著者

吉村 英哉 望月 智之 宗田 大 菅谷 啓之 前田 和彦 秋田 恵一 松木 圭介 中川 照彦

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.31, no.2, pp.217-219, 2007 (Released:2008-01-30)

参考文献数

10

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Previous studies reported a presumably unusual bony attachment of the pectoralis minor muscle. However, less attention has been given to the insertion of the continuation to the glenohumeral joint. The purpose of this study was to evaluate the frequency of this abnormal insertion of the pectoralis minor muscle, and also to investigate the relation between this continuation and the capsule. 81 anatomic specimen shoulders from 41 cadavers were dissected. The insertion of the pectoralis minor tendon to the glenohumeral joint was carefully investigated. The pectoralis minor tendon ran beyond the coracoid process and extended to the superior portion of the glenohumeral joint in 28 out of 81 specimens (34.6%). The continuing insertion divided the coracoacrominal ligaments into two limbs. The continuation was more variable, and consisted of the whole tendon in 6, the middle part in 5, the lateral part in 15, and the medial part in 2 specimens. Furthermore, the pectoralis minor tendon inserted to the posterosuperior border of the glenoid in 6, to the greater tuberosity in 7, and both to the glenoid and the greater tuberosity in 15 specimens. The prevalence of the anomalous insertion of the pectoralis minor tendon revealed to be as high as 34.6% in the present study. This may suggest that the pectoralis minor tendon plays an important role in the stability of the glenohumeral joint.

著者

佐藤 晋也 飯田 勝彦 高橋 憲正 菅谷 啓之 酒井 大輔 三枝 奨

出版者

一般社団法人 日本アスレティックトレーニング学会

雑誌

日本アスレティックトレーニング学会誌 (ISSN:24326623)

巻号頁・発行日

vol.5, no.2, pp.159-163, 2020-04-30 (Released:2020-06-05)

参考文献数

13

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本研究は僧帽筋下部に対して実践している筋力トレーニングの筋電図解析を行い,トレーニングの比較・検討を行うことを目的とした.対象は健常男性9名で,僧帽筋下部に対するトレーニング3種目(エクササイズ「Y」・「A」・「U」)を実施し,僧帽筋上部・中部・下部・三角筋後部の筋活動の%MVCの比較を行った.「Y」は「U」・「A」よりもすべての筋において有意に高い筋活動を示し,「U」は「A」よりもすべての筋において有意に高い筋活動を示した.以上の結果から「Y」は僧帽筋下部の強化に最も期待ができると考えられ,「U」は胸椎の伸展可動性を引き出しながら僧帽筋下部の強化を行う場合有効なトレーニングと考える.

著者

吉村 英哉 望月 智之 秋田 恵一 加藤 敦夫 山口 久美子 新井 隆三 菅谷 啓之 浜田 純一郎

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.707-710, 2011 (Released:2011-12-21)

参考文献数

18

被引用文献数

1

---

Our previous study revealed that the most proximal portion of the subscapularis tendon extended a thin tendinous slip to the fovea capitis of the humerus, and that the coracohumeral ligament (CHL) together with the SGHL was shaped like a spiral sling, supporting the long head of biceps and attached to the tendinous slip. Little information is available, however, regarding the relationship between CHL and the insertion of subscapularis on the lesser tuberosity. To clarify the significance of CHL, we examined the morphology of CHL and the subscapularis insertion in 20 cadaveric shoulders. The anterior portion of CHL arises from the base of the coracoid process and fans out laterally and inferiorly on the subscapularis. The fibers envelop the tendinous portion of the subscapularis on either side. As a result, the ligament forms a cable-like anterior leading edge over the rotator interval. The subscapularis tendon can appear in relative anatomic position unless the arm is brought into internal rotation and relaxation is achieved. We also demonstrated that CHL was associated with opening the bicipital sheath along its medial border during shoulder elevation. The coracohumeral ligament might contribute to the stability of the subscapularis tendon and to the morphology of the bicipital groove.

著者

松木 圭介 菅谷 啓之 前田 和彦 森石 丈二 望月 智之 秋田 恵一

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.31, no.2, pp.213-215, 2007

被引用文献数

7

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The purpose of this study was to examine the anatomy of the infraspinatus including the orientation of muscle fibers and the insertion to the greater tuberosity. Ninety-three shoulders from 52 cadavers were minutely dissected. After resection of the acromion and removal of the coracohumeral ligament, the infraspinatus muscle was carefully investigated macroscopically. After the orientation of muscle fibers was confirmed, the muscle was peeled from the proximal part to the distal part and the insertion of the infraspinatus tendon was examined. In 4 shoulders, muscle fibers were completely removed in water and the direction and insertion of the tendon were examined. The infraspinatus muscle originated both from the inferior surface of the spine of the scapula and the infraspinatus fossa, and inserted to the greater tuberosity. The muscle fibers originated from the spine were running dorsally and horizontally to the greater tuberosity. On the other hand, the fibers from the fossa were running ventrally and diagonally to the greater tuberosity. These fibers were merged at the insertion. The infraspinatus tendon had vast insertion to the greater tuberosity, and the most anterior part of the tendon was inserted to the most anterior portion of the greater tuberosity, bordering on the most anterior part of the supraspinatus tendon. The supraspinatus tendon is regarded as the most affected tendon in rotator cuff tears. However, the results of this study suggested that the infraspinatus tendon could be involved in the majority of rotator cuff tears. The infraspinatus may act not only in external rotation but also in abduction, because the infraspinatus tendon was inserted to the most anterior part of the greater tuberosity.

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

森石 丈二 黒田 重史 住吉 徹是 斎藤 政憲 丸田 喜美子 菅谷 啓之 石毛 徳之

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.217-219, 1996-10-15 (Released:2012-11-20)

参考文献数

5

被引用文献数

3

著者

前田 和彦 菅谷 啓之 新井 隆三 森石 丈二 望月 智之 吉村 英哉 松木 圭介 秋田 恵一

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.31, no.2, pp.209-211, 2007

被引用文献数

5

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It is generally believed that the supraspinatus tendon plays an important role in the shoulder function. However, precise anatomy of the supraspinatus tendon has not been well described. The purpose of this study was to investigate the anatomy of the supraspinatus tendon. 57 cadavers (103 shoulders) were used for this study. The clavicle and humerus were cut off at their proximal parts. After resection of the acromion, the coracohumeral ligament was carefully removed. In some specimens, the infraspinatus was completely removed from the humerus to observe the overlapping portion of the supraspinatus and infraspinatus. The supraspinatus muscle and its origin were carefully investigated macroscopically. In 4 shoulders, muscle fibers were completely removed to examine the direction and insertion of the supraspinatus tendon in detail. The supraspinatus muscle fibers originated from the spine of the scapula and the supraspinatus fossa, and they were running toward and attached to the thickest tendinous portion, which was located at the anterior part of the supraspinatus muscle. This tendinous portion was strongly attached to the most anterior portion of the greater tuberosity adjacent to the bicipital groove or at the lesser tuberosity (21.3%). Another part of the supraspinatus, which was located posteriorly, was attached to the greater tuberosity adjacent to the articular cartilage as a thin membrane. The insertion of the supraspinatus tendon revealed to be the most anterior portion of the greater tuberosity and the lesser tuberosity. These results suggested that the supraspinatus tendon worked more efficiently as an abductor of the shoulder joint with the arm externally rotated than internal rotation.

著者

吉村 英哉 望月 智之 宗田 大 菅谷 啓之 前田 和彦 秋田 恵一 松木 圭介 中川 照彦

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.31, no.2, pp.217-219, 2007

---

Previous studies reported a presumably unusual bony attachment of the pectoralis minor muscle. However, less attention has been given to the insertion of the continuation to the glenohumeral joint. The purpose of this study was to evaluate the frequency of this abnormal insertion of the pectoralis minor muscle, and also to investigate the relation between this continuation and the capsule. 81 anatomic specimen shoulders from 41 cadavers were dissected. The insertion of the pectoralis minor tendon to the glenohumeral joint was carefully investigated. The pectoralis minor tendon ran beyond the coracoid process and extended to the superior portion of the glenohumeral joint in 28 out of 81 specimens (34.6%). The continuing insertion divided the coracoacrominal ligaments into two limbs. The continuation was more variable, and consisted of the whole tendon in 6, the middle part in 5, the lateral part in 15, and the medial part in 2 specimens. Furthermore, the pectoralis minor tendon inserted to the posterosuperior border of the glenoid in 6, to the greater tuberosity in 7, and both to the glenoid and the greater tuberosity in 15 specimens. The prevalence of the anomalous insertion of the pectoralis minor tendon revealed to be as high as 34.6% in the present study. This may suggest that the pectoralis minor tendon plays an important role in the stability of the glenohumeral joint.

著者

仲島 佑紀 小林 雄也 高村 隆 岡田 亨 戸野塚 久紘 高橋 憲正 菅谷 啓之

出版者

社団法人 日本理学療法士協会関東甲信越ブロック協議会

雑誌

関東甲信越ブロック理学療法士学会 (ISSN:09169946)

巻号頁・発行日

vol.30, pp.78, 2011

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【目的】<BR>少年期の野球肘内側障害(以下、内側型野球肘)において、一般に画像上の異常所見により長期の投球禁止となる場合が少なくない。当院では早期より理学療法を施行することで安静期間の短縮を図ってきた。本研究の目的は少年期の内側型野球肘における、画像所見の違いによる競技復帰への影響を調査することである。<BR>【対象】<BR>2005年1月から2010年8月までに当院を受診した小中学生野球選手で内側型野球肘と診断され、競技復帰までの経過観察が可能であった症例のうち、明らかな画像上の異常所見を認めなかった144例をN群、内側上顆骨端核の裂離を有していた248例をS群とした。画像所見における分類は、当院放射線技師により撮影された初診時X線所見を主治医が診断したものを用いた。医師の指示の下、全例初診時より投球禁止と共に理学療法を直ちに施行した。なお、上腕骨小頭離断性骨軟骨炎の合併例は除外した。<BR>【方法】<BR>N群、S群における競技完全復帰率を算出した。さらに両群を完全復帰群(C群)、不完全復帰群(I群)に分類し、N-C群・N-I群・S-C群・S-I群の初診時と復帰時における身体機能の群内比較を行った。、次に復帰時の身体機能、ならびに復帰までの期間N-C群とN-I群、S-C群とS-I群で比較した。身体機能は肘関節可動域、肩甲帯機能(CAT・HFT)、股関節機能(SLR・HIR・HBD)評価を用いた。統計学的処理にはMann-Whitney U検定、Wilcoxon符号順位検定を用いた。なお本研究には当院倫理委員会の承認を得て行った。<BR>【結果】<BR>完全復帰率はN群82%、S群87%であった。N-C群、S-C群においてCAT・HFT・SLR・HIRが初診時よりも有意に改善していた(p<0.01)。N、S群ともにC群がI群に比しCAT・HFT・SLR・HIRが有意に大きかった(p<0.05)。復帰までの期間はN-C群:7.0±4.4週、N-I群:3.1±2.7週、S-C群:7.8±4.5週、S-I群:3.8±4.7週であった。<BR>【考察】<BR>今回の調査では画像所見にかかわらず競技完全復帰は7~8週で80%以上が可能であった。内側型野球肘の投球禁止期間は緒家により様々だが、安静期間における身体機能改善を目的とした理学療法アプローチは、競技復帰への重要な要素であるといえる。I群は機能改善が不十分かつ復帰までの期間が短く、コンプライアンスの悪い例であったと考えられる。競技復帰において画像所見は必ずしも影響するとは言えず、身体機能も含めた包括的な評価により投球再開を医師とともに協議し、症例に呈示していく必要があると思われる。

著者

松木 圭介 菅谷 啓之 前田 和彦 森石 丈二 望月 智之 秋田 恵一

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.31, no.2, pp.213-215, 2007 (Released:2008-01-30)

参考文献数

6

被引用文献数

14

---

The purpose of this study was to examine the anatomy of the infraspinatus including the orientation of muscle fibers and the insertion to the greater tuberosity. Ninety-three shoulders from 52 cadavers were minutely dissected. After resection of the acromion and removal of the coracohumeral ligament, the infraspinatus muscle was carefully investigated macroscopically. After the orientation of muscle fibers was confirmed, the muscle was peeled from the proximal part to the distal part and the insertion of the infraspinatus tendon was examined. In 4 shoulders, muscle fibers were completely removed in water and the direction and insertion of the tendon were examined. The infraspinatus muscle originated both from the inferior surface of the spine of the scapula and the infraspinatus fossa, and inserted to the greater tuberosity. The muscle fibers originated from the spine were running dorsally and horizontally to the greater tuberosity. On the other hand, the fibers from the fossa were running ventrally and diagonally to the greater tuberosity. These fibers were merged at the insertion. The infraspinatus tendon had vast insertion to the greater tuberosity, and the most anterior part of the tendon was inserted to the most anterior portion of the greater tuberosity, bordering on the most anterior part of the supraspinatus tendon. The supraspinatus tendon is regarded as the most affected tendon in rotator cuff tears. However, the results of this study suggested that the infraspinatus tendon could be involved in the majority of rotator cuff tears. The infraspinatus may act not only in external rotation but also in abduction, because the infraspinatus tendon was inserted to the most anterior part of the greater tuberosity.