- 著者
- 埜口 博司 落合 直之 坂根 正孝 宮永 豊
- 出版者
- Japan Shoulder Society
- 雑誌
- 肩関節 (ISSN:09104461)
- 巻号頁・発行日
- vol.25, no.2, pp.257-262, 2001
[Purpose]The purpose of this study was to evaluate the activity of shoulder muscles in various shoulder positions in the external rotational motion.<BR>[Materials and methods]We examined the non-dominant side of shoulders of 8 adult males who did not have any shoulder disorder. We pasted surface electrodes for 7 outer muscles and stuck needle electrodes into 3 inner muscles of each subject. Each person performed isometric external rotation motion in various loads (0,3,9,15Nm) in 6 positions (60° internal rotation, neutral,30° external rotation with arm at side, and neutral,45° external rotation,90° external rotation with arm at 90° abduction position) with a Cybex-NORM770. We obtained electromyograms of each muscle. An electromyogram signal during a maximum manual muscle strength test (MMT) was selected as the normalizing value (100%) for each subject.<BR>Each activity (%MMT) was atatistically compared, using Scheffe's test. The statistical significance was set at 0.01.<BR>[Results and conclusion]During isometric external rotation motion, in internal rotation or arm at side position, the activities of the muscles were low and the activities of the inner muscles were higher than those of the outer muscles, so these positions might be appropriate for rotator cuff exercises in the early phase of rehabilitation. While, in the 90° external rotation with arm at 90° abduction positi on, which is similar to the cocking phase of throwing, the activities of all the muscles including the outer muscles were very high. So we must be careful when we do shoulder exercise in such like position not to overload the shoulder muscles.
1 0 0 0 スノーボード、スキーによる肩の外傷の比較検討
- 著者
- 杉原 隆之 中川 照彦 三森 甲宇 石突 正文 四宮 謙一
- 出版者
- Japan Shoulder Society
- 雑誌
- 肩関節 (ISSN:09104461)
- 巻号頁・発行日
- vol.25, no.3, pp.511-514, 2001
We performed a comparative study on shoulder injuries between snowboards and skis.<BR>1665 patients injured by snowboarding or skiing visited our hospital from 1997 to 1999 (males: 1173, females: 492, averagc age: 25.3). There were 883 patients injured by snowboarding (males: 667, females: 216, average age: 23.6) and 782 patients injured by skiing (males: 506, females: 276, average age: 27.3).<BR>There were 523 patients (59.2%) with upper extremity injuries caused by snowboarding. Among them there were 191 patients (21.6%) with shoulder injuries. There were 62 fractures (clavicle: 40, proximal end of the humerus: 22),78 dislocations (acromioclavicular joint: 32, shoulder joint: 46) and 1 dislocation fracture (shoulder joint). There were 235 patients (30.1%) with upper extremities injured by skiing. Among them there were 133 patients (17.0%) with shoulder injuries. There were 53 fractures (clavicle: 36, proximal end of the humerus: 14, scapula: 3),41 dislocations (acromioclavicular joint: 10, shoulder joint: 31) and 6 dislocation fractures (shoulder joints).<BR>Snowboarders fall on their hands frequently. Therefore upper extremity injuries and shoulder injuries caused by snowboarding are considered to be more than by skiing.
- 著者
- 浜田 純一郎 大野 弥 玉井 和哉
- 出版者
- 日本肩関節学会
- 雑誌
- 肩関節 = Shoulder joint (ISSN:09104461)
- 巻号頁・発行日
- vol.26, no.2, pp.309-314, 2002-01-01
- 参考文献数
- 8
The purpose of this study was to identify whether the glenohumeral joint (GHj) or subacromial bursa (SAB) is the main inflamed site, and which pathway should be operated on for the degradation of the articular cartilage after a cuff tear. We obtained synovial fluid, SAB, the stump of a torn supraspinatus tendon (cuff), synovium, and articular cartilage (cartilage) from 8 patients with a complete-thickness tear. As a control, the cuff and cartilage were removed from 2 patients with tumors around the shoulders. We measured the concentration of interleukin-1 β (IL-1 β), IL-6, matrix metalloproteinase-1 (MMP-1), MMP-3. Immunohistochemical localization with antibodies to proliferative cell nuclear antigen (PCNA), IL-1 β, IL-6 and MMP-3 was performed using the ABC immunoperoxidase method. Concentrations of IL-1 β were 4.8±4.3 pg/ml, IL-6 485±4.3 pg/ml, MMP-1 417±330 ng/ml, MMP-3 6105±4258 ng/ml. A few nuclei were stained by PCNA but no cell by IL-1 β, IL-6, or MMP-3 in the control tissues. IL-1 β immunoreactivity was highest in the following order synovium, cuff, SAB, and cartilage ; for IL-6 the order was synovium, cuff, and SAB ; for MMP-3 in the order was synovium and cuff. Even though we found the same pathological findings (hyperplasia and abundant blood vessels) between the SAB and the synovium, expression of both IL-1 β and MMP-3 were much higher in the synovium than in the SAB. We conclude from these results that GHj is the main inflamed site after a cuff tear, and the extrinsic pathway is more greatly operated than the intrinsic pathway to cartilage degradation.
1 0 0 0 一流競泳選手の肩痛の発生原因と予防
- 著者
- 小松 泰喜 石川 知志 片山 直樹 武藤 芳照
- 出版者
- 日本肩関節学会
- 雑誌
- 肩関節 = Shoulder joint (ISSN:09104461)
- 巻号頁・発行日
- vol.26, no.2, pp.333-336, 2002-01-01
- 参考文献数
- 9
- 被引用文献数
- 1
Swimming is generally accepted as a sport with minimal physical injuries. However, swimmers frequently complain of shoulder pain, termed ”swimmer's shoulder”, which is thought to be a form of overused disorder. We investigated the factors related to shoulder pain in a cohort of elite swimmers in an attempt to isolate causes of this disorder. The subjects include 123 swimmers selected to participate in the Japan swimming championships between 1996 and 2000. Each participant had undergone complete medical examinations at the time of their competition. A study questionnaire was employed which asked the subject to grade the severity of their shoulder pain asked whether they trained with paddles and flippers, practiced any weight training, tubing and swim bench, did any stretching, and asked them to describe the type of swimming events in which they participated. The McNemar test and chi-square test were used in the statistical analysis. The incidence of shoulder pain was higher in swimmers who used paddles and flippers (p<0.01) and pain occurred more frequently during the weight training (p<0.01). Swimmers who stretched experienced a lower incidence of shoulder pain (p<0.01). There were no significant relationships between the shoulder pain and the type of swimming events or the practice of tubing and swim bench. : The use of the paddles and flippers as a training method needs to be investigated further as this appears statistically related to the development of ”swimmer's shoulder”, a frequently cited overuse disorder among the swimming population. Furthermore, the practice of performing stretching exercises appears to prevent shoulder pain in this population and should be included, as part of the warm-up routine.
1 0 0 0 OA 上腕二頭筋関節唇複合体の骨付着様式に関する組織学的研究
- 著者
- 伊崎 輝昌 緑川 孝二 柴田 陽三 緒方 公介 原 正文
- 出版者
- 日本肩関節学会
- 雑誌
- 肩関節 (ISSN:09104461)
- 巻号頁・発行日
- vol.18, no.1, pp.5-11, 1994-09-01 (Released:2012-11-20)
- 参考文献数
- 12
PurposeBiceps labrum complex (BLC) lesions most commonly occur during sports activities in which the arm is frequently held in an overhead position. Among the available literature there are few histological studies about BLC. The purpose of this study was to demonstrate the anatomy of BLC and its attachment to the glenoid and to evaluate the results of our treatment for BLC lesions.Materials and MethodsAnatomical Study: Sixty shoulders from 30 cadavers were studied. We recorded the appearance of the glenoid labrum and the LHB. Then, we removed the glenoid process from the scapula leaving all of the capsular insertion intact. Sections were each cut along the cornal plane and along the sagittal plane at 200-300 p m thickness on a rotary milling saw, and then ground to a 20 p m thickness. The sections were stained with Cole's hematoxylin and eosin and examined via light and polarized light microscopy.Clinical Cases:Thirty shoulders of 29 patients with BLC lesions underwent arthroscopic debridement of the superior labrum.ResultsAnatomical Study: The LHB inserted directly to the superior glenoid and its attachment extended to the middle of the posterior glenoid. The LHB was firmly attached to the superior glenoid from the edge of the glenoid rim. The attachment was gradually loose toward the middle of the posterior glenoid. The LHB was attached to a large surface of the glenoid.Clinical Cases:All patients were able to return to competitive sports.DiscussionsBased on our anatomical study, the LHB has a larger attachment area on the glenoid than had been previously reported. Therefore, we believe debridement of the superior labrum for BLC lesions preserves the LHB functions.
1 0 0 0 前鋸筋の機能解剖学的研究
- 著者
- 浜田 純一郎 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.3, pp.629-632, 2007 (Released:2008-01-25)
- 参考文献数
- 16
- 被引用文献数
- 1
To clarify the anatomy of the long thoracic nerve (LTN) and functional anatomy of 3 parts of the serratus anterior muscle (SA) from innervations and the shape of each fiber. We collected the 10 shoulders of 5 cadavers (3 males and 2 females,average age 82,4 years old). The upper, middle, and lower parts of SA were classified according to the Eisler's definition. We observed which components from C4, C5, C6, and C7 innervated each part of the SA. The upper part was mainly innervated by C5 fiber and also C4, C6, or C7 fibers connected to the parts in 8 of 10 shoulders. The long thoracic nerve consisted of C6 and 7 fibers innervated middle and lower parts. The cross section area of the upper part was wider than those of other parts, and the upper part ran in the direction of the anterior compared to that of the middle part. The upper part of SA may be worked as the center of the scapula in an up and downward rotation. Degenerative change or sprain of cervical spine and direct trauma to the medial scalenus muscle may have caused damage of LTN and then dysfunction of the SA.
1 0 0 0 OA 腱板断裂の自然経過
- 著者
- 建道 寿教 橋本 淳 橋本 卓 駒井 正彦 中村 真里 信原 克哉 中村 康雄
- 出版者
- Japan Shoulder Society
- 雑誌
- 肩関節 (ISSN:09104461)
- 巻号頁・発行日
- vol.28, no.3, pp.427-431, 2004
- 被引用文献数
- 2
The Purpose of this study was to analyze the articular contact pattern of the normal glenohumeral joint. There are few previous papers concerning the dynamic contact patterns, although the studies of using the cadaver or the tracking device have been reported. The subjects consisted of 10 normal volunteers. The subjects were fixed on a tilted stand with free motion around the scapula.3D MRI images were extracted at the scapular plane at every 30° between 30° and 150° in the supine position. The images obtained at each position were transmitted to a personal computer and the description of the bony frame by digitizing methods using the analyzing software were developed. Three dimensional reconstruction of the glenohumeral joint were performed. The items of measurement were the following (1)The contact area; the distances between the humeral head and the glenoid surface were calculated and the distribution set at the distances were considered to be the contact area. The shortest distance was regarded as the proximity of the joint. The change of the center of the distribution was investigated. (2)The center of the humeral head (3) Kinematics of the humerus; (from the aspect of the scapula) Results: (1)In the contact area; the minimum contact area had shifted superiorly up to 90 or 120° elevation, but after 120° it shifted inferiorly. Concerning the antero-posterior direction of the glenoid, it shifted antero-inferiorly at the elevated position compared to that of the 30Thlevation. (2)In the center of the humeral head; it shifted superiorly at 120° or 150° compaired to the 30° elevation. Its change was within 3mm. (3)In the Kinematics of the humerus; although the glenohumeral movement was totally 66°, it was only 17' after 90° elevation. We conclude that although the contact area shifted superior until 90°, it shifted to the central part of the glenoid over 120°, because the centripetal force might have worked at the elevated position. The distribution of the contact area was assumed to be reflected as a result of seeking a good congruity of the humeral head and the glenoid.
1 0 0 0 結合組織の創傷治癒より見た肩関節周囲炎の病態と治療
- 著者
- 青木 光広
- 出版者
- Japan Shoulder Society
- 雑誌
- 肩関節 (ISSN:09104461)
- 巻号頁・発行日
- vol.29, no.3, pp.621-624, 2005
Periarthritis of the shoulder is characterized by freezing phase, frozen phase, and thawing phase. However, the pathology of its clinical course is not clarified. Recent development of shoulder open surgery, arthroscopy, MRI and PET demonstrated that shoulders with persisting pain and contracture had hyperemia and edema of the joint capsule and subacromial bursa. Thus, we tried to elucidate clinical phases of frozen shoulder based on connective tissue repair and remodeling.<br>Early freezing phase of the shoulder is consistent with acute inflammatory phase of connective tissue repair. In this period, edema and hyperemia of the shoulder joint capsule appears with occurrence of shoulder pain (0 to 1 month from the onset). Late freezing phase of the shoulder is consistent with fibroplasias of connective tissue repair. In this period, infiltration of fibroblasts and new vessels in the capsule appears with progressive pain and reduction of range of motion (1 to 2 months from the onset). Freezing phase of the shoulder is consistent with consolidation stage of remodeling of connective tissue repair. In this period, fibrosis and thickening of the joint capsule appears with progressive contracture (2 to 6 months from the onset). Thawing phase of the shoulder is consistent with maturation stage of remodeling of connective tissue repair. In this period, remodeling of joint capsule appears with gradual relief from joint contracture (6 month to 1 year from the onset).<br>Joint capsule of the shoulder is known to have enough redundancy. However, if the inflammation of the capsule spreads all over the shoulder joint, fibrosis and production of collagen fibers in the capsule develops. Subsequent relief form joint contracture with remodeling of the capsule explains characteristic features of clinical staging of periarthritis of the shoulder. Comparing clinical stage and extent of connective tissue repair, theoretical back ground of physical therapy and surgical treatment is evident.
1 0 0 0 上肢挙上困難を主症状とする頚椎症性筋萎縮症の臨床成績
- 著者
- 小竹 俊郎 山川 知之 岡本 幸大
- 出版者
- Japan Shoulder Society
- 雑誌
- 肩関節 (ISSN:09104461)
- 巻号頁・発行日
- vol.29, no.3, pp.629-632, 2005
The purpose of this study was to evaluate 4 patients with marked atrophy of the shoulder girdle muscles caused by degenerative processes of cervical spine.4 patients presented themselves with deltoid paresis with the absence of sensory deficits or myelopathy. The patients were 3 males and one female. Their age at treatment was from 49 to 74 years-old with an average of 61.7 years old. Their mean follow-up period was 17months (17-29).3 cases underwent a cervical anterior decompression and one case was treated conservatively. The severity of deltoid paralysis was classified into five grades according to the manual motor power test and swallow tail sign. Theclinical outcome of each case was evaluated at pretreatment and at followup with JOA scores. Of 4 patients, three had C4/5 cervical spondylosis and one had C4/5 and C5/6. In the all cases, muscle power had improved significantly from MMT 2 to MMT 5. The JOA scores averaged 65.8 points at pretreatment and 98.8 points at follow-up. It is important for the differential diagnosis of shoulder girdle damage in cervical spondylotic syndrome of rotator cuff tears. The swallow tail sign in diagnosis and treatment was effective for a cervical spondylotic amyotrophy.
1 0 0 0 棘上筋停止部に関する解剖学的検討
- 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
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.
1 0 0 0 小胸筋の停止についての解剖学的研究
- 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.
1 0 0 0 拡散強調画像を用いた腱板筋機能評価
- 著者
- 落合 信靖 山﨑 博範 佐々木 裕 山口 毅 木島 丈博 松木 圭介 見目 智紀
- 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.461-463, 2013 (Released:2013-12-10)
- 参考文献数
- 9
- 被引用文献数
- 1
Background: Diffusion-weighted imaging (DWI) based on magnetic resonance imaging (MRI) can provide valuable information regarding the microstructure of tissues by monitoring the random movement of water molecules. The diffusion data can be used for determination of quantitative diffusion values such as the apparent diffusion coefficient (ADC). The purpose of this study was to evaluate rotator cuff muscle activity using DWI.Methods: DWI was performed before and after loaded on empty can test and full can test and compared before and after those tests.Results: ADC of supraspinatus, infraspinatus and superior portion of subscapularis were increased after empty can test. ADC of supraspinatus, superior portion of infraspinatus and superior portion of subscapularis were increased after full can test. Anatomical study showed that the infraspinatus had contributed in shoulder abduction in shoulder internal rotation.Discussion: This study showed the agreement with the anatomy of the previous study, an increase of ADC in supraspinatus and infraspinatus in empty can test and an increase of ADC in supraspinatus mainly in full can test. There were possibilities that DWI could evaluate the activity of rotator cuff muscle.
1 0 0 0 肩周囲筋群の筋電図学的解析とその臨床応用
- 著者
- 荻本 晋作 鶴田 敏幸
- 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.3, pp.1109-1115, 2016 (Released:2017-04-26)
- 参考文献数
- 16
健常成人男性の肩関節周囲筋群の筋電図解析を行い,臨床応用について検討した.棘上筋,棘下筋横走・斜走線維,小円筋にはエコー下にワイヤー電極,上腕二頭筋と三角筋の前・中・後部線維には表面電極を用い,3つの挙上の経路(前方,肩甲骨面,側方),4つの回旋角度(thumb down,palm down,thumb up,palm up),2つの挙上角度(45,90度),2つの負荷(自重,3 kg 重錘)を組み合わせた48通りの筋活動を計測した. 自重負荷では,側方挙上90度での最大内旋位で棘上筋は最大の筋活動となり棘下筋は最小の筋活動を示した.棘下筋は前方挙上90度での最大外旋位で高い筋活動を示すのに対し棘上筋の筋活動は最小となった.同一肢位では上腕骨は外旋するほど三角筋にかかる負担は少ない傾向であった.徒手検査では棘上筋は側方挙上内旋位,棘下筋は前方挙上外旋位でのテストが有用である可能性がある.
- 著者
- 山根 慎太郎 吉岡 千佳 大泉 尚美 末永 直樹
- 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.3, pp.927-929, 2013 (Released:2013-12-10)
- 参考文献数
- 8
- 被引用文献数
- 1
Background: The objective of this study was to analyze the rotator cuff muscles and other 7 muscles activity simultaneously during shoulder abduction by utilizing electromyographic (EMG) analysis.Methods: Measurements were compared between full can and empty can exercise. Non-dominant shoulders of five asymptomatic male volunteers (21-34 y.o.) were investigated. Fine-wire EMG electrodes were inserted into supraspinatus (SSP), infraspinatus (ISP), teres minor (TM), and upper and lower part of subscapularis (SSCU and SSCL). Surface electrode EMG were collected from lattisimus dorsi(LD), deltoid anterior(DA), middle(DM), posterior(DP), pectralis major upper(PMU), lower(PML), and trapezius(TRAP). The EMG data were collected during abduction exercises on the scapula plane while holding 1kg dumbbell. The EMG value was expressed as a percentage of MVC (maximum voluntary contraction) of the corresponding muscle to standardize.Results: %MVC of DM was significantly higher with empty can exercise. DP and TRAP showed a trend that %MVC was higher with empty can exercise (P=0.07,0.08) than with full can exercise. In the cuff muscle, we could not see any statistically significant difference, however, %MVC was higher in the ISP, SSCU, SSCL, TM with empty can exercise. It is reported that contraction of SSP is not different between full and empty can position.Conclusion: In this study, the other cuff muscles (ISP,SSC,TM) showed higher %MVC with empty can exercise. The empty can exercise may be a good exercise to recruit the all cuff muscles.
- 著者
- 三幡 輝久 渡辺 千聡 阿部 宗昭 木下 光雄
- 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.433-436, 2007
- 被引用文献数
- 1
The objective of this study was to assess the effect of shoulder horizontal abduction and external rotation on shoulder internal impingement. Eight cadaveric shoulders were tested using a custom shoulder testing system. Rotator cuff insertion points on the greater tuberosity were recorded using Microscribe digitizer at maximum external rotation position. Glenohumeral contact pressure at the maximum external rotation position was measured using a Fuji Prescale Film. Data were compared between the scapular plane (SP), 15 degrees horizontal abduction from scapular plane (15HA), 30 degrees horizontal abduction from scapular plane (30HA, simulated coronal plane), and 45 degrees horizontal abduction from scapular plane (45HA). The comparisons were also made between intact, after 20% stretching anterior capsule (an increased external rotation), and after an anterior capsular placation (a decreased external rotation). Data were analyzed using Tukey's post hoc test (p<0.05). Rotator cuff insertion points at 30HA and 45HA were located significantly anteriorly compared with those at the scapular plane and 15HA (p<0.01). The total contact pressure and total contact area in posterior glenohumeral joint at 30HA and 45HA were significantly greater than those at the scapular plane and 15HA (p<0.001). After stretching, maximum external rotation was increased and rotator cuff insertion points were significantly posteriorly located compared with intact condition at scapular plane (p<0.05). The cuff insertion points at more than 30 degrees of horizontal abduction were anterior to the posterior edge of glenoid, suggesting that excessive horizontal abduction, which is greater than coronal plane, may result in pathologic shoulder internal impingement.
1 0 0 0 肩関節包肩甲骨側付着部の解剖学的調査
- 著者
- 田崎 篤 二村 昭元 加藤 敦夫 山口 久美子 秋田 恵一 星川 吉光 望月 智之
- 出版者
- 日本肩関節学会
- 雑誌
- 肩関節 (ISSN:09104461)
- 巻号頁・発行日
- vol.36, no.3, pp.787-790, 2012
<B>Background:</B> Anatomical information of the insertion of the capsule around the glenoid is essential to recognize the pathological mechanism of shoulder disorders and perform better surgery.<BR><B>Methods:</B> Twenty five shoulders were dissected to investigated the morphology and size of the insertion of the capsule around the glenoid. We treated superior capsule as capsule-CHL. The location of glenoid rim was expressed as the location of the clock face of the glenoid.<BR><B>Results:</B> In the superior margin of the glenoid, the insertion of the capsule-CHL complex covered broadly to the base of the coracoid process in a triangular shape. Belt-like shape insertion was observed in posterior margin of the glenoid. Whereas as you followed anterior to the anteroinferior part, 4-5 oclock was thicker, then gradually thin down toward inferior. The average maximum width of the anterior and posterior insertion was 8.1mm (6.6-10.1mm)and 8.1mm (6.6-10.1mm), respectively. Although the width of insertion tapered, the capsule sent its fibers and connected to the lateral part of the LHT. Its attachment was observed as a thick portion from inside of the joint. This portion was observed as the posterior inferior gulenohumeral ligament.<BR><B>Conclusion:</B> The fact of thick attachment of the capsule on the glenoid rim should be considered when we perform surgery for shoulder instability. Fibrous connection between the capsule and LHT, which compensates for thin capsular attachment at inferior part, reinforces inferior stability. Since contraction of LHT pulls the inferior capsule inferiorly, this mechanism may have a role to avoid impingement of the inferior capsule.
1 0 0 0 アメリカンフットボール選手に発症した上腕骨頭軟骨損傷の2例
The symptoms of cartilage injury of humeral head are not well known. We experienced two cases of traumatic cartilage injury of humeral head in American football players.<BR>Both cases were young(21 and 20 years old), male college American football players and they were both running backs. The first case complained of motion pain for 1 year since he had fallen on his left shoulder after a tackle. This case showed osteoarthritic change and impression fracture of humeral head. The second case complained of pain and felt a click in abduction-external rotation after a blunt hit on his right shoulder by tackle one week before. The MRI showed Bankart lesion and cartilage injury of humeral head.<BR>In both cases, full thickness cartilage defects of humeral head were observed and these lesions were engaged to the anteroinferior edge of glenoids when the shoulders were abducted and externally rotated. They were treated by arthroscopic Bankart repair and returned to the sports after standard rehabilitation. Now they are relieved of their symptoms.<BR>There are few reports of cartilage injury of humeral head because the diagnosis is difficult without arthroscopy. These two lesions are located in the posterior portion of humeral head, which is different from typical Hill-Sachs lesions. There are cartilage lesions in anterior glenoid in both cases, which may induce the symptoms such as subluxation or click in abducted-external rotated position. These cases reveal that cartilage injury of humeral head is not rare in high-energy injury, especially in collision sports.
- 著者
- 設楽 仁 高岸 憲二 下山 大輔 石綿 翔 高澤 英嗣 一ノ瀬 剛 山本 敦史 小林 勉
- 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.755-759, 2013
<B>Background:</B> There are many studies about the relationship between brain functional changes and chronic pain such as CRPS, fibromyalgia, osteoarthritis of the knee and chronic back pain.<BR>However there is no study about the relationship between brain functional changes and shoulder disease. The purpose of this study is to clarify the brain functional changes regarding to shoulder pain using functional magnetic resonance image (fMRI) in rotator cuff tear (RCT) patients.<BR><B>Methods:</B> Nine healthy volunteers and 9 RCT patients participated in this study. Brain activation was examined by fMRI technique (3 Tesra-MRI). We applied an active shoulder motion task and a motor imagery task during fMRI.<BR><B>Results:</B> In the active shoulder motion task, there was significant activation in the right premotor cortex, right primary somatosensory cortex, right superior parietal lobule, bilateral prefrontal cortices, right intraparietal sulcus, anterior cingulate cortex, left lingual gyrus and left cerebellum in RCT group compared to normal group.<BR>In the motor imagery task, there were brain activities in the left prefrontal cortex and supplementary motor area which was related to the pain matrix despite the absence of feeling pain in RCT group compared to normal group. <BR><B>Conclusion:</B> The current study reveals that RCT can cause reorganization of the central nervous system, suggesting that such an injury might be regarded as a neurophysiologic dysfunction, not a simple peripheral musculoskeletal injury. This study is the first evidence that the pain with RCT is related to the brain functional change.
1 0 0 0 OA 子供の投球動作の特徴
- 著者
- 中溝 寛之 橋本 淳 中村 真里 金谷 整亮 信原 克哉 中村 康雄
- 出版者
- 日本肩関節学会
- 雑誌
- 肩関節 (ISSN:09104461)
- 巻号頁・発行日
- vol.28, no.2, pp.355-358, 2004-08-30 (Released:2012-11-20)
- 参考文献数
- 5
- 被引用文献数
- 1
The purpose of this study was to investigate the characteristics of baseball pitching motion in young pitchers. Sixty-five asymptomatic pitchers were analyzed with a motion capture system. The subjects were classified into two groups according to their age: A: 34cases (10-15 years old), B: 3lcases (19-34 years old). Kinematic and kinetic parameters were used to compare the differences between the two groups. Abduction and horizontal adduction angles of the upper arm were smaller in group A at ball release. The trunk was less flexed and twisted, but was bent much more toward the non-throwing side in the group A. There were no significant differences between the two groups with regard to the elbow angles, the wrist angles and the interval from arm-cocking phase to ball release. Our results showed that the young pitchers tend to put their pitch arm behind their trunk at ball release. That position is not close to “Zero Position”. It causes stretching the anterior structure of the shoulder. Furthermore, the shoulder is overloaded by the rotational stress from the end of armcocking phase to ball release. Repetition of this stress might cause epiphyseal damage for young pitchers. The young pitchers should be taught proper pitching mechanics. Limitation on pitches might be able to reduce the risk of epiphyseal damage in young pitchers.