著者
仲川 喜之 梅垣 修三 尾崎 二郎 富田 恭治 中垣 公男 桜井 悟良 松倉 光晴 建道 寿教
出版者
日本肩関節学会
雑誌
肩関節 (ISSN:09104461)
巻号頁・発行日
vol.18, no.1, pp.110-115, 1994-09-01 (Released:2012-11-20)
参考文献数
5
被引用文献数
1

The purpose of this report is to evaluate the results of treatment for fractures of the scapula with associated injuries. This study was composed of 123 patients (130 fractures). One hundred and seven were males and 16 were fenales. Their average age was 44.8 ranging from 3 to 84. The fractures were divided into four types as follows; scapular body: 54 cases, scapular neck: 40 cases, coracoid process: 18 cases, acromion or scapular spine: 18 cases. Seven cases had fractures in more than one location. Eighty-one of the 123 cases (66%) had assoceated injuries. Ninety-four cases were treated conservatively and 29 cases surgically. The results of the treatment were evaluated by the J.O.A.score.The results of cases without any nerve injuries were judged as excellent (mean score of conservative cases: 92.3 points, surgical cases: 97.1 poinys). Cases with nerve injuries had poor results (mean score of the conservative cases: 80.3 points, surgical cases: 85.7 points).An association between scapular fractures and fractures of the ribs is common. In those cases, a pneumothorax may not develop immediately after a traumatic episide, but it may occur after a few days. An acromioclavicular dislocation is apt to be associated with a fracture of the coracoid process, in which case, surgical treatment is indicated. A displaced fracture of the scapular neck associated with a clavicular fracture on the same side is unstable, in which case, surgical treatment is indicated. A rotator cuff tear is apt to be associated with a fracture of the scapular body or but it is often overlooked, Associated nerve injuries have a great inflvence on the results. It is important to examine an associated nerve imjury and to start rehabilitation as soon as possible. neck, very
著者
橋内 智尚 櫻井 悟良 尾崎 二郎 今田 光一
出版者
日本肩関節学会
雑誌
肩関節 (ISSN:09104461)
巻号頁・発行日
vol.25, no.3, pp.415-418, 2001-09-05 (Released:2012-11-20)
参考文献数
11

The purpose of this study is to investigate the pathogenesis and treatment of shoulder pain in hemiplegia.60 shoulders in 60 patients were available and separated into three types on the bases of pain (no or slight, mild, severe). The duration of the hemiplegia, tenderness points, range of motion, manual muscle testing, sensory deficit, edema and the X-ray findings were statistically analyzed. The subacromial bursae of 31 shoulders in 60 patients were injected (A group: 9 shoulders, xylocaine and dexamethazone / B group: 22 shoulders, sodium hyaluronate). Then 4 shoulders were operated on using the one portal arthroscopy. The tenderness points of the C-A arch and around the C-A arch increased with the pain. The improvement rates of pain were 61.7% in A group and 59.1% in B group. A decrease in pain was noted in all of the patients who had been operated on with the one portal arthroscopy. Pain of the shoulder in hemiplegia may be attributable to the C-A arch. Attention to the C-A arch may be of importance.
著者
尾崎 二郎 仲川 喜之 増原 建二
出版者
日本肩関節学会
雑誌
肩関節 (ISSN:09104461)
巻号頁・発行日
vol.12, no.2, pp.211-213, 1988-08-10 (Released:2012-11-20)
参考文献数
6

Twelve cases with isolated tear of the subscapularis tendon were observed during 250reconstructive procedures on the rotator cuff. The patients' age was 51.6 years on average. All of the patients had a definite history of trauma to an affected shoulder and persistent pain in the anterior shoulder part, combined with the inability to evevate the extremity. Arthrography was performed on all, and revealed that the dye had extravasated into the subacromial bursa, however, the supraspinatus tendon was intact on the external rotation view. Operative findings revealed that an isolated rupture of the subscapularis tendon was confirmed in all. In 10 cases with rupture of the supero-medial part of the subscapularis tendon, medial dislocation of the bicipital long tendon was observed. Therefore, the authors conclude that the supero-medial part of the subscapularis tendon, including the medial bundle of the coracohumeral ligament, is the most important portion which keeps the bicipital long tendon aligned with the sulcus, and that during reconstructive procedures on the shoulder capsule, these changes should be carefully looked for and evaluated.