著者

夏 恒治 望月 由 平松 武 柏木 健児 安達 長夫 菊川 和彦 白川 泰山 大前 博路 横矢 晋 奥平 信義

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.3, pp.453-457, 2004-08-30 (Released:2012-11-20)

参考文献数

14

被引用文献数

1

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CT-osteoabsorptiometry gave us the information about the distribution of mineralization of subchondral bone plate (DMSB). DMSB reflected the stress distribution of joint surface. We analyzed the stress distribution of glenoid cavities in throwing injures of the shoulder by CT-osteoabsorptiometry. Twenty eight patients with throwing injuries of the shoulder,24 patients with other shoulder disorders, and 4 healthy volunteers without any shoulder disorders were evaluated in this study. Group T included 28 affected shoulders of patients with throwing injuries of the shoulder. Group C included 60 non-affected shoulders of all subjects. Three dimensionally reconstructed computed tomograms (3D-CT) and DMSB of the glenoid cavities were filmed before the series of treatment. The glenoid cavity was divided into 7 areas; anterior-superior, anterior, anteriorinferior, posterior-inferior, posterior, posterior-superior and center area. The value of each area was classified into 4 grades. In group C, the mean value of the anterior-superior areas was significantly higher than those of the other areas. Meanwhile in group T, the highest mean value was that of the anterior-superior area. However, the mean values of anterior, posterior, and posterior-inferior areas were significantly higher than those of group C. The form of glenoid cavity in group T evaluated by 3D-CT showed the posterior and posterior-inferior enlargement of the glenoid cavity, which could be interpreted as a Bennett's lesion. Our results supported the hypothesis that a Bennett's lesion would be a reactive bone growth against stress onto the glenoid cavity.

著者

当真 孝 山口 浩 森山 朝裕 金谷 文則

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.42, no.2, pp.526-528, 2018

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我々は広範囲腱板断裂に対し,初期固定力が高く,縫合糸による腱内応力の集中が少ないと報告されているSurface-holding法を用いて手術を行ってきた.今回,一次修復が可能であった術後成績を報告する.対象は広範囲腱板断裂に対して直視下Surface-holding法を用い一次修復術を施行した56例56肩中,1年以上経過観察可能であった50例50肩を対象とした.性別は男性38肩,女性12肩.平均年齢65歳,経過観察期間26カ月.調査項目はJOA スコア,自動屈曲,外旋,内旋(JOA スコアを用いて点数化),Sugaya分類を使用した術後腱板修復状態(type4,5を再断裂)とした.JOAスコアは術前平均57点が術後89点,屈曲は術前平均91°が術後143°,外旋では術前平均39°が52°,内旋は術前平均3.7点が4.9点へ有意差をもって改善を認めた.Sugaya分類typeⅣが3肩,typeⅤが0肩で,再断裂は3肩(6%)であった.Surface-holding法は,再断裂率の低い有用な術式と考えられた.

著者

橋内 智尚 櫻井 悟良 尾崎 二郎 今田 光一

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.25, no.3, pp.415-418, 2001-09-05 (Released:2012-11-20)

参考文献数

11

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The purpose of this study is to investigate the pathogenesis and treatment of shoulder pain in hemiplegia.60 shoulders in 60 patients were available and separated into three types on the bases of pain (no or slight, mild, severe). The duration of the hemiplegia, tenderness points, range of motion, manual muscle testing, sensory deficit, edema and the X-ray findings were statistically analyzed. The subacromial bursae of 31 shoulders in 60 patients were injected (A group: 9 shoulders, xylocaine and dexamethazone / B group: 22 shoulders, sodium hyaluronate). Then 4 shoulders were operated on using the one portal arthroscopy. The tenderness points of the C-A arch and around the C-A arch increased with the pain. The improvement rates of pain were 61.7% in A group and 59.1% in B group. A decrease in pain was noted in all of the patients who had been operated on with the one portal arthroscopy. Pain of the shoulder in hemiplegia may be attributable to the C-A arch. Attention to the C-A arch may be of importance.

著者

林田 賢治 米田 稔 岡村 健司 広岡 淳 脇谷 滋之 妻木 範行

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.17, no.2, pp.315-319, 1993-09-01 (Released:2012-11-20)

参考文献数

8

被引用文献数

1

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To decide the appropriate treatment for articular-side partial rotator cuff tears (APRCT),31patients with arthroscopically documented APRCT were surgically treated and reviewed retrospectively. The mean age at time of operation was 31 years old (13-62) and the mean post-operative follow-up period was 22.5 months (12-66). APRCT was classified into three groups according to the depth of the cuff tear, the superficial tear (S-tear), the intermediate tear (I-tear), and the deep tear (D-tear).8 patients with a S-tear were treated by arthroscopic debridement of the lesion (S-tear &debridement group).23 patients had an I-tear.16 of them had an arthroscopic debridement of the lesion (I-tear & debridement group) performed of time, and 7 of them were treated by open repair procedure (I-tear & repair group).3 patients with a D-tear were treated by open repair procedure (D-tear & repair group). Arthroscopic or open subacromial decompression were simulteneously performed in all of the cases. The functional results were graded by Constant's shoulder rating scale (1987) which consisted of the evaluation of pain, function, range of motion, and strength of abduction. Clinical results were evaluated by the ratio of the rating scale; the involved side / the healthy side (%). Statistic significances were calculated by Student's t-test.According to the ratio of total clinical evaluation, the S-tear & debridement group was 99.3 +2.9%, the I-tear & debridement group was 97.4 + 4.4%, the I-tear & repair group was 87.3 + 7.7%, and the D-tear & repair group was 87.5 + 14.0%. There were no significant differences between the S-tear & debridement group to 2 and the I-tear & repair group to 4, but there was a significant difference between the I-tear & debridement group to the I-tear & repair group (p <0.01). The results of the strength of abduction were the S-tear & debridement group was 93.6 + 11.4%, the I-tear & debridement group was 98.4 + 18.7%, the I-tear & repair group was 78.6 + 11.2%, and the D-tear & repair group was 97.6 + 4.1%. A significant difference was also seen between the I-tear &debridement group to the I-tear & repair group (p <0.01).In this follow-up study, two things were clarified. Firstly, the clinical outcome of an arthroscopic debridement for APRCT was not influenced by the depth of a lesion with less than half of a rotator cuff thickness. Secondly, the arthroscopic debridement for an intermediate type APRCT with subacromial decompression provided a more favorable clinical outcome than did the open repair technique.

著者

矢野 雄一郎 玉井 和哉 野原 裕 吉崎 邦夫 浜田 純一郎

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.32, no.2, pp.241-244, 2008 (Released:2008-08-30)

参考文献数

6

被引用文献数

1

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To clear whether healthy subjects elevate and lowered their dominant and non dominant shoulder joints in the same manner or not was significantly valuable to understand the pathology of shoulder diseases: rotator cuff tear; impingement syndrome; stiff shoulder; and loose shoulder. 20 young healthy participants (17 males and 3 females, average age 22.6 years old) participated in this study. They randomly elevated and lowered both shoulder joints in the scapular plane at three times and were recorded by 3 dimensional motion analyzer. We calculated the scapulohumeral rhythm in each 10° and analyzed the setting phase. There was statistically no significant difference in the scapulohumeral rhythm between the dominant and non dominant shoulders. Scapulohumeral rhythm was stable (3.5) from 60° in elevation to 50° in lowering, however, individual variation of scapulohumeral rhythm (more than 3.5) was identified except the previous shown angles. To elevate both shoulder joints in the same manner mean that we can compare both shoulders about the scapula motion and arm elevation in patients with shoulder disorders. The setting phase is defined as until 60° in elevation, and moreover, a similar phase as the setting phase with various scapular motion is recognized in the lowering motion.

著者

伊藤 博元 白井 康正 井伊 京一郎 横内 正直 石川 雅人 柴崎 徹 沢泉 卓哉

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.10, no.2, pp.195-197, 1986-07-28 (Released:2012-11-20)

参考文献数

7

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Methods of reduction of anterior dislocations of the shoulder have commonly used the Kocher or Hippocratic maneuvers.Many surgeons had prefered the Kocher leverage technique, but recently some authors have not recommended their use because of the possibility of increasing damage to the capsule, soft tissues and injuring the axillary vessels and the brachial plexus. While Milch recommended the forward elevation maneuvers for reduction of anterior dislocations of the shoulder as the simple and safe techniques.Twenty cases were performed with the forward elevation maneuver for the shoulder dislocation in our hospitals. The patients are placed in a supine position on the examining table, intravenous and intramuscular medication are not required. The patients are instructed to relax as much as possible while the maneuver is performed, the arm is very slowly and gently abducted untill 90 degrees.The horizontal adduction on the 90 degrees plane is applied to 90 degrees flextion position, forward flexion is continued untill reduction is carryed out. Nineteen of 20 cases were obtained complete reduction without assistants and anesthesia by this techniques, another one case was needed the muscle relaxant due to severe pain.

著者

吉松 俊紀 福島 一雅 元島 清香 斎藤 明義 龍 順之助 吉松 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.27, no.2, pp.387-390, 2003-08-20 (Released:2012-11-20)

参考文献数

7

被引用文献数

1

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This report showed that the analysis of the isokinetic strength test for throwing shoulder injuries could be used to determine the appropriate time for the patient to return to pitching. During the last six years, among two hundred sixtyfive players studied, one hundred fifty high school baseball players were found to be uninjured while one hundred fifteen players were found to be suffering from throwing shoulder injuries. The tests were carried out using a CybexR II Multi-Joint Dynamometer. The patients were seated with their shoulders abducted at 90 degrees and their elbows flexed at 90degrees. The shoulders were tested for their rotational strength. We observed an imbalance of isokinetic strength of the shoulder by noticing a difference between the internal and external rotational strengths. In addition, we examined the data of concentric isokinetic endurance strength that had not been reported previously. Returning to pitching was found to be highly possible when the patients corrected the imbalance of internal and external rotational strengths and their concentric isokinetic endurance strength was above 70% measured by the concentric endurance strength test. Correction of the imbalance of internal and external rotational strengths and the improvement of endurance strength were considered to be necessary to judge the appropriate time for returning to pitching.

著者

井手 淳二 山鹿 眞紀夫 北村 歳男 田上 学 前田 智 高木 克公 森澤 佳三

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.21, no.2, pp.311-314, 1997-06-25 (Released:2012-11-20)

参考文献数

7

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(Purpose)We Studied the diagnosis and surgical management of suprascapular nerve entrapment neuropathy in athletes.(Materials and methods)Eighteen patients with infraspinatus muscle atrophy were studied. Fourteen were men and 4 women. Their mean age was 27 (range 14 to 40) years. The diagnosis was confirmed by physical and electromyographic examinations. As an ancillary test, MRIs of the shoulder joint were obtained. Those patients with rotator cuff tear were excluded from this study.(Results)Electromyographic examinations showed an abnormality in 8 patients. Two of them had isolated paralysis of the infraspinatus muscle. We operated on 4 patients with suprascapular nerve entrapment. We performed a release of the superior scapular transverse ligament on 2 patients with paralysis of the supraspinatus and infraspinatus muscles, a shaving of the spinoglenoid notch on a patient with isolated paralysis of the infraspinatus muscle and removed the ganglion cyst in 1. All the patients had good results, however, they needed 1 or 2 years to recover from paralysis.(Conclusion)Early diagnosis and treatment are important for the management of suprascapular nerve entrapment neuropathy in athletes.

著者

岩堀 裕介 佐藤 啓二 花村 浩克

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.377-381, 2000-09-30 (Released:2012-11-20)

参考文献数

7

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The effect of the throwing form correction for a baseball shoulder was evaluated. Materials and methods: Forty-five baseball pitchers with throwing pain in their shoulders were examined. All were males aged 10 to 31 years (mean 17.4), with a duration of shoulder pain on throwing of 32 months in average (range 2 weeks to 11 years). The throwing motions were recorded by a digital video camera and were evaluated as to whether there were any problems in the throwing form. The throwing form was corrected and grade of pain relief and return to pitching was inquired into. Results: Forty-two of the 45 cases (93%) had one or more problems in their throwing form. Problems in the throwing arm in 35 cases (83%), in the trunk or lower extremities motion in 32 cases (76%) and in the opposite arm in 23 cases (55%) were observed.Remarkable or moderate pain relief in 28 cases (67%) and complete return to pitching in 21 cases (50%) were gained by throwing form correction. The outcomes were better in the younger cases and the cases with the shorter periods form the onset of the pain. Conclusion: The throwing form correction was effective for baseball shoulder, especially for the younger cases.

著者

呉屋 五十八 末永 直樹 大泉 尚美 吉岡 千佳 山根 慎太郎 谷口 昇 金谷 文則

出版者

日本肩関節学会

雑誌

肩関節

巻号頁・発行日

vol.41, no.3, pp.763-767, 2017

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2002年から2014年までの間に,一次修復不能な後上方腱板広範囲断裂に対し広背筋・大円筋移行術を行い2年以上経過観察可能であった25例25肩の術後成績を検討した.関節症変化がなく,骨頭を温存し移行術を行ったのは12例12肩(RCT群),関節症をともなうcuff tear arthropathyで小径骨頭を用いた人工骨頭置換術と移行術を行ったのは13例13肩(CTA群)であった.RCT群は平均年齢65.0歳,男性11例,女性1例,平均経過観察時間は38.3ヵ月であった.CTA群は平均年齢68.6歳,男性4例,女性9例,平均経過観察時間は52.9ヵ月であった.両群の術前と最終観察時のJOAスコアと肩関節可動域,外旋ラグサインの変化,合併症,さらにRCT群では術前と最終観察時のX線所見,術後のMRIによる再断裂の有無を調査した.<BR> JOAスコアはRCT群39.9点から77.7点,CTA群は40.6点から78.0点へ,屈曲はRCT群は49.6&deg;から141.3&deg;,CTA群は56.5&deg;から136.9&deg;へ,外旋はRCT群は15.4&deg;から33.3&deg;,CTA群は16.2&deg;から29.2&deg;へ有意に改善した.外旋ラグサインは術後全例で消失していた.合併症は認めなかった.RCT群で4肩(33.3%)に術後の肩甲上腕関節症の進行を認め,4肩(33.3%)に骨頭上方化の進行を認めた.再断裂は認めなかった.両群でJOAスコア,外旋ラグサインを含め可動域の改善を認めており,広背筋・大円筋移行術は一次修復不能な後上方腱板断裂に対する有用な手技であると考えられた.

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

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.27, no.3, pp.545-548, 2003-10-30 (Released:2012-11-20)

参考文献数

10

被引用文献数

2

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We sought to evaluate our current method of surgical treatment of the recurrent anterior dislocation and subluxation in JSDF personnel. Twenty-three shoulders in twenty-one personnel were evaluated. All were males with an average age of twenty four point seven years old (range nineteen to thirty-three) at the time of surgery. The average time of follow-up was four years and one month (range two to six years and four months). The evaluations of clinical results were by: 1. Rowe' s shoulder score,2. Range of motion,3. Re-dislocation ratio,4. Satisfaction rating,5. Return to pre-morbid activities,6. Complications.Twenty-two of twenty-three shoulders had good to excellent results when rated by the Rowe's scoring method. Redislocation ratio was 0 %, re-subluxation ratio was 4%. The average range of motion was diminished to seven degrees when compared to the normal unaffected side. Almost all of the twenty-one patients were satisfied with the treatment. Four failed to return to their pre-injury activities because two feared a re-dislocation and two were not in their pre-injury circumstances. The physical demands of the JSDF pesonnel are strenuous and demanding. JSDF personnel with dislocated shoulder require careful and precise repair to stabilize the shoulder to return as soon as possible to the force and as many as their pre-injury activities. The symptoms of recurrent dislocation or subluxation were enough to keep some individuals from returning to their full pre-injury functions. Confidence and stability are the keys to successful repair and return. If these findings are not there, JSDF personnel must be directed into less strenuous activities.

著者

尾崎 二郎 仲川 喜之 増原 建二

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.12, no.2, pp.211-213, 1988-08-10 (Released:2012-11-20)

参考文献数

6

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Twelve cases with isolated tear of the subscapularis tendon were observed during 250reconstructive procedures on the rotator cuff. The patients' age was 51.6 years on average. All of the patients had a definite history of trauma to an affected shoulder and persistent pain in the anterior shoulder part, combined with the inability to evevate the extremity. Arthrography was performed on all, and revealed that the dye had extravasated into the subacromial bursa, however, the supraspinatus tendon was intact on the external rotation view. Operative findings revealed that an isolated rupture of the subscapularis tendon was confirmed in all. In 10 cases with rupture of the supero-medial part of the subscapularis tendon, medial dislocation of the bicipital long tendon was observed. Therefore, the authors conclude that the supero-medial part of the subscapularis tendon, including the medial bundle of the coracohumeral ligament, is the most important portion which keeps the bicipital long tendon aligned with the sulcus, and that during reconstructive procedures on the shoulder capsule, these changes should be carefully looked for and evaluated.

著者

下川 寛一 伊藤 仁

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.30, no.2, pp.281-284, 2006-06-30 (Released:2012-11-20)

参考文献数

15

被引用文献数

1 14

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The purpose of this study was to clarify the clinical outcomes and problems of arthroscopic rotator cuff repair (ARCR) in patients 65-years of age and older. We evaluated the clinical results and repair integrity using MRI in 42 patients with ARCR (18 men and 24 women, mean age at the time of surgery 70.3 years old). Preoperatively and at the time of follow-up (at a mean of 19.1 months), the patients were assessed with Japanese Orthopaedic Association (JOA) shoulder scores. Subjective symptoms and JOA shoulder scores of all patients improved after surgery (p<0.0001). The average postoperative JOA shoulder score at 12 months after surgery improved to 96.5 (vs.51.5 preoperatively) points. An average postoperative abduction range improved to 170°(preoperatively 94° ), and external rotation improved to 61° (preoperatively 20° ). Postoperative complications including CRPS, shoulder stiffness and anchor failure were not seen in this series. No differences were observed in clinical outcomes compared with 24 shoulders in patients 65-years of age and younger. MRI examinations 6months postoperatively showed high intensity in the repaired cuff in 9 of 18 shoulders that had had large and massive tears, whereas small and medium tears presented good repair integrity in 88% (21 of 24 shoulders).

著者

橋口 宏 江川 慶長 伊藤 博元

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.30, no.3, pp.485-488, 2006-08-18 (Released:2012-11-20)

参考文献数

5

被引用文献数

3

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The purpose of this study was to analyze factors that influence the outcome of nonsurgical treatment for partial-thickness rotator cuff tears (PTRCTs). Sixty-one patients with PTRCT included 34 women and 27 men with a mean age of 55.7 years old were evaluated.43 patients had a history of trauma such as a fall or traffic accident. The types of PTRCT were revealed by MRI. A bursal-sided tear of the cuff was observed in 32patients, a joint-sided tear in 20 and an intratendinous tear in 9. All the patients were treated nonsurgically for a mean duration of 5.7 months. Satisfactory results were achieved in 28 patients.33 patients with unsatisfactory results eventually required surgery. Factors of the 33 nonresponsive patients to the 28 responsive patients to treatment were compared. The factors were as follows; characteristics of the patients, range and strength of the shoulder motion, and radiographic factors, such as size of the subacromial spur and acromial morphology. All data were statistically evaluated using a logistic analysis. The significance level was set at P < 0.05, and odds ratios were figured. Identified factors that had a significant difference between the two groups were age, size of the subacromial spur, bursal side tear, and range of forward elevation (FE) and external rotation (ER). Positive correlation was demonstrated in age and range of the motions, and negative correlation in size of the spur. Each ratio of age, size of the spur, bursal. side tear, FE and ER was 3.33, 2.55, 33.33, 1.1 and 1.11respectively. This study suggested that the younger the age, a bursal-sided tear, a large subacromial spur and motion restriction of the shoulder are factors that induce a poor outcome of nonsurgical treatment for PTRCTs.

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

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.