๋ฉ”์ธ ์ฝ˜ํ…์ธ ๋กœ ๊ฑด๋„ˆ๋›ฐ๊ธฐ
Case #3
ํ™˜์ž ์ •๋ณด: 34 ์„ธ, ๋‚จ์„ฑ
์ ์‘์ฆ: ์–ด๊นจ ์†์ƒ

Case #3

์†Œ๊ฒฌ

์ง„๋‹จ

์—ญ Hill-Sachs ๋ฐ Bankart ๊ณจ์ ˆ์„ ๋™๋ฐ˜ํ•œ ํ›„๋ฐฉ ๊ฒฌ๊ด€์ ˆ ํƒˆ๊ตฌ

์ƒ˜ํ”Œ ๋ณด๊ณ ์„œ

๊ธ‰์„ฑ ์—ญ Hill-Sachs ๊ฐ์ž… ๊ณจ์ ˆ ๋ฐ ๊ธ‰์„ฑ ์ตœ์†Œ ์ „์œ„ ์—ญ Bankart ๋ณ‘๋ณ€์„ ๋™๋ฐ˜ํ•œ ํ›„๋ฐฉ ๊ฒฌ๊ด€์ ˆ ํƒˆ๊ตฌ.

๊ฒฌ๋ด‰์‡„๊ณจ ๊ด€์ ˆ ์ •๋ ฌ ์œ ์ง€๋จ.

๊ณ ์ฐฐ

  • ๊ฒฌ๊ด€์ ˆ ํƒˆ๊ตฌ๋Š” ์ „๋ฐฉ, ํ›„๋ฐฉ, ํ•˜๋ฐฉ์˜ ์„ธ ๊ฐ€์ง€ ์ฃผ์š” ์œ ํ˜•์ด ์žˆ์œผ๋ฉฐ, ์ „๋ฐฉ์ด ๊ฐ€์žฅ ํ”ํ•ฉ๋‹ˆ๋‹ค. ๊ฐ ํƒˆ๊ตฌ ์œ ํ˜•์˜ ๋ฐฉ์‚ฌ์„ ํ•™์  ๋‹จ์„œ๋Š” ๋‹ค์Œ๊ณผ ๊ฐ™์Šต๋‹ˆ๋‹ค:
    • ์ „๋ฐฉ: ์ƒ์™„๊ณจ๋‘๊ฐ€ ๊ด€์ ˆ์™€์˜ ํ•˜๋‚ด์ธก์— ์œ„์น˜
    • ํ›„๋ฐฉ: ์ƒ์™„๊ณจ๋‘๊ฐ€ AP ์ดฌ์˜์—์„œ ๊ด€์ ˆ์™€์— ๋Œ€ํ•ด ์ •ํ™•ํžˆ ์œ„์น˜ํ•œ ๊ฒƒ์ฒ˜๋Ÿผ ๋ณด์ผ ์ˆ˜ ์žˆ์Œ. ๊ฒฌ๊ด€์ ˆ์ด ์ „ํ˜•์ ์œผ๋กœ ๋‚ดํšŒ์ „์— ๊ณ ์ •๋จ (์ด๋ฅธ๋ฐ” "์ „๊ตฌ" ์ง•ํ›„)
    • ํ•˜๋ฐฉ: ์ƒ์™„๊ณจ๋‘๊ฐ€ ๊ด€์ ˆ์™€ ํ•˜๋ฐฉ์— ์œ„์น˜ํ•˜๋ฉฐ ํŒ”์ด ์ข…์ข… ์™ธ์ „์— ๊ณ ์ •๋จ (๋จธ๋ฆฌ ์œ„๋กœ ์˜ฌ๋ฆฐ ์ƒํƒœ, ์ผ๋ช… "ํ•˜๋ฐฉ ํƒˆ๊ตฌ(luxatio erecta)")
  • ๊ด€๋ จ ๊ณจ์ ˆ:
    • Hill-Sachs
      • ์ƒ์™„๊ณจ๋‘๊ฐ€ ๊ด€์ ˆ์™€์— ์ถฉ๋Œํ•˜๋Š” ํ›„์™ธ์ธก ์ƒ์™„๊ณจ๋‘๋ฅผ ๋”ฐ๋ผ ๋ฐœ์ƒ
      • ๋‚ดํšŒ์ „ ์ดฌ์˜์—์„œ ๊ฐ€์žฅ ์ž˜ ๋ณด์ž„
      • ํ›„๋ฐฉ ํƒˆ๊ตฌ์— ์˜ํ•œ ์—ญ Hill-Sachs -> ํ•˜๋‚ด์ธก ์ƒ์™„๊ณจ๋‘์˜ ๊ฐ์ž… ๊ณจ์ ˆ, ๋ฐฉ์‚ฌ์„ ์ดฌ์˜์—์„œ "๊ตฌ" ์ง•ํ›„๋ฅผ ์ดˆ๋ž˜
    • Bankart
      • ๊ด€์ ˆ์™€ ์ „๋ฐฉ ์—ฐ, ๋ฐฉ์‚ฌ์„ ์ดฌ์˜์—์„œ ๋ณด๊ธฐ ์–ด๋ ค์šด ๊ฒฝ์šฐ๊ฐ€ ๋งŽ์Œ
      • ํ›„๋ฐฉ ๊ฒฌ๊ด€์ ˆ ํƒˆ๊ตฌ ์‹œ ์—ญ Bankart (ํ›„๋ฐฉ ์—ฐ)

์ฃผ์„์ด ์žˆ๋Š” ์ด๋ฏธ์ง€ ๋ฐ ์ผ๋Ÿฌ์ŠคํŠธ

Red arrows: reverse Hill-Sachs fracture of the inferomedial humeral head resulting in a trough sign on frontal views.

Red arrows: reverse Hill-Sachs fracture of the inferomedial humeral head resulting in a trough sign on frontal views.

Red arrow: posterior shoulder dislocation with minimally displaced fracture of the posterior glenoid, best shown on this axillary view.

Red arrow: posterior shoulder dislocation with minimally displaced fracture of the posterior glenoid, best shown on this axillary view.

์ฐธ๊ณ ๋ฌธํ—Œ

์‚ฌ์ดํŠธ ํ”ผ๋“œ๋ฐฑ

์—ฌ๋Ÿฌ๋ถ„์˜ ํ”ผ๋“œ๋ฐฑ์€ CaseStacks ๊ฐœ์„ ์— ๋„์›€์ด ๋ฉ๋‹ˆ๋‹ค. ์˜๊ฒฌ, ์ œ์•ˆ ๋˜๋Š” ๋ฐœ์ƒํ•œ ๋ฌธ์ œ๋ฅผ ๊ณต์œ ํ•ด ์ฃผ์„ธ์š”.

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