002
  • Purpose: We compared the results of open and arthroscopic Bankart repair in traumatic recurrent anterior dislocation ,3f the shoulder. Materials and methods: We analysed 7 cases underwent open Bankart repair (group I) and 13 cases underwent arthroscopic Bankart repair (group Ⅱ). The average follow-up period was 68.1 months (51-113 months) in group I and 41.1 months (16~57 months) in group Ⅱ. All patients in group I and Ⅱ were non-athletes. We analyzed statistically objective evaluation, such as the stability of shoulder joint, the range of motion, pain, impaired throwing, Bankart rating system by Rowe and subjective evaluation, visual analog scale (VAS) between two groups. Results: In terms of dominant and non-dominant shoulders, the age at initial episode of dislocation, the elapsed time from injury to surgery, the number of preoperative dislocations associated with susceptibility to apprehension. respectively, there was no statistically significant differences between two groups. In group I the average Rowe's scortls was 84.3 and 3 cases (43%) had excellent results,4 cases (S7cfo), good ones. In group H the average Rowe's scores was 87.3 and 7 cases (54%) had excellent results,6 cases, good ones. There was tendency to show more excellent results in group ll, but there was no statistically significant differences. The average VAS were 90.3 points in group I and 88 points in group Ⅱ, which showed also no statistically significant differences. Conclusion: Open and arthroscopic Bankart repairs had no significant difference and showed also good results in travinatic recurrent anterior dislocation of shoulder.

견관절 전방 재발성 탈구 환자에서 발생한 이중 Hill-Sachs 병변 - 증례 보고 - (Double Hill-Sachs Lesion in a Recurrent Anterior Shoulder Dislocation Patient -A Case Report -)

  • 김용민;박경진;김동수;최의성;손현철;조병기;홍경호
    • 대한관절경학회지
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    • 제15권2호
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    • pp.121-124
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    • 2011
  • Hill-Sachs 병변은 견관절 탈구 환자에서 가장 흔히 보이는 병변으로 상완골두의 후외방 골결손으로 지칭된다. 처음 탈구되는 환자에서도 관찰될 수 있으며, 탈구가 진행될 될수록 진행하여 탈구의 수와 Hill-Sachs 병변의 관찰정도는 비례관계가 있는 것으로 알려져 있다. Hill-Sachs 병변의 위치와 유무는 견관절 불안정성에 중요한 의미를 띄는 것으로 이해되고 있다. 저자들은 재발성 전방 견관절 탈구 환자에서 동반된 이중 Hill-Sachs 병변1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

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