• 제목/요약/키워드: Rotator Cuff Tears

검색결과 220건 처리시간 0.025초

Anterolateral Mini-open Fixation with a Patch Augmentation for Latissimus Dorsi Tendon Transfer in Irreparable Rotator Cuff Tears: Technical Note

  • Kim, Du-Han;Kim, Dong-Hu;Cho, Chul-Hyun
    • Clinics in Shoulder and Elbow
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    • 제18권4호
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    • pp.269-271
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    • 2015
  • Latissimus dorsi tendon transfer is a well-established method for treatment of irreparable posterosuperior rotator cuff tears. We report on an anterolateral mini-open technique with a porcine dermal patch augmentation for latissimus dorsi tendon transfer. Use of this technique would result in avoidance of deltoid damage by anterolateral mini-open approach and reduction of failure rate by patch augmentation.

스포츠와 연관된 회전근 개 부분층 파열 (Partial Thickness Rotator Cuff Tears of the Shoulder Related to the Sports)

  • 박태수
    • 대한정형외과학회지
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    • 제54권4호
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    • pp.302-308
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    • 2019
  • 견관절통은 특히 던지기 운동선수에서 흔히 생기는 임상증세다. 전문적인 선수뿐만 아니라 여가활동으로 참여하는 대중의 던지기 선수에서 회전근 개 부분층 파열이 발생할 위험은 상존한다. 본 논문에서는 던지기 선수에서 회전근 개 부분층 파열이 있는 경우 부상의 특징, 치료 전략 및 그 결과에 대하여 문헌고찰을 통하여 알아보고자 한다.

회전근개 파열의 수술적 치료 후 회전근개 초음파 소견 (Postoperative Ultrasound Findings of the Rotator Cuff Tendon after Arthroscopic Repair of a Rotator Cuff Tear)

  • 권동락
    • Clinical Pain
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    • 제19권2호
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    • pp.64-69
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    • 2020
  • Ultrasound (US) imaging is an efficient, easy to use, rapid, dynamic, noninvasive, with rare side-effects and inexpensive tool allowing for facilitated diagnosis and management of the painful shoulder. It also has advantages over other imaging modalities in the evaluation of the postoperative shoulder for rotator cuff integrity and correct anchor and suture placement, as well as rotator cuff analysis following repair surgery. Early postoperative tendons frequently had a hypo- echoic echo texture and the absence of a fibrillar pattern, which might be misinterpreted as recurrent tears. however, these features often normalized into tendons with an increased echo texture and the reappearance of a fibrillar pattern at 6 months. Based on these sequential findings, the US findings within 3 months after surgery should be interpreted with caution to accurately understand and monitor the repaired tendon status.

40대 이후 발생한 견관절 탈구와 회전근 개 파열 (Anterior Dislocation of the Shoulder with Rotator Cuff tear Over the 5th Decades of Age)

  • 문영래;이상홍;김정호
    • 대한관절경학회지
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    • 제6권2호
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    • pp.131-135
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    • 2002
  • 목적 : 40대 이상의 중장년층에서 견관절 전방 탈구와 동반된 회전근 개 파열환자에서 예후 인자를 파악하고자 하였다. 대상 및 방법 : 1995년 5월부터 1998년 10월까지 내원한 견관절 탈구 후 발견된 회전근 개 파열 12 예의 환자를 대상으로 하였으며, 환자의 연령은 42세에서 67세까지 였고, 이중 2예에서 액와 신경 마비를 보였으며 대결절 골절을 동반하였다. 모든 예에서 회전근 개 파열을 보였으며 파열 범위는 8예가 광범위 파열 3예가 광범위 파열, 1예가 소범위 파열이었다. 결과 : 견관절 탈구와 동반된 회전근 개 파열 환자에서 회전근 개 봉합술을 시행한 결과 불행 삼주징을 동반한 2예를 제외 한 10예에서 UCLA shoulder rating scale 을 이용하여 결과를 판정한 바 양호 이상의 결과를 보였다. 결론 : 중장년층에서 발생한 견관절 탈구의 경우 동반 병변의 확인과 액와신경 손상이 동반된 회전근 개 파열 환자에서 적절한 회전근 개 봉합술 및 액와 신경 손상에 대한 적절한 재활 프로그램이 필요하리라 사료된다.

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A Correlation Study of Clinical Outcomes by Quantification of Fatty Degeneration of the Subscapularis: Partial vs. Whole Cross-section

  • Park, Joo Hyun;Lee, Kwang Yeol;Rhee, Sung Min;Oh, Joo Han
    • Clinics in Shoulder and Elbow
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    • 제21권2호
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    • pp.67-74
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    • 2018
  • Background: Fatty degeneration of rotator cuff is a well-known predictor of postoperative outcome. The purpose of this study was to evaluate the clinical features of rotator cuff tears involving subscapularis, and investigate whether fatty degeneration quantified from only the upper subscapularis correlates better with clinical outcomes than quantified from the whole subscapularis. Methods: We retrospectively analyzed 315 consecutive patients who underwent arthroscopic repair for rotator cuff tears involving subscapularis with a minimum follow-up of 1 year. Preoperative and postoperative visual analogue score for pain, range of motion and functional scores were assessed. Integrity of the repaired tendon was assessed at the 1-year follow-up with either magnetic resonance imaging or ultrasonography. Results: The mean Goutallier grade of whole cross-section was significantly lower than that of upper cross-section (1.59 vs. 1.71, p<0.05), but significantly higher than that of lower cross-section (1.59 vs. 1.01, p<0.05). In analysis of 37 re-tears, the occupancy of severe fatty degeneration in upper cross-section was 86.5%, which was significantly higher than that seen in whole cross-section (56.8%, p<0.05). We calculated the cut-off tear size for prediction of re-tears as 19.0 mm for retraction and 11.0 mm for superior-inferior. The cut-off Goutallier grade was 2.5 for both whole and upper cross-sections, but area under the curve was greater in the upper cross-section than the whole (0.911 vs. 0.807). Conclusions: As fatty degeneration of upper subscapularis demonstrated a more distinct spectrum than whole subscapularis, we suggest that measuring fatty degeneration of upper subscapularis can be a more useful method to predict clinical prognosis.

중등도 이상의 어깨통증을 동반한 근육둘레띠(가시위근) 부분파열 환자를 위한 물리치료 프로그램 : 편심성 훈련과 동심성 훈련의 효과 비교 (Physical Therapy Program for Patients with Partial Rotator Cuff (Supraspinatus) Tears with Moderate to Severe Shoulder Pain : Comparison of the effects of eccentric training and concentric training)

  • 추연기
    • 대한통합의학회지
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    • 제11권1호
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    • pp.87-98
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    • 2023
  • Purpose : This study was to verify the effectiveness of eccentric training and to make clinical recommendations on detailed application methods by comparing the effects of changes in acromiohumeral distance (AHD), pain intensity, muscle strength, and functional performance after applying a 12-week eccentric training program (ET group) or concentric training program (CT group) for patients with partial rotator cuff (supraspinatus) tears with moderate to severe shoulder pain. Methods : A total of 29 subjects were assigned to either the "ET group (n=15)" or the "CT group (n=14)" through simple randomization and were measured in the same way at baseline before intervention, 4 weeks and 12 weeks after intervention. All subjects received a physical therapy program 12 sessions 3 times a week for the first 4 weeks, and physical therapy program, 12 sessions a week, from 4 weeks to 12 weeks, for a total 20 sessions. Ultrasound machine was used for AHD, visual analog scale (VAS) was used for pain intensity, electronic hand held dynamometer was used for muscle strength, Korean Constant shoulder score (K-CSS) used for functional performance. Results : AHD, pain intensity, and muscle strength did not show significant differences at 4 weeks, but improved numerically, and showed significant differences at 12 weeks (p<.05), showing superior results in the eccentric training group compared to the concentric training group. Functional performance showed significant changes at both 4 and 12 weeks (p<.05), and excellent results were also found in the eccentric training group. Conclusion : In patients with partial rotator cuff tears with moderate to severe shoulder pain, an eccentric training program increased acromiohumeral distance (AHD), reduced pain, and increased muscle strength. Therefore, it can be clinically presented as an intervention method that can quickly and effectively improve functional performance, which is the ultimate goal of physical therapy.

회전근 개 재파열 후 봉합술 (Revisional Rotator Cuff Repair)

  • 김경일;정진영
    • 대한정형외과학회지
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    • 제54권2호
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    • pp.91-99
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    • 2019
  • 대부분의 환자는 관절경적 회전근 개 봉합술 후 통증이 완화되고 기능적 호전을 보이지만 일부 환자는 수술 후에도 증상이 지속된다. 재파열은 생물학적, 기술적, 외상적 요인이 복합적으로 작용하여 발생한다. 회전근 개 봉합술 후 재파열이 지속되는 통증의 원인일 수도 원인이 아닐 수도 있다. 따라서 이런 환자들의 평가 및 치료는 난해하여 철저한 문진, 이학적 검사, 적절한 영상 검사를 통해서 통증의 원인에 대한 분석이 이루어져야 한다. 재봉합술의 시행 여부는 환자의 나이, 기능적 요구도 회전근 개의 상태, 수술 전 관절 운동 범위, 삼각근의 상태, 관절과 상완 관절의 관절염의 유무에 따라 결정되어야 한다. 성공적인 재봉합술은 술기뿐만 아니라 수술 전 환자 교육 또한 중요하다.

회전근 개 파열과 동반된 회전근 개 근육 내 낭종 - 증례 보고 - (Intramuscular Cyst of the Rotator Cuff Associated with Tear of the Rotator Cuff - A Case Report -)

  • 유재철;하해찬;강홍제
    • Clinics in Shoulder and Elbow
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    • 제11권1호
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    • pp.53-56
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    • 2008
  • 견관절 주위 낭종 중 상견갑 신경 포착 증후군을 일으킬 수 있는 상부 관절순 주위 낭종과 회전근 개 파열과 동반된 견봉 쇄골 관절 낭종이 여러 저자들에 의해 보고된 바 있다. 이 두 가지 낭종에 비해 상대적으로 드물고 덜 알려진 형태로 회전근 개 근육 내 낭종이 있으며, 저자들이 한 예를 경험하였기에 보고하고자 한다.

Dynamic three-dimensional shoulder kinematics in patients with massive rotator cuff tears: a comparison of patients with and without subscapularis tears

  • Yuji Yamada;Yoshihiro Kai;Noriyuki Kida;Hitoshi Koda;Minoru Takeshima;Kenji Hoshi;Kazuyoshi Gamada;Toru Morihara
    • Clinics in Shoulder and Elbow
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    • 제25권4호
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    • pp.265-273
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    • 2022
  • Background: Massive rotator cuff tears (MRCTs) with subscapularis (SSC) tears cause severe shoulder dysfunction. In the present study, the influence of SSC tears on three-dimensional (3D) shoulder kinematics during scapular plane abduction in patients with MRCTs was examined. Methods: This study included 15 patients who were divided into two groups: supraspinatus (SSP) and infraspinatus (ISP) tears with SSC tear (torn SSC group: 10 shoulders) or without SSC tear (intact SSC group: 5 shoulders). Single-plane fluoroscopic images during scapular plane elevation and computed tomography (CT)-derived 3D bone models were matched to the fluoroscopic images using two-dimensional (2D)/3D registration techniques. Changes in 3D kinematic results were compared. Results: The humeral head center at the beginning of arm elevation was significantly higher in the torn SSC group than in the intact SSC group (1.8±3.4 mm vs. -1.1±1.6 mm, p<0.05). In the torn SSC group, the center of the humeral head migrated superiorly, then significantly downward at 60° arm elevation (p<0.05). In the intact SSC group, significant difference was not observed in the superior-inferior translation of the humeral head between the elevation angles. Conclusions: In cases of MRCTs with a torn SSC, the center of the humeral head showed a superior translation at the initial phase of scapular plane abduction followed by inferior translation. These findings indicate the SSC muscle plays an important role in determining the dynamic stability of the glenohumeral joint in a superior-inferior direction in patients with MRCTs.