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

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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

建道 寿教 橋本 淳 橋本 卓 駒井 正彦 中村 真里 信原 克哉 中村 康雄

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.28, no.3, pp.427-431, 2004

被引用文献数

2

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The Purpose of this study was to analyze the articular contact pattern of the normal glenohumeral joint. There are few previous papers concerning the dynamic contact patterns, although the studies of using the cadaver or the tracking device have been reported. The subjects consisted of 10 normal volunteers. The subjects were fixed on a tilted stand with free motion around the scapula.3D MRI images were extracted at the scapular plane at every 30° between 30° and 150° in the supine position. The images obtained at each position were transmitted to a personal computer and the description of the bony frame by digitizing methods using the analyzing software were developed. Three dimensional reconstruction of the glenohumeral joint were performed. The items of measurement were the following (1)The contact area; the distances between the humeral head and the glenoid surface were calculated and the distribution set at the distances were considered to be the contact area. The shortest distance was regarded as the proximity of the joint. The change of the center of the distribution was investigated. (2)The center of the humeral head (3) Kinematics of the humerus; (from the aspect of the scapula) Results: (1)In the contact area; the minimum contact area had shifted superiorly up to 90 or 120° elevation, but after 120° it shifted inferiorly. Concerning the antero-posterior direction of the glenoid, it shifted antero-inferiorly at the elevated position compared to that of the 30Thlevation. (2)In the center of the humeral head; it shifted superiorly at 120° or 150° compaired to the 30° elevation. Its change was within 3mm. (3)In the Kinematics of the humerus; although the glenohumeral movement was totally 66°, it was only 17' after 90° elevation. We conclude that although the contact area shifted superior until 90°, it shifted to the central part of the glenoid over 120°, because the centripetal force might have worked at the elevated position. The distribution of the contact area was assumed to be reflected as a result of seeking a good congruity of the humeral head and the glenoid.

著者

中村 康雄 林 豊彦 中村 真里 建道 寿教 信原 克哉 菊入 大輔 桐生 慎哉

出版者

バイオメカニズム学会

雑誌

バイオメカニズム (ISSN:13487116)

巻号頁・発行日

vol.17, pp.111-121, 2004 (Released:2005-04-15)

参考文献数

17

被引用文献数

1 1 2

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Diagnosis of a shoulder joint injury, particularly one brought about during sports activities, necessitates measurement of its motion accurately and noninvasively. Conventional measurement of shoulder joint movement, however, deals solely with relative movement between humerus and thorax, neglecting other components of the joint. We have focused on 6-DOF measurement of scapula movement relative to the thorax, a subdominant component of shoulder movement. Such motion data, however, cannot easily be obtained by means of a marker-based motion-capture system, due to the skin mobility relative to the skeleton. The objective of this study was to validate measurement accuracy of scapula movement when measuring markers are attached to the skin above the scapula’s bony landmarks.We employed an open MRI (Magnetom Open, Siemens, Germany) to measure the shoulder joint and markers attached to the subject’s skin. Five and three markers were attached to the skin above the scapula and thorax, respectively. Three volunteers (24.0±2.64 years old), who possessed no distinct kinetic dysfunctions in their shoulders, served as subjects, in this preliminary study. Their shoulder movements were sampled at three humeral elevation angles (0°, 90°, 150°) on a frontal plane by open MRI. In order to reduce the skin mobility, the same movements were recorded, using a more accurate method in which the scapula’s markers were relocated into correct positions, determined through the palpation of an experienced physical therapist, at each humeral elevation. In an attempt to validate the skin mobility, we measured the deviation of the markers from the scapula’s bony landmarks during humeral elevation. Next, the scapula movements were estimated by two different methods as follows: the registration technique using bony shape and the least squares method using the set of markers.The results demonstrated that the deviation of the markers could be reduced into less than or equal to 19.0 mm if the markers were remounted at each elevation angle. Using the remounted markers, we verified the estimated error of position and orientation of the scapula to lie within 10.1° and 6.4 mm, respectively.In conclusion, we validated measurement accuracy of the scapula movement using skin markers above the scapula’s bony landmarks. The results showed that a motion-capture system is capable of quantitatively measuring the static shoulder joint movement with the scapula.