著者

戸野塚 久紘 菅谷 啓之 高橋 憲正 河合 伸昭 中島 亮 寺谷 威 真鍋 博規 安藤 晃 森石 丈二

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.35, no.3, pp.877-881, 2011 (Released:2011-12-21)

参考文献数

13

被引用文献数

1

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The purpose of this study is to determine a target ROM (T-ROM) at 3 months after arthroscopic rotator cuff repair, by which patients can expect eventual full recovery. Subjects consist of 209 shoulders in 202 patients, including 116 males and 86 females with an average age of 61.5 years old, who underwent primary arthroscopic rotator cuff repair and were followed-up for a minimum of 2 years. There were 30 partial-thickness tears, 120 small to medium and 57 large to massive full-thickness tears. Anterior elevation (AE), external rotation at side (ER), and internal rotation (IR) ROM at 3 month after surgery (ROM-3M) were measured, and divided into five groups according to the values. The final ROM at 24 months after surgery was compared with each ROM-3M of these subgroups in order to determine the T-ROM. Then, according to the T-ROM, patients were also divided into two groups: less than the T-ROM (AE-, ER-, and IR-); and more than the T-ROM (AE+, ER+, and IR+), and average ROM in each group were compared with each other. The final ROM of AE was significantly better in the group of more than 120° than less than 120 degrees. Therefore, the T-ROM of AE was determined as 120°. Similarly, those of ER and IR were determined as 10° and L5 level. ROM at 6 and 9 months in the AE+ group was significantly better than those of the AE- group. Further, every ROM at 3 to 24 months in the ER+ group was significantly better than those of the ER- group. In conclusion, ROM at 3 months after surgery affects final shoulder function. Surgeons and therapists should pay attention to the T-ROM at 3 months after surgery described above in order to maximize patients's final shoulder function.

著者

河合 伸昭 菅谷 啓之 高橋 憲正 戸野塚 久紘 中島 亮 寺谷 威 真鍋 博規 安藤 晃 森石 丈二

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.35, no.3, pp.903-906, 2011 (Released:2011-12-21)

参考文献数

14

被引用文献数

2

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Primary frozen shoulder is believed to be a self-limited disease. However, many patients complain of prolonged symptoms such as night pain and refractory stiffness. The purpose of this study is to estimate the efficacy of steroid injection to the glenohumeral joint for primary stiff shoulder associated with night pain. Subjects consisted of 115 consecutive patients, including 37 males and 72 females with an average age of 59.4 years old, who were diagnosed as having primary frozen shoulder at the shoulder clinic in our institute from May to November, 2009. Our treatment principles are as follows: we recommend patients who complain of night pain to keep their arm at rest and carry out trunk and scapular exercises, in addition to steroid injection to the glenohumeral joint once a week until the night pain subsides. Then, physiotherapy is initiated of the hand of therapists. Range of motion at the first visit and at the time when the night pain disappeared was evaluated, as well as that at the final follow-up which was 5.8 months on average.The mean forward flexion, external and internal rotation significantly improved when the night pain disappeared, which was 4.8 weeks on average, from 97.5, 9.2°, and S level to 117.5, 17.4°, and L4 level. The range of motion at the final follow-up was 144 degrees in flexion, 31 in external rotation, and L2 level in internal rotation.Steroid injection to the glenohumeral joint was effective for pain relief for patients with primary frozen shoulder associated with night pain. Removing inflammation at the glenohumeral joint is a key factor when treating such patients and this also enables patients to proceed with effective physiotherapy.

著者

中村 英記 山本 ゆかり 竹口 諒 堀井 百祐 真鍋 博美 平野 至規 北村 晋逸 室野 晃一

出版者

名寄市立総合病院

雑誌

名寄市立病院医誌 = The Jounal of Nayoro City Hospital (ISSN:13402749)

巻号頁・発行日

vol.23, no.1, pp.1-4, 2015-07-01

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名寄市立総合病院の位置する北海道上川北部地区は, 福井県とほぼ同規模の広大な面積に人口約7 万人が居住する2次医療圏であり, 全国有数の過疎地域である. 当地区では近年, 周産期医療の集約化が進められ, 平成16年以降, 分娩可能施設は当院のみとなっている。過疎地域における周産期医療の集約化は, 限られた医療資源を有効利用する上で必要な方策であるが, 遠距離分娩の 加など新たな問題も生じている。また, 当院にはこれまで新生児集中治療室(NICU) がなく, 早産児や重症児は, 2次医療圏こえて旭川市の周産期センター病院に母体・新生児搬送するケースが多かった。 しかし, 急性期の長距離搬送にはリスクを伴う。 また, 搬送先の周産期センタ病院で超低出生体重児が出生したような場合, 急性期を過ぎてもback-transfer(逆搬送) による転院受け入れが当院では困難であったため, 場合によっては数か月にわたり長期間の家族との分離を余儀なくされ, その後の良好な母子関係の確立が阻害されることもあった。 平成24年7月, 地域の周産期医療の充実を図るため, 当院では3床のNICU(加算2) を開設し,人工呼吸管理が常時施行できる体制とした。 具体的には,切迫早産時の母体搬送基準を緩和し, 加えて慢性期の新生児逆搬送を積極的に受け入れるようにした(表1)。現行の基準としてから2年が経過したが, 実際に母体搬送数や新生児搬送数は減少しているのか, また早産児・重症児の入院を受け入れるようになったことで予後が悪化しているところである。今回われわれは、NICU開設後、当院における周産期医療がどのように変化したか、検討したので報告する。

著者

真鍋 博

出版者

美術出版社

雑誌

美術手帖 (ISSN:02872218)

巻号頁・発行日

no.234, pp.7-10, 1964-04