著者

松田 雅彦

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.34, no.2, pp.339-341, 2010

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The aim of this study is to clarify the natural course of Rockwood grade 3 acute acromioclavicular dislocation without medications.<BR>19 patients who had been diagnosed Rockwood grade 3 acute acromioclavicular dislocation at Yamagata Saisei Hospital from 1998 to 2007, and had also been followed without medications were investigated. They were all men, whose average age at injury was 32.4 years(range, 16 to 67 years). The mean follow-up period was 5.8 years(range, 2 to 9 years). We evaluated pain, limitation of motion, click, appearance, weakness, sensory disturbance, sport activity and satisfaction. The pain, limitation of motion and satisfaction were evaluated with visual analogue scale(VAS: range, 0 to 100). The average point of pain was 7.3(range, 0 to 23), ten cases were 0 points. The average point of limitation of motion was 12.4(range, 0 to 35), nine cases were 0 points. Click existed in 8 cases. Severe float were in seven cases, mild float were in 12 cases. Only one case had weakness, sensory disturbance and discomfort of throwing activity. The average satisfaction was 91.5(range, 84 to 100), seven cases were 100 points.<BR>The natural course of Rockwood grade 3 acute acromioclavicular dislocation without medications had a satisfactory outcome, except for appearance.

著者

橋本 瑛子 落合 信靖 佐々木 裕 山口 毅 木島 丈博 山崎 博範 松木 圭介

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.3, pp.779-783, 2014 (Released:2014-11-21)

参考文献数

14

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近年,肝臓等で報告があるIDEAL法は脂肪と水を分離して描出でき,定量評価可能なMRI撮像法である.本研究の目的は,IDEAL法,単純T2強調像,単純CT像からの腱板筋脂肪変性を比較し,大・広範囲腱板断裂の一次修復の可否を検討することである.IDEAL法を撮像した47例50肩を対象とした.IDEAL法では,斜位矢状断で各腱板筋にROIを設定し,In Phase,Fat Imageの信号値から脂肪を定量した.同撮像面で単純T2強調像,単純CT像から腱板筋脂肪変性の割合を算出した.IDEAL法と単純T2強調傍矢状断像から分類したGoutallier分類は解離し,単純T2強調像での脂肪変性評価はIDEAL法に比較し過小評価する傾向を認めた.また,大・広範囲腱板断裂の一次修復不能群ではIDEAL法での棘上筋実質部成分・棘下筋の脂肪含有率と単純T2強調像での棘下筋の脂肪含有率が有意に高値で,一次修復可否の判断材料となり得た.

著者

佐々木 毅志 山本 敦史 小林 勉 設楽 仁 一ノ瀬 剛 下山 大輔 濱野 哲敬 高岸 憲二 大澤 敏久

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.411-413, 2014 (Released:2014-10-01)

参考文献数

13

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夜間痛は肩関節疾患の特徴的な愁訴の一つであるが,その詳細については不明な点が多い.本研究の目的は肩関節疾患における夜間痛について調査を行い,その特徴と背景因子について検討することである.2011年4月1日から2013年3月31日の期間における当科肩外来初診患者232人を対象とした.男性121人,女性111人,平均年齢56.4歳であった.年齢,性別,診断名,罹患側,肩関節痛の症状,肩関節可動域,筋力,夜間痛の頻度,夜間痛の症状,理学所見との関連について調査を行った.対象の58.2%に夜間痛を認め,その64.4%は肩痛のためほとんど毎日夜間に覚醒し,93.3%は体位による疼痛の増減を認めた.夜間痛がある例はない例と比較すると年齢が高く,安静時痛が強い例が多かった.

著者

今井 智仁 尼子 雅敏 津田 悦史 杉本 憲一 岡村 健司 瀧内 敏朗

雑誌

肩関節 = Shoulder joint (ISSN:09104461)

巻号頁・発行日

vol.27, no.3, pp.545-548, 2003-05-01

被引用文献数

2

著者

水野 直子 米田 稔

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.497-501, 2007

被引用文献数

7

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Although arthroscopic techniques for anterior shoulder instability have generally yielded good results and decreased the morbidity, a recurrence has been the most serious postoperative complication. In 2005 we developed a new type of arthroscopic Bankart repair: the double anchor footprint fixation (DAFF) technique. It simulates a conventional open transosseous Bankart repair. The purpose of this study was to introduce this technique and evaluate the short-term surgical results. We investigated 45 shoulders (34 males and 11 females) which underwent a DAFF technique. The mean age at operation was 24.1 years old and the mean postoperative follow-up period was 13 months. DAFF technique was consisted of a trough preparation and double anchor footprint fixation in order to make a larger area of the footprint repair. The shoulders had their internal rotation immobilized for 3 weeks after the operation. We evaluated the postoperative range of motion, return to sports, recurrence and JSS shoulder instability score. Regarding the postoperative range of motion, elevation recovered early, but external rotation could not recover so early. More than 12 months after the operation, 23 patients completely returned to sports, 5 patients returned partially. There was no recurrence of a dislocation. The JSS-SIS improved from 52.9 preoperatively to 94.9 postoperatively. An arthroscopic Bankart repair with a DAFF technique could be performed successfully. We need a long-term follow-up and to study more about the time of starting ROM exercises.

著者

萩尾 友宣 柴田 陽三 篠田 毅 伊崎 輝晶

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.837-840, 2011 (Released:2011-12-21)

参考文献数

9

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Proprioception was studied in rotator cuff tear and normal shoulder using active angle reproduction test. Subjects and methods: In cuff tear group(RCT), 33 cases (33 shoulders) were studied. They were 19 males and 14 females, their average age was 66.4 years.The average active elevation angle was 112.4° and the average external rotation angle was 51.4°. As a control group (C), 20 cases (20 shoulders) who had not had previous injury or disease in their shoulder were studied. Average elevation angle was 160.3° and average external rotation angle was 61.9°. The subjects were studied sitting on a chair and had a bandage put over their eyes. They rotate or elevate their shoulder to any angle. The difference absolute values between average of 3 times of reproduction of the angle and the target angle were studied. The target angles were 30° of internal rotation, 30° and 45° external rotation, 30°, 45° and 60° of elevation. In 30° of IR, error angle revealed 7.0° in RCT and 2.6° in C group (P<0.01). These were 4.6° and 2.5°(P<0.01) in 30° of ER, 3.6° and 2.5°(P=0.15) in 45° of ER. These were 4.0° and 2.1° in 30° of elevation (P<0.05), 4.1° and 1.9° in 45° of elevation (P<0.01), 4.8° and 2.4° in 60° of elevation(P<0.01). Proprioception of rotator cuff tear was lower than that of normal shoulder.

著者

菊川 和彦 奥平 信義 糸谷 友志

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.35, no.2, pp.681-683, 2011

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We report a rare case of humeral avulsion of middle glenohumeral ligament. A 35-year-old male, who had a 10-year career of gymnastics felt an apprehension of subluxation in his left shoulder. By moving his shoulder forward, he felt a subluxation and at the end stage of flexion he felt a click and a dull pain. Tenderness of rotator interval, crank test and relocation test were all positive. MRI revealed MGHL injury or HAGL lesion. Arthroscopic examination revealed humeral avulsion of middle glenohumeral ligament. Repair of MGHL by suture anchor method was performed. Postoperatively, there was good relief of pain and apprehension of subluxation. MGHL injury was mostly of joint side avulsion, humeral avulsion of MGHL injury was very rare. Diagnosis of MGHL injury is difficult, but careful inquiry into medical history and clinical examination can lead to proper diagnosis.