著者

竹内 聡志 土屋 篤志 杉本 勝正 大藪 直子 後藤 英之 武長 徹也 鷹羽 慶之 大塚 隆信

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.40, no.2, pp.495-498, 2016 (Released:2016-10-07)

参考文献数

9

---

原テストにおけるCombined abduction test(CAT)とHorizontal flexion test (HFT)と肩関節可動域の関係について調査を行った.2012年から2014年にメディカルチェックを行った大学生・社会人野球選手96名(平均年齢20.9歳,平均野球歴10.9年)を対象とした.全ての選手に原テスト11項目,肩可動域測定を施行した.その結果から,CAT・HFT共に陽性群(CH群),CAT陽性群(C群),HFT陽性群(H群),CAT・HFT共に陰性群(N群)に分類し,肩関節下垂位(1st),90°外転位(2nd)および90°屈曲位(3rd)における内外旋角度との関連を調査した.CH群49名,C群8名,H群8名,N群31名であった.CH群,C群,H群において非投球側と比較して投球側の2nd 内外旋総可動域(total arc)が有意に減少していたが,N群では有意差がなかった.投球側の2nd total arcは肩後方タイトネスの存在により,非投球側と比較して減少することが報告されている.この結果から,CAT・HFTは肩後方タイトネスの評価に有用である可能性が示された.

著者

武長 徹也 竹内 聡志 後藤 英之 吉田 雅人 西森 康浩 大塚 隆信 杉本 勝正 大藪 直子 土屋 篤志 多和田 兼章

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.3, pp.1121-1123, 2009

---

<B>Background:</B> The purpose of the present study was to evaluate the clinical results of conservative treatment for rotator cuff tears.<BR><B>Methods:</B> 33 shoulders of 28 patients were evaluated and diagnosed as having rotator cuff tear with magnetic resonance image or ultrasonography in our institution. There were 13 male cases (17 shoulders), and 15 female cases (16 shoulders). The average age of the 33 shoulders at the time of the diagnosis was 70.9 years old (range 56 to 82 years) and their mean follow-up period was 37.5 months (range 12 to 106 months). With respect to tear size, 4 shoulders were categorized as massive tears, 5 were large tears, 14 were medium tears, 9 were small tears. There was 1 partial tear at the bursal side. The clinical results were evaluated by Japanese Orthopaedic Association shoulder scoring system (JOA score) and pre and post therapeutic active range of motion was also investigated.<BR><B>Results:</B> The average JOA score improved from 69.2 points at first exam to 84.0 points at the final follow-up. However, younger patients (less than 60 years old) showed deterioration. Improvement of active range of motion has been confirmed from 139 to 156 degrees in elevation, from 135 to 150 degrees in abduction, from 57 to 63 degrees in external rotation and from L2 to L1 level in internal rotation at the final follow up.<BR><B>Conclusion:</B> In most of the cases, clinical results of conservative treatment for rotator cuff tears were satisfactory except for younger and active patients.

著者

多和田 兼章 竹内 聡志 鷹羽 慶之 後藤 英之 武長 徹也 大塚 隆信 杉本 勝正 大藪 直子 土屋 篤志

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.38, no.3, pp.795-797, 2014 (Released:2014-11-21)

参考文献数

9

---

今回の研究の目的は当院における肩関節脱臼に対するStimson法の整復率について調査することである.当院救急外来にて研修医がStimson法で整復を行った肩関節前方脱臼21例22肩(平均年令60.8歳,男性13例,女性8例)を対象とした.外傷性脱臼が14肩,反復性脱臼が8肩であった.整復できた群をStimson法群,Stimson法で整復できなかった群をFailure群とし,比較を行った.当院におけるStimson法の整復率は40.9%(9/22肩)であった.他の13肩はzero position法で整復された.Failure群13肩では年齢が高く,合併損傷を伴う外傷性脱臼が多い傾向にあった.Stimson法は簡便で,非侵襲的だが,整復時間を要することや低い整復率が問題である.当施設においても40.9%と他の整復法と比較して低い整復率であった.

著者

中野 幸雄 日比野 仁子 杉本 勝正

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.2, pp.235-239, 2001-08-02 (Released:2012-11-20)

参考文献数

5

被引用文献数

1

---

[Purpose]The coracohumeral(CH)ligament is deeply related to the restriction of lateral rotation of the shoulder joint. The present report concerns our experience in evaluation of the CH ligament by 3D MRI in relation to the restriction of a lateral rotation.[Materials and methods]The study covered 43 shoulders of 43 patients who had disorders in the shoulder since 1999, and underwent 3D MRI examination. Of these subjects, llshoulders of llpatients were examined twice, when the symptom was distinct and at a stage of remission. As controls,9shoulders of 8 healthy persons were observed. The MRI equipment used was Model SIGNA HORIZON LX 1. OT of GE Yokokawa Medical, and images were constructed on the basis of 3D GRASS images (TR 32, TE 15) derived from 100 consecutive slices of 1mm thickness. The correlation of the angle of lateral rotation as measured at the time of MRI examination with the thickness, length and signal intensity of CH ligament determined on MRI image was checked.[Results]The mean values of lateral rotational angle, and thickness of CH ligament were 71.1°and 3.1mm, respectively, in the normal group(N), while those in the symptomatic group(S)were 35.6°and 5.2mm. A significant correlation was recognized between the lateral rotation angle and the thickness of the CH ligament. No significant correlation was seen between the lateral rotation angle, signal intensity and ligament length. in group S2 where the MRI examination was carried out twice, at the symptomatic phase and at the remission phase, the lateral rotation angle increased and the thickness of the CH ligament reduced significantly in the remission phase in comparison to those in the symptomatic phase.[Conclusion]The more the lateral rotation was restricted, the greater the thickness of the CH ligament was. This study indicates that the movable range of the shoulder joint can be estimated on the basis of image diagnosis.

著者

杉本 勝正 松井 宣夫 種田 陽一 大藪 直子 藤森 修

出版者

Japanese Society for Joint Diseases

雑誌

日本リウマチ・関節外科学会雑誌 (ISSN:02873214)

巻号頁・発行日

vol.11, no.1, pp.71-76, 1992-06-05 (Released:2010-10-07)

参考文献数

6

被引用文献数

3

---

Twenty-six coracohumeral ligaments (C-H hg) were studied by histochemical methods in order to investigate collagen structures and distribution of the nerves. The collagen structure of the C-H hg was different from that of the shoulder capsule in that tere was mainly Type III collagen in it. On the other hand, both Type I and III collagen were in the capsule of the shoulder joints. Regarding the distribution of the nerves, there were a lot of different types. Some C-H hg had many nerves and some had few nerves. Histologically the C-H hg was loose connective tissue which was connected with the periosteum of the coracoid process. We think such a characteristic of the C-H hg may be associated with the cause of frozen shoulder.

著者

土屋 篤志 大藪 直子 後藤 英之 堀内 統 吉田 雅人 西森 康浩 大塚 隆信 武長 徹也 杉本 勝正

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.35, no.2, pp.567-569, 2011

---

We investigated the shoulder function of the frozen shoulder after an average of thirty months (12 to 108 months) of the conservative treatment. In this study, 17 shoulders of 16 patients (13 males and 3 females) of non-traumatic frozen shoulder without rotator cuff tear were investigated. The mean age of all cases was 66 years old, ranging from 47 to 76 years old. At an average of 30 months follow-up, the clinical results and shoulder function including subjective and objective evaluation, range of motion and shoulder strength using micro FET, were investigated. The mean JOA score was 63.7 points at the initial treatment and 82.5 points at the end of the treatment. After thirty months of the treatment, JOA score was improved to 93.4 points. About 88% of the patients were satisfied with their daily living, although 16.7% of the patients changed sports activity level or their work. Seven of 17 patients who were satisfied with their ADL, restricted some concrete action related to shoulder function such as scratching their back. The range of motion of flexion, abduction and external rotation of the affected side tended to be lower compared with the normal side, but not significantly. The strength of the shoulder of the affected side was improved without a significant difference from normal side. The prognosis of the frozen shoulder was relatively good with a little discomfort for living and a limitation of sports activity.

著者

中野 幸雄 高田 直也 後藤 英之 松井 宣夫 藤森 修 山田 和順 杉本 勝正 大薮 直子

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.1, pp.111-116, 1996-10-15 (Released:2012-11-20)

参考文献数

13

被引用文献数

1

---

PurposeThe anatomical characteristics and nerve distribution in the coracohumeral ligament(C-Hligament)and surrounding tissue were studied. The role of the ligament in periarthritis of the shoulder was assessed.Materials and Methods Specimens were obtained from 30 cases,50 joints at autopsy. The cases consisted of 14 males and 16females; with an age range from 29 to 98 years(mean 78 years). The C-H ligament and its surrounding tissues were excised en bloc.Paraffin sections, vibratome sections and whole mount preparations were made and subjected to immunohistochemical staining using NF, PGP9.5, SP and CGRP antibodies in order to the distribution of sensory nerve fibers.