• 제목/요약/키워드: Shoulder Dislocation and Fracture

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상완골 근위부 분쇄성 골절 및 탈구에서 시행한 견관절 반치환술 (Hemiarthroplasty in Comminuted Fracture and Dislocation of the Proximal Humerus)

  • 황성관;김용석
    • Clinics in Shoulder and Elbow
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    • 제1권2호
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    • pp.205-211
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    • 1998
  • 저자들은 상완골 근위부의 골절탈구로 일차성 견관절 반치환술로 치료받은 환자 25례중 14례를 대상으로 치료결과를 분석하여 다음과 같은 결론을 얻었다. 1. 전례에서 동통은 소실되거나 완화되었으나 Neer의 평가에 따라 총 14례중 5례에서만 만족할만 한 결과를 믿었으며 나머지 9례에서는 불만족한 결과를 보였다. 2. 수상시 상완곤두의 분쇄상이 심하거나, 수술이 지연되어 골편치 연화가 심한 경우 상완골 길이와 humeral offset의 유지가 힘들었으며, 견관절 반치환술 시팽한 측이 정상측보다 1cm 이상 단축을 보인 경우가 5례였으며 이 경우 능동적 견관절 운동범위가 정상측보다 감소되었다. 3. 견관절 반치환술은 분쇄상 상완골 근위부 골절에서 사용되어지며 동통의 감소와 기능의 호전은 있으나 완전한 회복은 어려우며 수술시 연부조직 손상이 적고 적당한 후염각, 결절의 재건 과 회전근개의 수복은 필수적이다. humeral offset과 길이의 유지는 술 후 능동적 견관절 운동 범위의 향상에 영향을 미치며 아울러 환자의 협조하에 체계적인 재활운동이 필요할 것으로 사료된다.

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Clinical and Radiological Results of Hook Plate Fixation in Acute Acromioclavicular Joint Dislocations and Distal Clavicle Fractures

  • Oh, Joo Han;Min, Seunggi;Jung, Jae Wook;Kim, Hee-June;Kim, Jae Yoon;Chung, Seok Won;Kim, Joon Yub;Yoon, Jong Pil
    • Clinics in Shoulder and Elbow
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    • 제21권2호
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    • pp.95-100
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    • 2018
  • Background: The purpose of this study was to evaluate the clinical outcomes and complications of hook plate fixation in acromioclavicular (AC) joint dislocations and distal clavicle fractures. Methods: We retrospectively reviewed a series of 60 consecutive patients with hook plate fixation for AC joint dislocation (group I) and distal clavicle fracture (group II). Groups I and II had 39 and 21 patients, respectively. Clinical results were evaluated using the pain visual analogue scale (VAS), simple shoulder test, and Constant-Murley scores. In addition, subacromial erosion and stiffness were evaluated as complications. Results: At the removal, the pain VAS was $2.69{\pm}1.30$ and $4.10{\pm}2.14$ in groups I and II, respectively, which were significantly different (p=0.003). The simple shoulder test score was $9.59{\pm}1.60$ and $7.81{\pm}2.67$ in groups I and II, respectively, which were also significantly different (p=0.002). Subacromial erosion was significantly more frequent in group II (14/21 patients, 66.7%) than in group I (15/39 patients, 38.5%) (p=0.037), and stiffness was also higher in group II (17/21 patients, 81.0%) than in group I (22/39 patients, 56.4%), but it was not significant. Conclusions: Hook plate fixation showed good clinical and functional results for the treatment of acute unstable AC joint dislocation and distal clavicle fracture. But, in distal clavicle fractures, there are more subacromial erosion and stiffness compare with acute unstable AC joint dislocation.

Comminuted Radial Head Fracture in All-arthroscopic Repair of Elbow Fracture-dislocation: Is Partial Excision of the Radial Head an Acceptable Treatment Option?

  • Yang, Hee Seok;Kim, Jeong Woo;Lee, Sung Hyun;Yoo, Byung Min
    • Clinics in Shoulder and Elbow
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    • 제21권4호
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    • pp.234-239
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    • 2018
  • Background: In elbow fracture-dislocation, partial excision of the comminuted radial head fracture that is not amenable to fixation remains controversial considering the accompanying symptoms. This study was undertaken to evaluate the results of radial head partial excision when the comminuted radial head fracture involved <50% of the articular surface in all-arthroscopic repair of elbow fracture-dislocation. Methods: Patients were divided into two groups based on the condition of the radial head fracture. In Group A, the patients had a radial head comminuted fracture involving <50% of the articular surface, and underwent arthroscopic partial excision. Group B was the non-excision group comprising patients with stable and non-displacement fractures. Follow-up consultations were conducted at 6 weeks and at 3, 6, 12, and 24 months after surgery. Results: In all, 19 patients (Group A: 11; Group B: 8) met the inclusion criteria and were enrolled in the study. At the final follow-up, all 19 patients showed complete resolution of elbow instability. No significant differences were observed in the range of motion, visual analogue scale score, and Mayo elbow performance score between groups. Radiological findings did not show any complications of the radiocapitellar joint. However, nonunion of the coracoid fracture was observed in 3 patients (Group A: 1; Group B: 2), without any accompanying instability and clinical symptoms. Conclusions: Considering that the final outcome is coronoid fracture fixation and lateral collateral ligament complex repair for restoring elbow stability, arthroscopic partial excision for radial head comminuted fractures involving <50% of articular surface is an effective and acceptable treatment for elbow fracture-dislocation.

Atlanto-Axial Fracture-Dislocation (환축추 골절 및 탈구) 환자 1례(例)에 대한 증례보고 (Clinical observation on a case of patient with Atlanto-Axial Fracture-Dislocation)

  • 임희정;이해복;최성권
    • Journal of Acupuncture Research
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    • 제18권5호
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    • pp.185-194
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    • 2001
  • Objective : By process of treatment for a case which diagnosed as Atlanto-Axial Fracture-Dislocation and admitted from the 2nd, December, 2000 to the 18th, December, 2000, the results are as follows. Methods : Clinical observation and analysis about a case of Atlanto-Axial Fracture-Dislocation was done, who visited Dong-in-dang Oriental Medicine Hospital. This case is managed by integrated therapy of oriental medicine. This patient was diagnosed as stagnation of Ki and stasis of blood(氣滯血瘀), deficiency of Um of the liver and kidneys(肝腎陰虛) and medicated gamisekyung-tang(加味舒經湯) and kanghwalsokdan-tang(羌話續斷湯). As acupucture treatments, we could get the effective results by providing the patient with acupuncture on the nape, shoulder, Lt upper limb and Rt distant point Conclusion : We could get the effective results that case of Atlanto-Axial Fracture-Dislocation with severe rigid neck and Motor disturb of neck, was treated with oriental medicine and acupuncture therapy.

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60세 이상 환자에서 발생한 외상성 견관절 전방 탈구 (Traumatic Anterior Shoulder Dislocation in Patients Older than 60 Years of Age)

  • 하종경;유재두;박성필;신상진
    • Clinics in Shoulder and Elbow
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    • 제9권1호
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    • pp.42-49
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    • 2006
  • Purpose: This study evaluated clinical results, and recommended treatment protocol of traumatic anterior shoulder dislocation in the patients older than 60 years of age. Materials and Methods: Thirty-eight patients with first traumatic anterior shoulder dislocation aged over 60 years were included. The average age was 69.4 (range, 60 to 87 years). There were 8 men (average age of 71.6) and 30 women (average age of 69). Most common cause of injuries was a fall on the outstretched hand. The additional injuries were evaluated using MRI or CT arthrogram in the patients with significant pain and weakness while movements after 2 weeks sling immobilization. Results: Fifteen patients (39%) had rotator cuff tears and 5 patients (14%) had greater tuberosity fractures. The sizes of rotator cuff tears were diverse; 2 partial tears, 1 small tear, 4 medium tears, 3 large tears and 5 massive tears. Among 5 massive cuff tears, 3 patients revealed cuff arthropathy after reduction. 4 patients (11%) had recurrent dislocation more than one time during 1 month after the first dislocation. Bankart lesions revealed in 5 patients and three of them had associated rotator cuff tears. 3 out of 5 patients with Bankart lesions, 13 out of 15 patients with rotator cuff tears and 3 patients with displaced greater tuberosity fracture had operations. Conclusion: The injury mechanism of shoulder dislocation in patients older than 60 years of age seems to have either anterior or posterior mechanism. The diagnosis and treatment should be approached 2 weeks after dislocation.