著者

宮崎 誠司 浜田 一寿 中島 知隆 内山 善康 福田 宏明

出版者

Japan Shoulder Society

雑誌

肩関節 = Shoulder joint (ISSN:09104461)

巻号頁・発行日

vol.22, no.3, pp.371-374, 1998-09-30

参考文献数

9

被引用文献数

1

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In order to evaluate the residual disabilities caused by chronic acromioclavicular (A-C) dislocations,14 Judo athletes (7 cases of Grade II and 7 cases of Grade III) injuries were reviewed. Clinical examinations and isokinetic muscle strength of internal/external rotation and of flexion/extension in the supine position were examined. In Grade II, there were no clinical symptoms or differences in isokinetic muscle strength between the involved and uninvolved sides.<BR>In Grade III,4 cases had motion pain and 3 cases felt weakness in Judo practice. In Grade III the A-C joints, the directions of instability were horizontal as well as vertical. Work magnitudes of extension (60 deg/sec) and those of external rotation at 30&deg; abduction (60 and 120 deg/sec)were less in the involved side than those in the uninvolved sides. Isokinetic muscle strength of extension and external rotation at 30&deg; abduction (60 deg/sec) in Grade III was smaller than that in Grade II. Characteristically, the involved side of Grade III cases had less power than the uninvolved side in flexion/extension above the horizontal level. In Grade III, the torn A-C capsular and coracoclavicular ligaments produce more unstable A-C joints than in Grade II.<BR>During an arm elevation above the horizontal level, more than 3/4 of a clavicle rotation occurs and is controlled by the trapezoid ligament. Unstable A-C joint causes an unstable scapula, leading to muscle weakness of the shoulder, especially in flexion/extension above the horizontal level. The current study showed that the Grade III had patterns in the flexion/extension which were different in the involved and uninvolved sides.<BR>This could explain why there is weakness above the horizontal level in Grade III injuries. Therefore, an operation is recommended for Grade III A-C injuries of Judo athletes.

著者

内山 善康 浜田 一寿 中島 知隆 福田 宏明 宮崎 誠司

出版者

Japan Shoulder Society

雑誌

肩関節 = Shoulder joint (ISSN:09104461)

巻号頁・発行日

vol.22, no.3, pp.537-541, 1998-09-30

参考文献数

10

被引用文献数

6

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The purpose of this study was to compare the limitations between the external rotation (ER) of athletes in overhand sports players (OS) and judo players (JP) with traumatic anterior shoulder instability after a modified inferior capsular shift (MICS)procedure. Thiryt-two shoulders of OS and 38 shoulders of JP were operated on using MICS and were observed for more than 12 months postoperatively.<BR>Twenty-six dominant and 6 nondominant shoulders were examined directly. There were 21 &ldquo;tsurite&rdquo; (lapel grip) and 17 &ldquo;hikite&rdquo; (sleeve grip) shoulders in JP. The average ages at surgery of OS and JP were 22.9 and 21.5 years old, respectively.<BR>All the patients had had an episoders of sports injury. There were no recurrences in OS, but 3 (8%)in JP. In OS,12% of the dominant shoulders and 67% of the no ndominant sides after MICS could perform better their sports activities than preoperatively. The ratios of JP which showed a better performance were 15% of operated &ldquo;tsurite&rdquo; and 52% of the operated &ldquo;hikite&rdquo; sides. The average decrease of ER motion in dominant shoulders of OS was 18.8&deg;in the hanging position and 14.5&deg;in 90&deg;of abduction. In JP, &ldquo;tsurite&rdquo; sides had 3.3&deg;and 4.8&deg;of limitation on 0&deg;and 90&deg;of abduction, respectively. There was on other limitation of ROM in either OS or JP, postoperatively. Based on comparisons of ER motion between OS and JP showing better sport activity, ER at 90&deg;abduction should be 80&deg;for the dominant side of OS and 85&deg;for the &ldquo;tsurite&rdquo; side of JP in order to get a better performance, postoperatively. Thus, the &ldquo;tsurite&rdquo; side in JP should be treated in the same manner as that of the dominant side of OS.