著者

保坂 正人 中土 幸男 斎藤 覚 北側 恵史 松田 智 土金 彰

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.2, pp.238-243, 1991-09-01 (Released:2012-11-20)

参考文献数

11

被引用文献数

2

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Seventeen cases ( 8 males and 9 females ) of peripheral nerve paralyses associated with fractures or fracture-dislocations of the proximal humerus and dislocations of the shoulder joint were studied. The patients' ages ranged from 17 to 85 years with an average of 56.9 years. The lesions of paralyses consisted of 7 brachial plexuses,7 axillary nerves, one with both axillary nerve and suprascapular nerve and 2 median nerves.Open reductions were performed in 10, and closed reductions were made in the remaining 7. Two cases underwent surgical explorations of the nerves secondarily after reduction. One had a complete tear of the axillary nerve which was repaired using nerve grafting, and the other had an incomplete tear of the axillary nerve on whom neurolysis was performed.Thirteen cases were followed electromyographically after reduction. Nine of the 13 had denervations, and 4 of the 13 had polyphasic waves. Among 9 cases, which showed a denervation at the first examination, nascent units were observed within 2 to 4 months after the injury.Most cases of paralyses associated with fractures or fracture-dislocations of the proximal humerus and dislocations of the shoulder joint recovered spontaneously. However, surgical intervention should be considered for the nerves in those cases without regenerating findings in the EMG within the 4 months after injury.

著者

保坂 正人 町田 拓也 山崎 郁哉 下形 光彦 堤本 高宏

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.19, no.2, pp.360-363, 1995

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We wish to present a tabulation of the shoulder joint disorders we encountered in the last two years. The degenerative Changes in the rotator cuff which consist of a wide variety of diseases, which we consider important to differentiate.<br>The subjects were 406 outpatients with shoulder joint disorders. In cases of impingement syndrome, elevation disturbance without contracture, impingement signs and the impingement test were used as a diagnostic criteria. Frozen shouldrs were taken into account only in cases with contracture.<br>There were 170 cases (average age of 57.3) of the impingement syndrome. Rotator cuff tears were observed in 23 of the cases resistant to treatment. There were 77 cases (average age of 58.5) with a frozen shoulder. There were 55 cases (average age of 64.2) of rotator cuff tear or 78 cases when the 23 cases were corrected from the impingement syndrome were included. Then there were 36 cases (average age of 55.2) of calcified tendinitis, 10 cases (average age of 49.8) of bicipital tendinitis and 8 cases (average age of 71.5) of osteoarthrosis of the shoulder joint. There were 50 other cases.<br>The findings of a survey on the patients' backgrounds revealed the existence in many cases with the impingement syndrome and the rotator cuff tear to be among farm and blue-collar workers and that of many cases with calcified tendinitis among females.<br>When treating an impingement syndrome and a rotator cuff tear, we limited the patients' work and encouraged rest. Kinetic therapy was the basic therapy for a frozen shoulder. Steroid injections into the subacromial bursa proved efficacious in cases of impingement syndrome. Attention ought to be paid to the advance of degenerative changes in the rotator cuff and the existence of its tears. Conservative therapy was not satisfactory enough for more than half of the cases with a rotator cuff tear, and about one third of all the cases required surgery. Satisfactory results were obtained with steroid injections into the subacromial bursa for calcified tendinitis.