著者

山口 久美子 加藤 敦夫 秋田 恵一 望月 智之

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.34, no.3, pp.587-589, 2010-08-04

参考文献数

4

被引用文献数

1

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Coracohumeral ligament (CHL) is situated in the gap between the supraspinatus and the subscapuralis. There are only a few studies concerning the CHL after Clark and Harryman II (1992) in spite of the important role that fills the rotator interval. In this study, we dissected six shoulders of three cadavers to observe the spatial distribution of the CHL in detail. Four shoulders of two cadavers were processed to analyze the attachment of the rotator cuff and the capsule histologically. For the histological analyses, whole parts of the CHL were removed emblock, and serial sections were made from proximal to distal. In gross anatomy, the CHL attached to the proximal lateral surface of the coracoid process in its most proximal part. It filled the rotator interval between the supraspinatus and the subscapularis. Most distal part of the CHL extended to both the superior and inferior surfaces of supraspinatus, and both the anterior and posterior surfaces of subscapularis. In the rotator interval, CHL connected to the superior glenohumeral ligament (SGHL). There was no clear border between the CHL and the SGHL in either gross anatomy or histologically. Histologically, the CHL contained only fine loose slack collagen fibers without any dense fiber that is normally observed in a ligament. With flexion and the extension, the CHL were stretched to pull the rotator interval. From these observations, the CHL seems to work with the SGHL for the stability of the long head of the biceps during shoulder movement.

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

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.

著者

酒井 清司 阿部 由美子 金森 昌彦 黒田 重史

出版者

Japan Shoulder Society

雑誌

肩関節 = Shoulder joint (ISSN:09104461)

巻号頁・発行日

vol.23, no.2, pp.277-279, 1999-07-30

参考文献数

3

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Our objective was to elucidate the effective factors for atrophic changes of a torn supraspinatus muscle quantatively.<BR>Patients and Methods. We analyzed the data of 100 patients with shoulder pain and examined their MRIs due to shoulder pain; the clinical features and the measured data from the MRI; the severity of the cuff tear, the area of the supraspinatus muscle sectioned oblique sagittally at the articular edge of the glenoid (S). To revise the physique differences, the maximum transverse diameter of the humeral head (D) was also measured. The severity of the cuff tears were divided into 6 grades; no tear (grade 0), partial thickness tear (grade 1), small tear (grade 2), medium tear (grade 3), large tear (grade 4), massive tear (grade 5). A stepwise regression analysis was used for the detection of the effective factors.<BR>Results.1) 67 cases had no-cuff tear and 33 cases had a cuff tear.2) In the no-cuff tear group, the sectioned area of the supraspinatus muscle (S) simply correlated with the maximum transverse diameter of the humeral head (D) no relation with sex or the side, hence the S/D was used as the revised marker of the sectioned area of the supraspinatus muscle. The stepwise regression analysis resulted in S/D=550.9-2.5x(age) in the no-cuff tear group (P<0.01).3) In the cuff tear group, stepwise regression analysis resulted in S/D=705.0-53.3x(cuff tear grade)-4.5x(age) (P<0.01).<BR>Conclusion. Deterioration of the rotator cuff tear may be a more of a causative factor for atrophic changes of the supraspinatus muscle than aging.

著者

前田 朗 成田 陽二郎 米田 稔 広岡 淳

出版者

Japan Shoulder Society

雑誌

肩関節 = Shoulder joint (ISSN:09104461)

巻号頁・発行日

vol.23, no.2, pp.349-352, 1999-07-30

参考文献数

10

被引用文献数

1

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The purpose of this study was to know the time-course from primary shoulder dislocation to recurrence in young rugby players. We sent questionnaire about shoulder dislocation to all highschool/college rugby teams in the Kyushu area (No. of players; 5476). Based on the answers from the players who had undergone shoulder dislocations, we divided them into two groups; Group I: immobilization for 0-3 weeks at the time of initial dislocation(n=61), and Group II: immobilization for 4-7weeks (n=18). We compared the time-course from primary dislocation to recurrence between the two groups using the Kaplan-Meier method. The age of primary dislocation was between 14 and 23 years old ( ave.; 16.7 ). The probability of recurrence was 78%,44%, and 70% after one year; 85%,69%, and 81% after two years in Groups I, II, and the whole groups respectively. The average period from restart of rugby to recrurrence was 9.8,30.6, and 19.7 months in Groups I, II, and the whole groups respectively. The symptom-free period could be elongated if immobilization was done for 4 weeks or more in comparison with cases immobilized for 3 weeks or less (p<0.05). However, the high recurrence ratio showed limitations of immobilization therapy for primary shoulder dislocations of rugby players.

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

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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 &beta; (IL-1 &beta;), IL-6, matrix metalloproteinase-1 (MMP-1), MMP-3. Immunohistochemical localization with antibodies to proliferative cell nuclear antigen (PCNA), IL-1 &beta;, IL-6 and MMP-3 was performed using the ABC immunoperoxidase method. Concentrations of IL-1 &beta; were 4.8&plusmn;4.3 pg/ml, IL-6 485&plusmn;4.3 pg/ml, MMP-1 417&plusmn;330 ng/ml, MMP-3 6105&plusmn;4258 ng/ml. A few nuclei were stained by PCNA but no cell by IL-1 &beta;, IL-6, or MMP-3 in the control tissues. IL-1 &beta; 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 &beta; 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.

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

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Swimming is generally accepted as a sport with minimal physical injuries. However, swimmers frequently complain of shoulder pain, termed &rdquo;swimmer's shoulder&rdquo;, 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 &rdquo;swimmer's shoulder&rdquo;, 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.

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