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C. Scapular fractures

C1. Clinical features

(1) ๊ฒฌ๊ฐ‘๊ณจ ๊ณจ์ ˆ์ด ์ผ์–ด๋‚˜๋ ค๋ฉด ๋งŽ์€ ์–‘์˜ ์—๋„ˆ์ง€๊ฐ€ ํ•„์š”ํ•˜๋‹ค.
โ†’ ๋‹ค๋ฅธ ๋ถ€์œ„ ์†์ƒ์— ๋Œ€ํ•œ ํ‰๊ฐ€๊ฐ€ ๊ฐ™์ด ํ•„์š”ํ•จ.
(3) ๋Œ€๋ถ€๋ถ„์˜ 2~4์ฃผ ์ •๋„์˜ ๋ณด์กด์  ์น˜๋ฃŒ์™€ ์ง„์ž Pendular shoulder exercises์— ์ž˜ ์น˜๋ฃŒ๋จ.
(4) ์ˆ˜์ˆ ์  ์น˜๋ฃŒ๋Š” glenoid articular fracture, angulated glenoid neck fracture, rotator cuff tear์™€ ๊ด€๊ณ„๋œ acromial fracture ๊ทธ๋ฆฌ๊ณ  ๋ช‡๋ช‡ coracoid fracture์˜ ๊ฒฝ์šฐ ํ•„์š”ํ•  ์ˆ˜ ์žˆ์Œ.

C2. Diagnosis

(1) Chest AP๋งŒ์œผ๋กœ ์ข…์ข… ํ™•์ธํ•˜์ง€ ๋ชปํ•  ์ˆ˜ ์žˆ์Œ.
(2) AP, lat, axillary scapular view๋“ฑ scapular series๋ฅผ ์ดฌ์˜ํ•˜๊ฑฐ๋‚˜ CT ์ดฌ์˜์„ ํ†ตํ•ด ์ง„๋‹จ.

C3. Scapulothoracic dislocation

(1) ์ฃผ ํ˜ˆ๊ด€์€ ์‡„๊ณจ๋™๋งฅ ๋˜๋Š” ์•ก์™€๋™๋งฅ์ด ํ”ํ•˜๋ฉฐ Brachial plexus ์†์ƒ. (2) Severe massive traction force์— ์˜ํ•ด ๋ฐœ์ƒ
(3) โ… ํ˜• ๋ฐ โ…กํ˜• ์†์ƒ์€ ํœด์‹, ๋ƒ‰์ฐœ์งˆ, ์ง„ํ†ต์ œ ๋ฐ ๊ณ ์ •์„ ํ•œ ํ›„ ๋น ๋ฅธ range-of-motion ์šด๋™์„ ์‹œํ–‰ํ•œ๋‹ค. (7~14์ผ). (4) โ…ขํ˜• ์†์ƒ์€ ๋ณด์กด์ ์œผ๋กœ ์น˜๋ฃŒํ• ์ง€ ์ˆ˜์ˆ ์  ์น˜๋ฃŒ๋ฅผ ํ• ์ง€ ๋…ผ๋ž€ ์ค‘์ด๋‚˜, ์ถ”์„ธ๋Š” ํŒ”๊ฑธ์ด๋กœ ๊ณ ์ •ํ•˜๋Š” ์ชฝ์œผ๋กœ ๊ฐ€๊ณ  ์žˆ๋‹ค. (5) โ…ฃ, โ…ค, โ…ฅ ํ˜•์€ ์‹ฌํ•œ ์†์ƒ์œผ๋กœ ๋Œ€๋ถ€๋ถ„์˜ ์ „๋ฌธ๊ฐ€๋Š” ์ˆ˜์ˆ ์  ์น˜๋ฃŒ๋ฅผ ์ถ”์ฒœ.