著者

筒井 廣明 山本 龍二 安楽 岩嗣 三原 研一 今里 有紀彦 保刈 成

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.15, no.1, pp.13-17, 1991-09-01 (Released:2012-11-20)

参考文献数

11

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The shoulder joint is the most mobile joint in the body combined with a small glenoid and a large humeral head. This joint has been thought to be an unstable joint because of its anatomical structure and the recurrence rate from initial dislocations. Our opinion of this joint is that it has most distinguished stabilizing mechanisms for keeping a wide range of motion.1. The first stabilizing mechanismThis mechanism is the bony combination of the radius between the glenoid cavity and the humeral head. The anatomical study showed the radius of a cross section of the glenoid was 16.8 mm and of the humeral head 22 mm. The computation of the maximum permissible kinetic vector that enables the humeral head to be on the glenoid was 43°.2. The second stabilizing mechanismThe second mechanism is the function of the anterior capsule including the inferior glenohumeral ligament.The anterior capsule works involuntary in both its tension and direction as the centripetal force does against the shear force.3. The disadvantages of these two stabilizing mechanismsThe disadvantages of these two stabilizing mechanisms are; - Inefficiency against the increased anterior kinetic vector during the positioning of the upper extremities vertically against the glenoid- The decrease of bony structural intensity compared with other joints such as the hip joint.4. The third stabilizing mechanismThe third stabildzing mechanism is the function of the shoulder girdle.Its first function is the mobility of the scapula working as shock ab s orber against the share force that falls on the glenohumeral joint.The second is the function of the shoulder girdle muscles such as the pectoralis major and the deltoid.In conclusion, therefore, a normal shoulder joint should be the most distinguished joint with these stabilizing mechanisms physically and anatomically maintaining a wide range of motion.

著者

鈴木 一秀 筒井 廣明 三原 研一 牧内 大輔 西中 直也

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.31, no.3, pp.489-492, 2007

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The purpose of this study was to clarify the condition of reattachment of the labrum to the glenoid rim after an arthroscopic Bankart procedure using suture anchors with an MR arthrography (MRA). We studied 48 cases ( 35 males and 13 females) after surgery with a recurrent anterior dislocation or subluxation. The patients ranged in age from 16 to 53 years old (average, 24.7). An MRA was performed at an average 11.8 months after the operation. In the MRA with an axial image and an oblique axial image in abduction and external rotation (ABER) position, we evaluated the invasion of contrast materials between the labrum and glenoid rim using the inferior 6 slice images of the glenoid rim. The 576 slices were categorized into 1 of 3 groups : good, fair, and poor. We used the JSS Shoulder Instability Score (Instability Score) for clinical evaluation. Axial images (total of slices : 288) revealed good (83.3%), fair (14.9%), and poor (1.7%). Oblique axial images in the ABER position (total of slices : 288) revealed good (77.43%), fair (19.8%), and poor (2.8%). The clinical results using the Instability Score had no significant differences between the group that had all good results in six slices and the group that had fair or poor results more than 1 slice in 6 slices of axial images and oblique axial image in the ABER position. The healing of IGHL-LC to the medial glenoid neck was recognized in 97-98% of the total slices. A non-union or re-avulsion of the labrum to articular cartilage of the glenoid were recognized in 15 to 20 % of the total slices, however the clinical results of arthroscopic Bankart repair were satisfactory.

著者

西中 直也 近 良明 Banks Scott A 三原 研一 鈴木 一秀 大田 勝弘 牧内 大輔 松久 孝行 筒井 廣明 杉本 英治 蒲田 和芳

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.32, no.3, pp.509-512, 2008 (Released:2008-11-21)

参考文献数

16

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The glenoid bare spot commonly is observed in the adult shoulder. Carter et al. proposed that cartilage thickness was affected by normal homeostatic loads. The purpose of this study was to measure glenohumeral translation during shoulder abduction in order to explore development of the glenoid bare spot. 10 healthy shoulders (average 31.1 years old) were studied. 3D models of the scapula and humerus were created from CT scans. Motions were recorded with fluoroscopy during active abduction in neutral rotation for unloaded and a 3kg loaded trial. 3D motions were determined using model-based 3D-to-2D registration. Humeral translation was referenced in the superior/inferior direction to the assumed location of the bare spot (center of the circle described by the bony margins of the inferior glenoid). The bare spot location averaged 4.3mm inferior to the superior/inferior midpoint of the glenoid. Glenohumeral contact was 2.6 and 3.1mm superior to the bare spot for unloaded and loaded conditions with the arm at the side. The humeral head moved upward gradually with abduction to 4mm above the bare spot above 70° abduction (p>0.05, 0 vs 3kg). The glenoid surface stabilizes humeral head translation. Carter et al. suggested that cartilage grew thickest with high mechanical demands (compression and sliding) and thinner where demands were low. Humeral translation away from the bare spot with abduction suggests that lower loads were experienced when the humeral head was near the bare spot and larger loads were experienced with humeral translation away from the bare spot. These kinematic observations were consistent with Carter's framework for cartilage growth and provided a plausible explanation for the development of the glenoid bare spot.

著者

筒井 廣明 山本 龍二 安楽 岩嗣 三原 研一 今里 有紀彦 保刈 成

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.15, no.1, pp.13-17, 1991

被引用文献数

3

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The shoulder joint is the most mobile joint in the body combined with a small glenoid and a large humeral head. This joint has been thought to be an unstable joint because of its anatomical structure and the recurrence rate from initial dislocations. Our opinion of this joint is that it has most distinguished stabilizing mechanisms for keeping a wide range of motion.<BR>1. The first stabilizing mechanism<BR>This mechanism is the bony combination of the radius between the glenoid cavity and the humeral head. The anatomical study showed the radius of a cross section of the glenoid was 16.8 mm and of the humeral head 22 mm. The computation of the maximum permissible kinetic vector that enables the humeral head to be on the glenoid was 43&deg;.<BR>2. The second stabilizing mechanism<BR>The second mechanism is the function of the anterior capsule including the inferior glenohumeral ligament.<BR>The anterior capsule works involuntary in both its tension and direction as the centripetal force does against the shear force.<BR>3. The disadvantages of these two stabilizing mechanisms<BR>The disadvantages of these two stabilizing mechanisms are; - Inefficiency against the increased anterior kinetic vector during the positioning of the upper extremities vertically against the glenoid<BR>- The decrease of bony structural intensity compared with other joints such as the hip joint.<BR>4. The third stabilizing mechanism<BR>The third stabildzing mechanism is the function of the shoulder girdle.<BR>Its first function is the mobility of the scapula working as shock ab s orber against the share force that falls on the glenohumeral joint.<BR>The second is the function of the shoulder girdle muscles such as the pectoralis major and the deltoid.<BR>In conclusion, therefore, a normal shoulder joint should be the most distinguished joint with these stabilizing mechanisms physically and anatomically maintaining a wide range of motion.

著者

筒井 廣明 管 直樹 山口 光國 山本 龍二 三原 研一 保刈 成 上里 元 鈴木 一秀 大島 和 内川 友義

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.19, no.2, pp.310-316, 1995

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Purpose<br>The purpose of this study is to recognize the effect of exercise for cuff muscles using EMG.<br>Materials and Methods<br>5 healthy young men, aged from 17 to 29 yrs., were examined. The "resisted external rotation"exercise for the infraspinatus muscle was estimated. The Cuff-Y exercise with a yellow Thera-Band and F. W. Jobe's strengthening exercise with a 1.5kg weight were compared. During the exercises, the infraspinatus, the supraspinatus, the deltoid, and the middle fiber of the trapezius were examined with EMG. The EMG was recorded continuously from the beginning for 5 minutes.<br>Results<br>The exercise withe the yellow Thera-Band could dominate the activity of the infraspinatus muscle compared to other muscles. As for the exercises with a 1.5kg weight, it was difficult to keep the activity of the infraspinatus advantageous and the 5 volunteers demonstrated five different patterns of muscle activity. Furthermore, the relative activity of the infraspinatus gradually decreased with time.<br>Conclusion<br>Exercises for cuff muscles should be carried out to keep the dominant activity of the targeted muscle compared to other muscles. The setting of the load and time limit both failed and the purpose of the exercise could not be attained.

著者

山口 光國 筒井 廣明 山本 龍二 三原 研一 保刈 成 鈴木 一秀 上里 元 大島 和 内川 友義 菅 直樹 牧内 大輔

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.20, no.2, pp.325-328, 1996-11-30 (Released:2012-11-20)

参考文献数

4

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PurposeWe investigated the muscle strength of the scapulothoracie joint which is apt to be affected by the position of other joints.

著者

筒井 廣明 山口 光國 山本 龍二 三原 研一 保刈 成 鈴木 一秀 上里 元 大島 和 内川 友義 菅 直樹 牧内 大輔

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.20, no.2, pp.337-340, 1996-11-30 (Released:2012-11-20)

参考文献数

6

被引用文献数

1

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[Purpose]Cuff exercises are usually performed to improve the shoulder function and to keep the condition of the shoulder of throwing athletes. Thus, there are a large number of athletes who could not acquire the expected effects of the exercises. In this study, we examined the estimation of the cuff function and the daily exercises of the athletes electromyographically.

著者

鈴木 一秀 南 和延 筒井 廣明 三原 研一 保刈 成 上里 元 内川 友義 菅 直樹 大田 勝弘 牧内 大輔

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.23, no.3, pp.373-376, 1999

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[Purpose] The purpose of this study is to analyze the influence of the scapulothoracic joint on the rotator cuff function using integrated electromyography.<BR>[Materials and Methods] Ten shoulders of ten young males who were diagnosed as having dysfunction of scapulothoracic joint with &lceil;Scapula-45&rfloor; radiography and resisted abduction and external rotation test. The activities of the supraspinatus, infraspinatus, deltoid, and biceps were evaluated electromyographically with the loads at 45 degrees elevated position in the scapular plane. Subsequently the activity of these muscles was collected with a manual assist to the scapulothoracic function. The EMG activity was expressed as a percentage of the Max MMT (%MMT).<BR>[Results] The EMG activity increased with the load in all the cases. In 80% of the total cases, the relationship between the supraspinatus and deltoid did not change irrespective of the load (deltoid/supuraspinatus=1 /1.3) without manual assistance. The %MMT of the supraspinatus and deltoid of these cases showed a significant difference between the activity with and that without manual assistance. The tendency was remarkable at 3kg load. In 20% of the total cases, a dysfunction of rotator cuff was noted.<BR>[Conclusion] The results suggest the function of scapulothoracic joint has an effect on the rotator cuff function.