著者

柴田 陽三 緑川 孝二 内田 洋子 渡辺 伸彦 緒方 公介 伊崎 輝昌

雑誌

肩関節 = Shoulder joint (ISSN:09104461)

巻号頁・発行日

vol.21, no.2, pp.351-355, 1997-06-25

被引用文献数

1

著者

山口 光國 筒井 廣明

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.33, no.3, pp.805-808, 2009 (Released:2010-01-29)

参考文献数

7

被引用文献数

6

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We investigated the movement of the shoulder girdle which included the humerus position that athletes need to throw. We examined the movement of the shoulder girdle and relations with the state of the shoulder which we were aware of. The materials were 53 athletes to know their throwing movement. Their average age was 17 - 38 years old. (average 24.4±4.8) The results, the shoulder condition and the relations with the range of motion accepted middle-class correlation for the external rotation and internal rotation movement in the state of 90° flexion. The shoulder condition and the relations with the movement of the shoulder girdle accepted strong correlation in anterior, superior, inferior and the posterior recognized middle-class correlation. The result of this appraisal method did not accept significance between the pitching side and the un-pitching side. (p<0.01) The movement of the shoulder girdle on the basis of the humerus strongly influenced the condition of the shoulder of which we were aware of rather than the range of the shoulder motion. Although ROM was important as a medical treatment, it cannot be said that it was enough in respect of prevention of an obstacle. This evaluation method was important from a viewpoint of injury prevention to it. And this method was simple and we thought very easy to use.

著者

奥脇 透

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.22, no.2, pp.359-362, 1998

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[Purpose] We evaluated the shoulder alignment by measuring the sloping angles of shoulders. Materials and Methods: Photos were taken of 362 male sloping anglesof their shoulders were measured on the photos. The angle was measured by two lines; one line was drawn from the neck to the acromion. The other line was drawn between bilateral acromions. All the athletes were evaluated their shoulder type by three methods. First, they gave their impressions of their own shoulders. Secondly, they were evaluated by seven trainers. Thirdly, Iseki's method of measuring sloping shoulders was used to evaluate the position of the acromion in relation to the upper edge of the sternum. The athletes were also questioned about their shoulder injury history and the sports they played.<BR>[Results] The average sloping angle was 24.2 &plusmn;3.6&deg; on the right side,25.1 &plusmn;3.7&deg; on the left side. There was no lateralization. According to the trainers evaluation 42 cases (12%) displayed sloping sh oulders, the so called nadegata type; 98 cases(27%) had square shoulders, ikarigata; and the remaining 222(61%) were classified as namigata. The sloping angle was 28.2&plusmn;2.6&deg; in nadegata,25.0&plusmn;2.7&deg; in namigata and 20.9&plusmn;3.1&deg; in ikarigata. The angles of the three groups were all significantly different. The angles of the gymnasts were the greatest and the angles of the swimmers and the volleyball and soccer players were the smallest. There was no difference between the angles of athletes with shoulder injuries and those with no injuries.<BR>[Conclusion]The measurement of the sloping angle of shoulders is useful for the evaluation of shoulder alignment.

著者

木戸 忠人 井樋 栄二 今野 則和 佐野 晃久 浦山 雅和

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.22, no.2, pp.169-172, 1998

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The purpose of this study was to determine the in vivo function of the biceps as an active depressor of the humeral head. Thirty-eight shoulders were examined: 19 shoulders with rotator cuff tears (RCT, avg age 59 yrs) and 19 shoulders with normal MRI findings of the rotator cuff (Control, avg age 55yrs). A special arm brace which was fixed to the upper arm was used to keep the biceps in active contraction (biceps loading) during arm elevation. The subjects were asked to grasp a rubber band attached to the distal end of the brace, pull it proximally, and keep the elbow flexed against the resistant force producted by the band. The x-ray were obtained with the arm elevated at 0,45,90 degrees in the scapular plane with and without pulling the band. The center of the humeral head was determined using NTH image and compared between the groups with and without biceps loading. Without biceps loading, the positions of the humeral head at 0,45 degrees were significantly higher in RCT than those in Control (p=0.0101, p=0.0020, respectively). After loading the biceps, the humeral head was depressed significantly at each degree in RCT (P=0.0082, p=0.0259, p=0.0059, respectively). As a result of biceps loading, there were no more significant differences in the positions of the humeral head between RCT and Control (p=0.3285). The positions of the humeral head in RCT with biceps loading were similar to the positions in Control without biceps loading. This is the first study to show the in vivo function of the biceps as an active depressor. From these results, we conclude that the biceps is an active depressor of the humeral head in cuff-defficient shoulders.

著者

渡辺 公三 玉井 和哉 吉田 耕志郎

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.16, no.1, pp.47-49, 1992

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We set up Isometric exercises for patients with a glenohumeral joint contracture to do. The series of exercises consists of an abduction and an external rotation every 5 seconds, and internal rotation movements with a 5-second-rest interposed between each movement.<BR>The patients were ordered to keep their shoulders in the neut r al position while doing these exercises. We demanded that they do these exercises for about 10 minutes, twice a day at least.<BR>No patients had any local analgesics injected into their subacromial bursanor glenohumeral joint during this 4-week-isometric contraction exercise period.<BR>Loxoprofen sodium was prescribed as a painkiller when the patients wanted it.4 weeks later, we investigated the effects of these exercises in the relief of pain and recovery of motion.3 levels of pain were used in this study: better, no change, worse, compared with the pain the patients had when they started these exercises. The range of motion was indicated in total degrees of flexion, abduction and external rotation.<BR>Considering a margin of error, a 20-degree-increase or even from the beginning was considered as an -Improvement- and a 20-degree-decrease or even was considered as an -Aggravation-.<BR>We investigated 29 patients' 30 shoulders aged 56.9 years old on average. A relief of pain was observed in 64% of the patients and a recovery of motion in 67%.

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

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

美舩 美舩 乾 淳幸 坂田 亮介 原田 義文 高瀬 史明 植田 安洋 片岡 武史 国分 毅

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.476-480, 2016

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加齢に伴う腱板組織へのadvanced glycation end products(AGEs)沈着量の変化と力学的強度の変化を,SDラットを用いて検討した.3,6,12,24か月齢のSDラットの棘上筋腱を用いて組織学的検討を行い,力学的評価として棘下筋-上腕骨複合体の最大破断強度を引っ張り試験にて評価した.HE染色では12,24か月齢のラット腱板において細胞浸潤,コラーゲン線維配列の乱れを認めた.免疫染色では加齢に伴ってAGEs沈着の増加を認め,またAGE受容体の発現増加も認めた.TUNEL染色でも同様に加齢に伴うアポトーシスの増加を認め,力学的試験では12,24か月齢において破断強度の低下を認めた.我々はこれまでにin vitro実験において,AGEsが腱板由来細胞のReactive Oxygen Species発現を増加させ,アポトーシスを増加させることを明らかにしてきた.本研究より,肩腱板においてもAGEsの沈着が細胞障害性を持つ一方で,力学的な脆弱性と相関しており,AGEsの増加が加齢に伴う腱板断裂の一因になっていることが考えられた.

著者

植木 博子 吉村 英哉 日山 鐘浩 望月 智之 二村 昭元 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.38, no.2, pp.369-371, 2014

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小胸筋腱の停止が烏口突起をこえて延長する解剖学的破格は以前から知られている.過去に我々が調査した屍体解剖実習体では小胸筋延長腱の発現率は34.6%(81肩中21肩)であり,延長腱は烏口突起を越えて関節包の方に広がっていた.今回,肩腱板断裂症例において鏡視下修復術時に小胸筋延長腱の有無を確認し形態について観察した.<BR> 対象は2012年6月から12月までに当院で鏡視下腱板修復術を施行した腱板断裂症例25例(男性13例,女性12例)であった.術中にまず烏口突起基部を同定し小胸筋延長腱の存在を確認した.<BR> 延長腱は25例中10例(40%)に認められた.烏口突起に停止せずに上面を滑動し棘上筋の方向に向かい,烏口上腕靭帯とは明瞭に区別がついた.<BR> 臨床でも延長腱の発現頻度は比較的高く,その走行および付着の形態より肩甲上腕関節機能に影響を与えることが示唆された.鏡視下手術では延長腱の存在を留意する必要があると考えられた.

著者

森澤 豊 野口 政隆 川上 照彦 山本 博司 貞廣 哲郎

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.22, no.2, pp.267-269, 1998-06-25 (Released:2012-11-20)

参考文献数

3

被引用文献数

1

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We studied the mechanism of musculocutaneous neuropathy associated with the Boytchev procedure in cadavers.(Materials and methods)The subjects we re 21 adult cadavers (42 shoulders) for anatomical study. The distance from the anterior end of the coracoid process to the site of the entry of the musculocutaneous nerve trunk into the coracobrachialis muscle was determined as A, the distance to the insertion of the short head of the biceps among the nerve branches as B, and the distance to the coracobrachialis insertion site as C. Then, the coracoid process (served to measure the insertion of the short head of the biceps and that of the coracobrachialis) was returned to its original position beneath the full-thickness of the subscapularis muscle by the original Boytchev method, and the distance from the anterior end of the coracoid process to the lower margin of the subscapularis was determined as D.(Results)A was 47.5±13.2mm, B was 30.1±6.2mm, C was 33.9±7.5mm and D was 33.3±5.3mm. A was below D, i. e., the entry site of the musculocutaneous nerve trunk was above the lower margin of the subscapularis muscle, and entrapment of the musculocutaneous nerve trunk by the subscapularis muscle was present in nine shoulders (21.4%).(Discussion)In patients where the site of the entry of the musculocutaneous nerve trunk into the coracobrachialis muscle is at a higer position than the lower margin of the subscapularis, it appears necessary to take technical precautions such as passing the severed coracoid process through the lower one third of the belly of the subscapularis.

著者

林田 賢治 田中 誠人 小泉 宏太

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.853-856, 2011 (Released:2011-12-21)

参考文献数

4

被引用文献数

1

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The clinical result of arthroscopic triple row suture anchor repair (combined operation of double anchor footprint fixation and single row method) for complete rotator cuff tear is reported in the present study. Twenty-two shoulders (the average age at operation was 69 years old: range 53-78) were involved and followed for more than 6 months (average follow up: 10 months). The clinical results were evaluated with JOA shoulder score and post operative cuff integrity was assessed by MRI and classified with Sugaya's classification. The pre-operative average JOA score, which was 71.5, improved to 92.1 at follow up. Regarding post operative cuff integrity, complete repair (type 1 and 2) was seen in 13 shoulders (59%), repaired with thin tendon (type 3) was seen in 2 shoulders (9%), re-tear (type 4 and 5) was seen in 7 shoulders (32%). In re-tear cases, 6 of 7 were type 4, and type 5 was seen in only 1 case. Comparing this to our previous data of repair integrity of double row suture anchor method, type 4 increased and type 5 decreased. Cutting out tendon by tight bridging sutures could be the cause of increasing type 4, and tension adjustment of bridging sutures could be important to prevent tendon cut out.

著者

板寺 英一 市川 徳和 山川 晴吾 橋詰 博行 井上 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.24, no.3, pp.383-385, 2000-09-30 (Released:2012-11-20)

参考文献数

8

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We studied the MRI findings of a frozen shoulder in three different phases. Forty-one frozen shoulders were available for this study. The mean age of the patients was 58 years (range,43 to 77 years). The mean range of elevation of the shoulders was 118 degrees (range,80 to 140 degrees). There were 10 shoulders in the acute phase (less than 2 months),16 in the subacute plase (2 to 3 months),15 in the chronic phase (4 to 12 months). Oblique coronal, oblique sagittal, and axial sequences were made with the fast spin-echo technique using a 0.5-tesla MR Vectra unit. On T2-weighted images, high signal intensities (HIS) in the glenohumeral joint (GHJ), the subacromial bursa (SAB) and the bicipital groove (BG) were analyzed, and then the contraction of the axillary pouch was evaluated.HIS at the GHJ was moderate in 40%, slight in 20% and none in 40% of the shoulders in the acute phase; in 0%, in 63% and in 37%, respectively, in the subacute phase; and in 7%, in 40% and in 53%, respectively, in the chronic phase. HIS at the SAB was moderate in 0%, slight in 30% and none in 70% of the shoulders in the acute phase; in 0%, in 25% and in 75%, respectively, in the subacute phase; and in 0%, in 27% and in 73%, respectively, in the chronic phase. HIS at the BG was moderate in 30%, slight in 60% and none in 10% of the shoulders in the acute phase; in 25%, in 19% and in 56%, respectively, in the subacute phase; and in 13%, in 40% and in 47%, respectively, in the chronic phase. Contraction of the axillary pouch was observed in 20% of the shoulders in the acute phase,69%in the subacute phase, and 73% in the chronic phase.In conclusion, there were increased amounts of fluid at the GHJ and BG in the acu, t eb upt haosnely a small amount at the SAB. Shoulder stiffness may be caused by contraction of the GHJ capsule which develops as the intraarticular synovitis resolves.

著者

南 昌孝 森原 徹 大西 興洋 加太 佑吉 祐成 毅 古川 龍平 木田 圭重 琴浦 義浩 藤原 浩芳 久保 俊一

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.41, no.2, pp.541-544, 2017 (Released:2017-09-20)

参考文献数

8

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胸郭出口症候群(TOS)は,上肢のしびれや放散痛が生じる疾患である.投球時に同様の症状を訴える野球選手をしばしば経験するが,その疫学や病態は明らかでない.高校野球検診でTOSと診断された選手の疫学と病態を検討した.検診に参加した選手のうち,投球時に上肢のしびれや放散痛を自覚しWright testが陽性の選手をTOSの疑いありとした.そのうち病院を受診した選手の病態を検討した.TOSを疑われた選手は305名中13名であり,5名が病院を受診した.5名の身体所見は,肩甲骨の運動不良3例,胸椎のアライメント不良3例であった.すべての選手に運動療法を行い,2ヵ月以内に症状は消失した.野球選手のTOSは,筋の過緊張やリリース時の牽引などが原因とされている.今回経験した5例では筋の過緊張や肩甲骨下方偏位に加え,胸椎のアライメント異常が影響していると考えた.それらを改善することで症状は消失した.

著者

林田 賢治 中川 滋人

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.29, no.2, pp.427-430, 2005-06-30 (Released:2012-11-20)

参考文献数

6

被引用文献数

1

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The aim of this study was to elucidate the relation between ball speed in pitching during a baseball game and the power of external rotation (ER) of the shoulders. Nineteen games, which were at the national inter high school baseball tournament games in Japan, in which the pitchers threw more than 100 times, and the ER strength before the tournament and after the games were measured, were included in the present study. The straight balls were decided by the ball speed data and video tapes of the games and a mean straight ball speed in the first 30 pitches and the last 30 were calculated. The relation between the changes of ball speed and ER strength were assessed. In 8 of 19 games, the ball speed decreased more than 3 km/h between the first 30pitches and the last 30 pitches and these games were classified into speed decreased game (DG), and the other 11 games were into non DG. The mean ratios of ER strength of the throwing side to the non throwing side were 1.02 in non DG and 0.99 in DG before the tournament. The mean ratios of ER power were 1.02 in non DG and 0.95 in DG after the games. The differences of ER ratios between before the tournament and after the game were +0.012 in non DG and -0.041 in DG, and a statistical significant difference was recognized between them. A decrease of straight ball speed during a game relates to a decrease of ER strength ratio. Maintaining ER strength could be one of the ways to keep ball speed in the game.

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

松崎 昭夫

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.10, no.1, pp.72-74, 1986-07-28 (Released:2012-11-20)

参考文献数

6

被引用文献数

3

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16 cases of entrapment neuropathy of the axillary nerve in the quadrilateral space were reported. Etiology, symptomatology, differential diagnosis and therapy of this disorder were discussed. The complaints of the patients were pain on the dorsal and lateral aspect of the shoulder, especially in abduction, external rotation and horizontal abduction of the shoulder.Objective findings were sensory disturbance in the autonomo u s zone of the axillary nerve, muscle atrophy of the deltoid and the terses minor muscle and tenderness on the quadrilateral space. But in mild cases muscle atrophy was not observed. In two cases partial muscle spasmus of the deltoid and the teres minor muscle and tenderness on them were observed. In one case with muscle atrophy the electromyographic investigation showed neurogenic changes of the deltoid and the teres minor muscle: motor unit action potential were long in duration, high in amplitude and polyphasic. This case was operated on and satisfactory result followed neurolysis. In other cases there was a good response to local infiltration of steroid and procaine hydrochloride. Our cases suggest that this neuropathy might also be considered in the differential diagnosis of a patient presenting with shoulder pain. Useless diagnostic procedures and treatment can be avoided if the physician is aware of this condition.

著者

井上 駿也 髙橋 裕司 前田 卓哉 田村 将希 阿蘇 卓也 野口 悠 高橋 知之 古山 駿平 尾﨑 尚代 古屋 貫治 西中 直也

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.47, no.1, pp.181-186, 2023 (Released:2023-09-20)

参考文献数

16

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リバース型人工肩関節全置換術(RTSA)後の自動屈曲可動域,臨床スコアに対して術前三角筋体積が関係するかを検討した.術後2年以上経過観察可能であったRTSA患者23名を包含した.画像解析ソフト上で三角筋を前部(AD),中部(MD),後部(PD)に区分けし,各部位の指数を得た.術後自動屈曲可動域(6カ月,1年,1.5年,2年)とJOAスコア(2年)との相関の有無を,Spearmanの相関係数を用い検討した.術前AD体積指数と術後各時期での自動屈曲可動域との相関係数は,0.57(p < 0.01),0.73(p < 0.001),0.72(p < 0.001),0.70(p < 0,001)と全ての時期で有意な正の相関を認めた.術前PD体積指数と術後各時期での自動屈曲可動域との相関係数は,-0.34(p=0.11),-0.49(p < 0.05),-0.56(p < 0.01),-0.63(p < 0.01)と術後6カ月以外の時期で有意な負の相関を認めた.JOAスコアとの相関は術前AD体積指数のみ0.50(p < 0.05)と有意な正の相関を認めた.術前AD体積指数が高い症例ほど術後自動屈曲可動域およびJOAスコアは高くなる傾向にあり,術前PD体積指数が高い症例ほど術後自動屈曲可動域獲得に難渋する可能性が示唆された.

著者

宇田 宙照 福島 充也 後藤 康夫 池田 均 塚西 茂昭 信原 克哉

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.13, no.1, pp.11-15, 1989-11-01 (Released:2012-11-20)

参考文献数

3

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The clavicular movement during active elevation of the upper limb was analyzed in this study. Sixty right shoulders in normal sugjects were investigated by using “ Chneradiography” and the “ personal image analysis system”. The lateral lower margin and the conoid tubercle of the clavicle were measured as the points which demonstrate clavicular movement.During elevation of the upper limb in the scapular plane, the elevated ang l e s of the clavicle were calculated with the scapular movement in the following stages; “ setting phase”, the “ hanging joint” prase, “ transit zone”, and the “ joint needing support” phase.The results were as follows:1. The elevated angles of the clavicle increased gradually during elevation of the upper limb. Finally the average of maximum elevated angles of the clavicle was 41.5 degrees at 150degrees of the arm-trunk angle. We noticed the clavicular movement for every 10 degrees was uneven in this study.2. No remarkab l e elevation was noted in the “ setting phase”. The elevated angles of the clavicle reached 4.22 degrees during the setting phase. Clavicular movement is similar to scapular movement, however, it was slightly irregular and unstable.3. In the “ hanging joint” phase, the elevated angle of the clavicle was 3.69 degrees forevery 10 degrees.4. In “ transit zone”, the elevated angle of the clavicle was 4.02 degrees for every 10degrees. The ratio of clavicular movement was closest to the scapular movement in this phase. And this movement was the most characteristic.5. In the final stage, in the “ joint needing support” phase, the elevated angle of the clavicle increased 4.22 degrees of the elevation of the upper limb.6. The absolute relationship between scapular and clavicu l a r movements were obtained from these results.

著者

林 洸太 原 由紀則 星川 慎弥 田尻 康人

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.631-634, 2016 (Released:2016-10-07)

参考文献数

13

被引用文献数

2

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肩関節脱臼により障害される神経として腋窩神経以外の神経麻痺を合併することも稀ではない.今回,低エネルギーでの肩関節脱臼に伴う神経麻痺22例を対象として,麻痺発生頻度と各損傷神経の回復過程を検討した.損傷神経の発生頻度は肩甲上41%,腋窩73%,筋皮41%,橈骨59%,正中73%,尺骨64%であった.麻痺回復期間は,各神経の代表的支配筋間で有意差はなかったが,近位筋(三角筋;腋窩,上腕二頭筋;筋皮,橈側手根伸筋;橈骨)と遠位筋(小指外転筋;尺骨,示指深指屈筋;正中)と定義して比較すると,近位筋が3.6±1.8ヶ月,遠位筋が10.3±8.9ヶ月で,後者の回復が前者より有意に遅れていた.回復期間に影響を及ぼす可能性のある因子の比較において,軸索変性の有無を比較すると,遠位筋麻痺では軸索変性があると有意に回復が遅かった.遠位筋麻痺症例では軸索変性の有無の鑑別により回復時期の判断が可能であり電気生理学的検査を行うことが望ましい.

著者

竹内 康剛 山本 英樹

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.2, pp.571-574, 2013 (Released:2014-04-03)

参考文献数

8

被引用文献数

3

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Background: We experienced 2 cases of axillary artery injuries complicating proximal humeral fracture. Preoperative CT images were evaluated retrospectively in patients with proximal humeral fractures who underwent surgery in our hospital. The purpose of this study is to evaluate the association between the medial displacement of the humeral shaft and axillary artery injuries.Methods: A total of 27 patients with proximal humeral fractures who underwent open reduction and internal fixation between April 2010 and March 2012 were included in this study. There were 11 men and 16 women with a mean age of 63.0 years (24 to 92 years). We retrospectively evaluated preoperative CT images, and the distance between the medially displaced humeral shaft and the axillary artery was assessed.Results: Axillary artery injury was observed in 2 patients. The distance between the medially displaced shaft and the axillary artery showed a significant difference between the group with axillary artery injury (injury group: Group I) and the group without axillary artery injury (non-injury group: Group NI).Discussion: We consider that there is a risk of axillary artery injuries at the time of injury or reduction when patients have remarkable medial displacement of the shaft in a proximal humeral fracture, regardless of the AO classification, and therefore require adequate attention. We suggest that patients with remarkable medial displacement of the shaft in a proximal humeral fracture undergo preoperative CT angiography or doppler ultrasound to evaluate the risk of axillary artery injury.