5 0 0 0 小胸筋の停止についての解剖学的研究
- 著者
- 吉村 英哉 望月 智之 宗田 大 菅谷 啓之 前田 和彦 秋田 恵一 松木 圭介 中川 照彦
- 出版者
- 日本肩関節学会
- 雑誌
- 肩関節 (ISSN:09104461)
- 巻号頁・発行日
- vol.31, no.2, pp.217-219, 2007 (Released:2008-01-30)
- 参考文献数
- 10
Previous studies reported a presumably unusual bony attachment of the pectoralis minor muscle. However, less attention has been given to the insertion of the continuation to the glenohumeral joint. The purpose of this study was to evaluate the frequency of this abnormal insertion of the pectoralis minor muscle, and also to investigate the relation between this continuation and the capsule. 81 anatomic specimen shoulders from 41 cadavers were dissected. The insertion of the pectoralis minor tendon to the glenohumeral joint was carefully investigated. The pectoralis minor tendon ran beyond the coracoid process and extended to the superior portion of the glenohumeral joint in 28 out of 81 specimens (34.6%). The continuing insertion divided the coracoacrominal ligaments into two limbs. The continuation was more variable, and consisted of the whole tendon in 6, the middle part in 5, the lateral part in 15, and the medial part in 2 specimens. Furthermore, the pectoralis minor tendon inserted to the posterosuperior border of the glenoid in 6, to the greater tuberosity in 7, and both to the glenoid and the greater tuberosity in 15 specimens. The prevalence of the anomalous insertion of the pectoralis minor tendon revealed to be as high as 34.6% in the present study. This may suggest that the pectoralis minor tendon plays an important role in the stability of the glenohumeral joint.
1 0 0 0 頚横動脈の血管抵抗による肩こり患者の検討
- 著者
- 三森 甲宇 中川 照彦
- 出版者
- 日本肩関節学会
- 雑誌
- 肩関節 (ISSN:09104461)
- 巻号頁・発行日
- vol.37, no.2, pp.821-823, 2013 (Released:2014-04-03)
- 参考文献数
- 9
Background: We reported that transverse cervical artery had various forms in the cadaver. The purpose of this study was to examine patients with neck and shoulder pain from vascular resistance of the transverse cervical artery.Methods: The subjects consisted of 54 patients with neck and shoulder pain (group P) and 20 normal volunteers (group N). They were all females, and their mean age was 67.2 in group P and 70.4 in group N.Firstly isometric exercise around the neck and back was performed on all subjects in the sitting position. Patients were only asked whether the pain had changed before and after exercise. The transverse cervical artery was identified by color doppler ultrasonography, and pulsatility index (PI) was measured by pulsed doppler imaging. PI was compared between group P and group N, and was compared with the effects of exercise in group P.Results: After exercise, the pain was the same in 16 patients, improved partially in 27 patients and disappeared in 11 patients. PI of the deep branch in the group P was significantly larger than that in group N. PI of the deep branch in the 11 patients whose pain disappeared, tended to be smaller than that of the other patients.Conclusion: We suppose that high vascular resistance of the deep branch of the transverse cervical artery is a characteristic seen widely in patients with neck and shoulder pain.
1 0 0 0 第 1 肋骨疲労骨折による胸郭出口症候群の 1 例
- 著者
- 伊奈 沙織 二村 昭元 若林 良明 中川 照彦 宗田 大
- 出版者
- 日本肩関節学会
- 雑誌
- 肩関節 (ISSN:09104461)
- 巻号頁・発行日
- vol.36, no.3, pp.1099-1102, 2012 (Released:2012-10-25)
- 参考文献数
- 10
We experienced an extremely rare case of thoracic outlet syndrome (TOS) caused by fatigue fracture of the first rib. Case: A 25-year-old male, semi-professional volleyball player, he complained of numbness and weakness of the left upper extremity. Eden-Test, Morley-Test, and Wright-Test were positive on the left. X-ray showed bilateral first rib fractures (non-union on the left side), which was likely caused by heavy muscle training. 3D-CT suggested that the dynamic movement of the pseudoarthrosis following the fatigue fracture was developing incomplete brachial plexus palsy.We performed a surgical decompression by supraclavicular approach without clavicle osteotomy. Compression of the brachial plexus by the dynamic movement of the non-union site was observed. We resected the rib apporoximately 3cm in total.His symptoms had resolved completely after the operation, and he has no problems in playing volleyball.Only a few cases of TOS due to the first rib fracture that has been treated surgically, have been reported. It usually involves the lower trunk of brachial plexus, as we presented. Roos approach and supraclavicular approach are known for TOS operation. Clavicle osteotomy is usually required in the latter approach; however, the procedure seemed invasive for top athletes. Therefore, we chose a supraclavicular approach without clavicle osteotomy in this case. Through this approach, we could obtain a sufficient surgical field to decompress the brachial plexus. In conclusion, we experienced a rare case of TOS caused by non-union after fatigue fracture of the first rib in a volleyball player. Surgical treatment led to complete resolution of the symptoms.
1 0 0 0 上腕二頭筋長頭腱随意性脱臼の1例
- 著者
- 三森 甲宇 中川 照彦 古屋 光太郎 信原 克哉
- 出版者
- Japan Shoulder Society
- 雑誌
- 肩関節 (ISSN:09104461)
- 巻号頁・発行日
- vol.18, no.2, pp.313-317, 1994
- 被引用文献数
- 2
(Purpose) Voluntary dislocation of the tendon of the long head of the biceps is extremely rare. Here we will report on this dislocation in one patient.<br>(Patient) The Patient, a 37-year-old male fell down with his arm extended. Since then, he had a click and pain of the shoulder when he elevated his arm. When he had contracted his biceps with his arm extended and internally rotated, the tendon of the long head of the biceps dislocated from the bicipital groove. By elevating the arm 135 degrees from that position, the tendon reposited with a click and pain. Arthrography showed a dislocation of the tendon of the long head of the biceps. Arthroscopy and a tenodesis of the biceps tendon were performed.<br>(Conclusion) When observing the shoulder joint of a cadaver, the insertion of the subscapularis tendon was separated into two layers. One was a superficial layer, the other a deep one. Some parts of the superficial layer formed the transverse ligament. So we believe that the tendon of the long head of the biceps is often dislocated accompanying with a tear of the subscapularis tendon.
1 0 0 0 スノーボード、スキーによる肩の外傷の比較検討
- 著者
- 杉原 隆之 中川 照彦 三森 甲宇 石突 正文 四宮 謙一
- 出版者
- Japan Shoulder Society
- 雑誌
- 肩関節 (ISSN:09104461)
- 巻号頁・発行日
- vol.25, no.3, pp.511-514, 2001
We performed a comparative study on shoulder injuries between snowboards and skis.<BR>1665 patients injured by snowboarding or skiing visited our hospital from 1997 to 1999 (males: 1173, females: 492, averagc age: 25.3). There were 883 patients injured by snowboarding (males: 667, females: 216, average age: 23.6) and 782 patients injured by skiing (males: 506, females: 276, average age: 27.3).<BR>There were 523 patients (59.2%) with upper extremity injuries caused by snowboarding. Among them there were 191 patients (21.6%) with shoulder injuries. There were 62 fractures (clavicle: 40, proximal end of the humerus: 22),78 dislocations (acromioclavicular joint: 32, shoulder joint: 46) and 1 dislocation fracture (shoulder joint). There were 235 patients (30.1%) with upper extremities injured by skiing. Among them there were 133 patients (17.0%) with shoulder injuries. There were 53 fractures (clavicle: 36, proximal end of the humerus: 14, scapula: 3),41 dislocations (acromioclavicular joint: 10, shoulder joint: 31) and 6 dislocation fractures (shoulder joints).<BR>Snowboarders fall on their hands frequently. Therefore upper extremity injuries and shoulder injuries caused by snowboarding are considered to be more than by skiing.
1 0 0 0 小胸筋の停止についての解剖学的研究
- 著者
- 吉村 英哉 望月 智之 宗田 大 菅谷 啓之 前田 和彦 秋田 恵一 松木 圭介 中川 照彦
- 出版者
- 日本肩関節学会
- 雑誌
- 肩関節 (ISSN:09104461)
- 巻号頁・発行日
- vol.31, no.2, pp.217-219, 2007
Previous studies reported a presumably unusual bony attachment of the pectoralis minor muscle. However, less attention has been given to the insertion of the continuation to the glenohumeral joint. The purpose of this study was to evaluate the frequency of this abnormal insertion of the pectoralis minor muscle, and also to investigate the relation between this continuation and the capsule. 81 anatomic specimen shoulders from 41 cadavers were dissected. The insertion of the pectoralis minor tendon to the glenohumeral joint was carefully investigated. The pectoralis minor tendon ran beyond the coracoid process and extended to the superior portion of the glenohumeral joint in 28 out of 81 specimens (34.6%). The continuing insertion divided the coracoacrominal ligaments into two limbs. The continuation was more variable, and consisted of the whole tendon in 6, the middle part in 5, the lateral part in 15, and the medial part in 2 specimens. Furthermore, the pectoralis minor tendon inserted to the posterosuperior border of the glenoid in 6, to the greater tuberosity in 7, and both to the glenoid and the greater tuberosity in 15 specimens. The prevalence of the anomalous insertion of the pectoralis minor tendon revealed to be as high as 34.6% in the present study. This may suggest that the pectoralis minor tendon plays an important role in the stability of the glenohumeral joint.
1 0 0 0 上腕骨骨頭骨折に対し骨釘移植による再接合術が有用であった1例
- 著者
- 中川 照彦 土屋 正光 勝崎 耕世 小原 洋一 諏訪 清史 福田 修一 福島 芳宏
- 出版者
- 医学書院
- 雑誌
- 臨床整形外科 (ISSN:05570433)
- 巻号頁・発行日
- vol.37, no.6, pp.685-692, 2002-06-25
1997年~2001年の5年間に,SLAP lesionに対し鏡視下上方関節唇修復術を行った野球選手の投球障害肩17例17肩を対象とした.全例男性で,手術時年齢は平均25.1歳(16~51歳)であった.ポジションは投手11例.野手6例.レベルはプロ野球3例,社会人野球3例,大学野球1例,高校野球5例,草野球5例であった.鏡視下上方関節唇修復術はSnyderの手技に準じて行い,後療法では特に術後3カ月以降の投球メニューについて詳述した.徒手検査ではcrank test,anterior apprehension肢位での疼痛,三森テスト.O'Brien testが有用であった.12カ月以上フォローアップできた13例中11例(85%)で完全復帰を果たした.術後復帰までの平均期間は.投手8.4カ月,野手6.8カ月であった.鏡視下上方関節唇修復術の手術成績は良好であり,上腕二頭筋長頭腱関節唇複合体の解剖学的修復という面からも,本術式は推奨できるものと考える.