著者

村上 元庸 牧川 方昭 前野 幹幸 畑 正樹 七川 歓次

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.22-24, 1986-07-28 (Released:2012-11-20)

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When abducting the arm, the scapula and the humerus move cooperatively. This cooperation is known as “scapulohumeral rhythm”, and a constant relationship is said to exist between the abduction angle of the humerus and that of the scapula.But since the glenoid is too small to support the humeral head, it may happen that the humeral head will be dislocated or the soft tissue, like tendons or capsule, will be exposed to a excessive load, if the resultant force through the humeral head does not directly face to the glenoid. So we guess that a change of the resultant force which is consist of load and muscle power to the humerus may change the incline of the glenoid even at the same humeral abducting angle.In this study, we investigated the relationship between the glenoid inclination angle and the humeral abduction angle with or without block of the supraspinatus muscle power by the suprascapular nerve block.The subjects of this experiment was 5 healthy men, and the angle was measured by X-ray films which were taken at every 45 degrees abduction position with voluntary effort to abduct isometrically before and after the nerve block, and also the abduction torque was measured simultaneously by the Cybex- II.The result was that the inclination angle of the scapula was decreased after block, as the maximum defference at 90 degree abduction by 6 degree. And the torque was decreased by the mean of 25 %.From our hypothesis that the resultant force faces the glenoid perpendicularly, these results could be explained by the functional anatomy of the supraspinatus tendon. At 0 and 135 degree abduction the supraspinatus runs perpendicularly to the glenoid, so the resultant force does not change the direction after block. But at 90 degree abduction the position of the insertion of the supraspinatus is the highest of all abduction angle, so it acts to pull down the head. The resultant that force after block changes the direction upward, and so the glenoid inclination angle decreases to face the head.From these results, we guess a resultant force to the humeral head always faces to the glenoid by controlled constraction of the muscles around the shoulder.

著者

柴田 陽三 竹下 満 高岸 直人

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.10, no.1, pp.36-40, 1986-07-28 (Released:2012-11-20)

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Intra-articular pressure (1-A pressure) of the gleno-humeral joint (G-H Joint) was measured in order to elucidate the mechanism of shoulder joint. (Material and Method)Ten normal subjects were measured. Fluidfilled teflon tube, with two small perforations around tip, was inserted into the axillary pouch from anterior aspect of the shoulder joint. The end of tube was connected to a pressure transducer. Intra-articular pressure was measured during movement of the shoulder joint when subjects were sitting position.(Result) When none of saline was injected into the gleno-humeral joint, there was almost no change of intar-articular pressure. But, when 10 ml and 20 ml of saline were injected into G-H joint, I-A pressure rose at shoulder elevation. I-A pressure with 20 ml of saline was higher and rose more steeply at the same elevated position. It was demonstrated that 1-A pressure was highest at full elevation. The relationship of I-A pressure and joint position before and after full elevation demonstrated that the pressures were lower than for the same joint position before full elevation.There were peak pressures at the full internal rotated position and the full externa l rotated position, but latter was higher than the former. The lowest value of I-A pressure was showed at the slightly flexed, abducted and internal rotated position.And further measurements were done in the disease joints.

著者

菅原 誠 荻野 利彦 三浪 明男 福田 公孝 中里 哲夫

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.10, no.1, pp.68-71, 1986

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Shoulder pain is the most common problem in sports which require throwing motion. The causes of shoulder pain are resulted to tendinitis, bursitis, recurrent anterior dislocation and impingement syndrome in many cases. During a 15-Year period, from 1960 through 1985, we encounterd 8 patients with axillary nerve palsy according to throwing motion. The average age of these patients was 17years (range 13 to 20 years). All were students participating in a sports (Baseball: 2, Volleyball: 2, Table tennis: 1, Basketball: 1, Tennis: 1, Badminton: 1). Symptoms began with onset of pain and paresthesia around the shoulder without trauma in all patients. The point tenderness was always found posterioly in the quadrilateral space. Many patients had a normal range of motion of the shoulder. Sensory disturbance of the axillary innervated area and motorloss of deltoid muscle was minimun in all patients. Length of free from shoulder pain ranged from 2 weeks to 6 months with an average length of 2.7 months. Electromyographies were performed on five patients. The deltoid was observed for reduced interference patterns and polyphasic potentials. The surface electromyograms during throwing motion were recorded from the muscles around the shoulder. The contraction of teres major and the long head of the triceps was observed during acceleration to the beginning of follow through phase. We suspected the causes of axillary nerve palsy according to throwing motion were considered following: the shoulder in abduction, extention, external rotation during wind up phase causes stretching and entrapment of axillary nerve in quadrilateral space and in abduction, flexion, internal rotation during acceleration phase causes further entrapment by contraction of teres major and the long head of the triceps. This report indicate that a player who require throwing motion could sustain a injury to axillary nerve and this injury is not so rare and has been neglected.

著者

村上 元庸 小島 保二 前田 敏博 牧川方 昭 福田 眞輔 畑 正樹 吉川 玄逸

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.16, no.1, pp.96-102, 1992

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An ultrastructural study of the sensory nerve endings in monkeys' shoulder joints was undertaken, stained by Tago's method, which is the histochemical staining of acetylcholinesterase.<BR>The Pacini-type corpuscle is oval in shape and it consists of inner and o uter cores. At the center of the inner core, there is an unmyelinated axon terminal. The axon terminal has numerous mitocondoria. The lamellated inner core is composed of Schwann cell processes. Reaction products are found in the space between the axon terminal and the lamellar cell processes, in the interlamellar spaces and in some caveolae.<BR>In the Ruffini-typ e corpuscle, the axon terminal loses its mylin sheath and branches several times. The axon terminals are incompletely surrounded by a Schwann cell cytoplasm. The axon terminal has numerous mitochondoria and agranular vesicles. The Schwann cell cytoplasm surrounds a bundle of collagen fibrils. The reaction products are found between the axon terminal and the Schwann cell cytoplasm, and also around the Schwann cell cytoplasm.<BR>From their characteristic structure, it seems that the Pac i n i-type corpuscles respond to a pressure force from the humeral head. While the Ruffini-type corpuscles respond to a stretch force. The latter were thought to have a more important role as sensors of a dynamic stabilizing system.

著者

三浦 清司 黒川 正夫 鎌田 圭司 荒井 義之 高井 信朗 玉井 和夫 平澤 泰介

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.18, no.1, pp.54-59, 1994

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Accessory nerve pasly and long thoracic nerve palsy are common causes of a winged scapula. This study was designed to examine the three-dimensional movement of the scapula in them.<br>Six accessory nerve palsy patients and five long thoracic nerve palsy patients were examined.<br>The active arm elevation was allowed in both the sagittal and scapular planes. Eight points were determined as marking points of the spine, the sternum, the clavicle, the scapula and the humerus which were identified every thirty degrees. These were recorded on three VCRs. A threedimensional analysis system (ARIEL^TM) was employed. The affected and unaffected sides were measured before and after therapy, when possible.<br>In patients with accessory nerve palsy, the scapula (glenoid cavity) rotated downward (the downward rotation) in the early phase of arm elevation in the scapular plane. At the same time, the subscapular fossa tilted upward (the upward tilt) and the subscapular fossa tilted medially. In patients with long thoracic nerve palsy, on the other hand, the downward rotation and the upward tilt of the scapula were marked by a forward flexion. When the paralysis was restored, the scapular movement changed to a similar pattern to that of the unaffected side. This method is useful for the quantitative evaluation of the abnormality and the improvement of accessory nerve palsy and long thoracic nerve palsy.

著者

原 寛徳 伊藤 信之 岩崎 勝郎

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.18, no.1, pp.82-87, 1994

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<Purpose> The purpose of this study was to investigate the strength of the glenoid labrum and capsule.<br><Materials and method> 15 shoulders of fresh cadavers were used for this study.6 of them were the right side and the rest of the 9 were the left side. Their ages ranged from fifty-five to eightyeight years. There were 6 males and 3 females. We determined the anterior, inferior and posterior portion of the labrum and capsule as the 3,6 and 9 o'clock position, respectively. The labrum and capsle were cut in 5mm width pieces. After fixing the glenoid, each respective piece of labrum and capsule was strained. We measured the applied force which detached the labrum from the glenoid.<br><Results> The 4 o'clock position was comparatively weaker than any other position, irrespective of the age or sex of the cadaver.<br><Conclusion> We conclude that the anterior-inferior portion of the glenoid is weaker than any other portion.

著者

三森 甲宇 中川 照彦 古屋 光太郎 信原 克哉

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.18, no.2, pp.313-317, 1994

被引用文献数

2

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(Purpose) Voluntary dislocation of the tendon of the long head of the biceps is extremely rare. Here we will report on this dislocation in one patient.<br>(Patient) The Patient, a 37-year-old male fell down with his arm extended. Since then, he had a click and pain of the shoulder when he elevated his arm. When he had contracted his biceps with his arm extended and internally rotated, the tendon of the long head of the biceps dislocated from the bicipital groove. By elevating the arm 135 degrees from that position, the tendon reposited with a click and pain. Arthrography showed a dislocation of the tendon of the long head of the biceps. Arthroscopy and a tenodesis of the biceps tendon were performed.<br>(Conclusion) When observing the shoulder joint of a cadaver, the insertion of the subscapularis tendon was separated into two layers. One was a superficial layer, the other a deep one. Some parts of the superficial layer formed the transverse ligament. So we believe that the tendon of the long head of the biceps is often dislocated accompanying with a tear of the subscapularis tendon.

著者

土肥 潤二 村上 元庸 吉川 玄逸 福田 眞輔

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.19, no.1, pp.108-111, 1995-05-20 (Released:2012-11-20)

参考文献数

8

被引用文献数

1

著者

筒井 廣明 管 直樹 山口 光國 山本 龍二 三原 研一 保刈 成 上里 元 鈴木 一秀 大島 和 内川 友義

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.19, no.2, pp.310-316, 1995

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Purpose<br>The purpose of this study is to recognize the effect of exercise for cuff muscles using EMG.<br>Materials and Methods<br>5 healthy young men, aged from 17 to 29 yrs., were examined. The "resisted external rotation"exercise for the infraspinatus muscle was estimated. The Cuff-Y exercise with a yellow Thera-Band and F. W. Jobe's strengthening exercise with a 1.5kg weight were compared. During the exercises, the infraspinatus, the supraspinatus, the deltoid, and the middle fiber of the trapezius were examined with EMG. The EMG was recorded continuously from the beginning for 5 minutes.<br>Results<br>The exercise withe the yellow Thera-Band could dominate the activity of the infraspinatus muscle compared to other muscles. As for the exercises with a 1.5kg weight, it was difficult to keep the activity of the infraspinatus advantageous and the 5 volunteers demonstrated five different patterns of muscle activity. Furthermore, the relative activity of the infraspinatus gradually decreased with time.<br>Conclusion<br>Exercises for cuff muscles should be carried out to keep the dominant activity of the targeted muscle compared to other muscles. The setting of the load and time limit both failed and the purpose of the exercise could not be attained.

著者

井口 理 Olsen B. S. Vaesel M. T. Johannsen H. V. Søjbjerg J. O.

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.20, no.1, pp.87-90, 1996

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The intraarticular pressures of the glenohumeral joint were measured in 15 cadaveric shoulders during passive movement of the humerus and under various inferior loads on the humerus. Using the fiber-optic transducertipped catheter and air-tight connector, the basic intraarticular pressure was measured directly without the injection of any physiological saline solution the joint prior to the measurement. The initial intraarticular pressures were all negative with a mean value of -67.8 mmHg. During abduction-adduction movement the minimal intraarticular pressure was measured at 20 degrees of humeral abduction. During rotation, the minimal intraarticular pressure was observed at neutral humeral rotation. The intraarticular pressure decreased nearly linearly with the increasing inferior load on the humerus. These results indicate that the intraarticular pressure takes part in the stabilization of the glenohumeral joint and the negative intraarticular pressure of the glenohumeral joint induces the maximal stabilizing effect at 20 degrees of humeral abduction and neutral humeral rotation.

著者

山口 光國 筒井 廣明 山本 龍二 三原 研一 保刈 成 鈴木 一秀 上里 元 大島 和 内川 友義 菅 直樹 牧内 大輔

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.2, pp.325-328, 1996-11-30 (Released:2012-11-20)

参考文献数

4

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PurposeWe investigated the muscle strength of the scapulothoracie joint which is apt to be affected by the position of other joints.

著者

筒井 廣明 山口 光國 山本 龍二 三原 研一 保刈 成 鈴木 一秀 上里 元 大島 和 内川 友義 菅 直樹 牧内 大輔

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.2, pp.337-340, 1996-11-30 (Released:2012-11-20)

参考文献数

6

被引用文献数

1

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[Purpose]Cuff exercises are usually performed to improve the shoulder function and to keep the condition of the shoulder of throwing athletes. Thus, there are a large number of athletes who could not acquire the expected effects of the exercises. In this study, we examined the estimation of the cuff function and the daily exercises of the athletes electromyographically.

著者

中川 泰彰 松末 吉隆 中村 孝志

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.22, no.2, pp.161-164, 1998

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Purpose: We have previously reported that shoulder pain was the fourth, and disability was the second problem for sumo* wrestlers. We examined sumo wrestlers directly in order to study the shoulder problems in sumo.<BR>Materials and Methosds: Forty-three major league Western Japan Student Sumo Federation sumo wrestlers were examined from February to April 1997. Their means were as follows: height-174.4cm,ght-106.2kg, body mass index-34.9, age -19.3 years old and length of sumo career- 9.5 years. We obtained their past histories, present disabilities, physical examination, ranges of motion and shoulder joint laxities. Results Twenty-two cases (51%) had past histories of the shoulder problems, which were 10 cases (23%) of shoulder dislocations,5 cases (12%) of contusions,4 cases ( 9 %) of acromioclavicular dislocations and so on. Seven cases (16%) had present disabilites, which were 2cases of shoulder dislocations,2 cases of acromioclavicular joint dislocations and so on. According to this study, the less heavy sumo wrestlers tended to injure and dislocate their shoulders more, and the number who complained of shoulder problems increased, with the length of sumo careers. There were no significant influences seen between the ranges of motion, shoulder joint laxities and shoulder problems.<BR>Conclusion: The lighter sumo wrestlers tended to injure and dislocate their shoulders more. It interfered with the wrestling of sumo, who had previously dislocated their shoulder.

著者

鈴木 一秀 南 和延 筒井 廣明 三原 研一 保刈 成 上里 元 内川 友義 菅 直樹 大田 勝弘 牧内 大輔

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.23, no.3, pp.373-376, 1999

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[Purpose] The purpose of this study is to analyze the influence of the scapulothoracic joint on the rotator cuff function using integrated electromyography.<BR>[Materials and Methods] Ten shoulders of ten young males who were diagnosed as having dysfunction of scapulothoracic joint with &lceil;Scapula-45&rfloor; radiography and resisted abduction and external rotation test. The activities of the supraspinatus, infraspinatus, deltoid, and biceps were evaluated electromyographically with the loads at 45 degrees elevated position in the scapular plane. Subsequently the activity of these muscles was collected with a manual assist to the scapulothoracic function. The EMG activity was expressed as a percentage of the Max MMT (%MMT).<BR>[Results] The EMG activity increased with the load in all the cases. In 80% of the total cases, the relationship between the supraspinatus and deltoid did not change irrespective of the load (deltoid/supuraspinatus=1 /1.3) without manual assistance. The %MMT of the supraspinatus and deltoid of these cases showed a significant difference between the activity with and that without manual assistance. The tendency was remarkable at 3kg load. In 20% of the total cases, a dysfunction of rotator cuff was noted.<BR>[Conclusion] The results suggest the function of scapulothoracic joint has an effect on the rotator cuff function.

著者

乾 浩明 町田 明敏 橋本 淳 信原 克哉

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.25, no.3, pp.471-474, 2001

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This study examines the glenoid cavity using three-dimensional MRI. Forty volunteers were enrolled in the study. Three-dimensional scapular images were reconstructed using an open MRI and computer software. The tilting angles of the glenoid bone were measured in five consecutive axial planes perpendicular to the glenoidal long axis. Cross sections were divided into three types (concave, flat, and convex)according to the shape on each plane.<BR>The average tilting angles for the five planes from the bottom to the top were 3.3&plusmn;4.1,1.4&plusmn;3.8, -0.6&plusmn;1.9, -1.4&plusmn;3.3, -6.2&plusmn;3.3 degrees anteriorly, indicating that the three-dimensional bony structure of the glenoid was twisted anteriorly to posteriorly. Images on the bottom plane consisted of 82.5% concave type,15% flat type, and 2.5% convex type, while only 3 cases (7.5%) showed a concave shape in the top plane. The shape of the glenoid cavity is thought to be conducive for glenohumeral motion and stability.

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

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[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&deg; internal rotation, neutral,30&deg; external rotation with arm at side, and neutral,45&deg; external rotation,90&deg; external rotation with arm at 90&deg; 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&deg; external rotation with arm at 90&deg; 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.

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

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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

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

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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.

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

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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.

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