著者

遠藤 和博 佐原 亮 小出 将志 五十嵐 絵美 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.40, no.2, pp.487-490, 2016 (Released:2016-10-07)

参考文献数

7

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肩疾患では関節可動域制限を有することが多く,上腕の回旋制限とも捉えられる.本研究の目的は,肩屈曲90度での上腕回旋角度を計測し,肩関節疾患別の可動域制限と上腕回旋制限の関係を調査することである.健常群10名20肩,症候性腱板断裂群(RCT群)9名10肩,凍結肩群(FS群)14名15肩を対象とした.肩屈曲90度の前腕回外,中間,回内位の3肢位で水平面を0度として各上腕回旋角度を計測した.前腕中間位での上腕回旋角度においてRCT群は健常群より14.4度有意に外旋していた.中間位と回外位間の上腕外旋角度は,健常群39.5±7.3度と比較しRCT群,FS群ともに有意に低下し,中間位と回内位間の内旋角度は健常群18.0±8.7度であり,FS群と有意差を認めた.RCT群は上腕が外旋方向にシフトし内旋可動域制限を生じ,FS群では上腕の内・外旋角度ともに制限が強いためすべての可動域制限が起こる.

著者

中野 幸雄 高田 直也 後藤 英之 松井 宣夫 藤森 修 山田 和順 杉本 勝正 大薮 直子

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.111-116, 1996-10-15 (Released:2012-11-20)

参考文献数

13

被引用文献数

1

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PurposeThe anatomical characteristics and nerve distribution in the coracohumeral ligament(C-Hligament)and surrounding tissue were studied. The role of the ligament in periarthritis of the shoulder was assessed.Materials and Methods Specimens were obtained from 30 cases,50 joints at autopsy. The cases consisted of 14 males and 16females; with an age range from 29 to 98 years(mean 78 years). The C-H ligament and its surrounding tissues were excised en bloc.Paraffin sections, vibratome sections and whole mount preparations were made and subjected to immunohistochemical staining using NF, PGP9.5, SP and CGRP antibodies in order to the distribution of sensory nerve fibers.

著者

藤井 幸治 兼松 義二

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.27, no.3, pp.549-553, 2003-10-30 (Released:2012-11-20)

参考文献数

8

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The purposes of this study were to investigate the non and delayed union of diaphyseal fractures of the clavicle and to identify the risk factors associated with such problems. Two hundred three diaphyseal fractures of the clavicle were treated at our clinic from August 1987 to August 2000. Type2A fractures of Robinson's classification were forty-three and type2B were one hundred sixty. We treated all fractures conservatively till August 1990, but most fractures with complete displacement surgically since September 1990. The patients and treatment factors for nonunion and delayed union were analyzed statistically. All patients of type2A fractures with bony contact healed uneventfully. Two patients of type2B fractures without bony contact developed nonunion and five delayed union which was defined as healing more than five months. Two patients of nonunion were treated conservatively. One patient was thirty-nine years old and male.Another patient was fifty-seven years old, female and suffered from chronic hepatitis. Both fractures were displaced more than 20 mm after reduction. Two of five patients with a delayed union were treated surgically. One was fortyseven years old, male with a re-refracture and the other was sixteen years old, male with a refracture. The other three patients with a delayed union were treated conservatively and displaced more than 20 mm. In addition, their ages were fifty years or more. Most studies concerning the risk factors for nonunion focused on displacement In this study, displacements more than 20 mm were associated with poor prognosis of union the same as in our former studies. Furthermore age and refracture were considered as risk factors of a delayed union.

著者

菊川 和彦 奥平 信義 住元 康彦

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.43, no.4, pp.928, 2019

著者

福島 秀晃 森原 徹 三浦 雄一郎 甲斐 義浩 幸田 仁志 古川 龍平 竹島 稔 木田 圭重

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.43, no.3, pp.776-780, 2019

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腱板広範囲断裂(Massive Rotator Cuff Tears: MRCT)における上肢自動挙上可能例と不能例の三角筋・肩甲帯周囲筋群の筋活動を比較検討した.対象は健常者12名12肩(健常群),MRCT36名を上肢自動挙上可能な21名25肩(挙上可能群)と挙上不能な15名16肩(挙上不能群)とした.被験筋は三角筋前部・中部・後部線維,僧帽筋上部・中部・下部線維,前鋸筋とした.測定課題は肩関節屈曲0&deg;,30&deg;位を各5秒間保持し,分析は0-30&deg;間のR-muscle値を算出した.<BR> 三角筋各線維のR-muscle値は,挙上可能群と挙上不能群間において有意差を認めなかった.僧帽筋上部線維のR-muscle値は,健常群と比較して挙上不能群で有意に高値を示した(p < 0.05).また僧帽筋中部線維のR-muscle値は,挙上可能群と比較して挙上不能群で有意に高値を示した(p < 0.01).<BR> MRCTにおける三角筋各線維の筋活動は,上肢自動挙上の可否に影響しないことが示された.一方,僧帽筋中部線維の筋活動特性がMRCTにおける上肢自動挙上の可否に影響する可能性が示された.

著者

山田 均志 永井 英 鈴木 一秀

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.43, no.3, pp.844-848, 2019

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小中学生の投球障害肩の身体特性と保存療法における治療成績を検討することを目的とした.投球側肩痛を主訴に受診し,復帰までの経過観察が可能であった小中学生の野球による投球障害肩15例(平均12.4才)を対象とした.検討項目は単純レ線像の異常の有無により上腕骨近位骨端線損傷無し群(Pain群)と上腕骨近位骨端線損傷群(LLS群)の2群に分類し,機能低下部位,LLS群の骨端線修復までの期間,投球禁止期間,復帰までの期間を比較検討した.機能低下部位について2群間では有意差を認めなかったが,柔軟性やバランス能力などの機能低下を両群ともに高率に認めた.投球禁止期間,復帰までの期間はLLS群では有意に長期間を要した.投球障害の治療は単なる投球禁止のみではなく,メカニカルストレスの軽減や投球フォーム改善へ向けた柔軟性の獲得や機能低下部位に対する運動療法を行うことが重要であると考える.

著者

松木 圭介 菅谷 啓之 前田 和彦 森石 丈二 望月 智之 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.213-215, 2007 (Released:2008-01-30)

参考文献数

6

被引用文献数

14

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The purpose of this study was to examine the anatomy of the infraspinatus including the orientation of muscle fibers and the insertion to the greater tuberosity. Ninety-three shoulders from 52 cadavers were minutely dissected. After resection of the acromion and removal of the coracohumeral ligament, the infraspinatus muscle was carefully investigated macroscopically. After the orientation of muscle fibers was confirmed, the muscle was peeled from the proximal part to the distal part and the insertion of the infraspinatus tendon was examined. In 4 shoulders, muscle fibers were completely removed in water and the direction and insertion of the tendon were examined. The infraspinatus muscle originated both from the inferior surface of the spine of the scapula and the infraspinatus fossa, and inserted to the greater tuberosity. The muscle fibers originated from the spine were running dorsally and horizontally to the greater tuberosity. On the other hand, the fibers from the fossa were running ventrally and diagonally to the greater tuberosity. These fibers were merged at the insertion. The infraspinatus tendon had vast insertion to the greater tuberosity, and the most anterior part of the tendon was inserted to the most anterior portion of the greater tuberosity, bordering on the most anterior part of the supraspinatus tendon. The supraspinatus tendon is regarded as the most affected tendon in rotator cuff tears. However, the results of this study suggested that the infraspinatus tendon could be involved in the majority of rotator cuff tears. The infraspinatus may act not only in external rotation but also in abduction, because the infraspinatus tendon was inserted to the most anterior part of the greater tuberosity.

著者

小川 清久 皆川 邦直 松井 健郎

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.12, no.1, pp.95-100, 1988-08-10 (Released:2012-11-20)

参考文献数

2

被引用文献数

1

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Psychological factors have seemed to play an important role in voluntary shoulder dislocation. Nevertheless, there are no detailed reports of those who have received psychiatric treatment. We would now like to report the following 4 cases whose shoulder dislocations were caused as a manifestation of psychological factors.Case 1: 28 y. o., female. When the patient was about 16 years old, she dislocated both shoulders by minimal trauma; then, voluntary shoulder dislocation developed. She underwent five operations at a certain hospital from the age of seventeen. As the dislocation had recurred within 6 months postoperatively on each occasion, she visited our clinic. As we recognized split object relations, we told her to have a psychiatric examination. As a result, it became clear that she had a borderline personality disorder and the dislocation was a trend of autoclasia.Case 2: 22 y. o., female. This case is the similar disorder to Case 1, but, just a slight.Case 3: 15 y. o., female. Voluntary shoulder dislocation and pain appeared in her left shoulder two years ago. As her relations with her mother were unnatural, we recommended a psychiatric examination. The result clarified that an adjustment disorder during adolescence existed.Case 4: 23 y. o., female. Two years ago she suffered from traumatic dislocation caused by a traffic accident, and lost her fiance. Then, after she started going out with another man, dislocation of the shoulder began to occur at twilight accompanied by a syncope-like episode. Though it was spontaneously repositioned under general anesthesia, the dislocation occurred again when she came out from under the anesthesia. Therefore, we requested the cooperation of the psychiatric dept.. As a result, she was diagnosed as having hysterical neurosis.

著者

泉 政寛 池邉 智史 竹内 裕介 玉井 幹人

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.41, no.2, pp.616-619, 2017

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第1肋骨疲労骨折を2例経験したので報告する.2症例ともに高校野球の投手であった.投球後より右肩甲部の痛みを認め,単純X線にて第1肋骨疲労骨折の診断となった.1~2ヶ月間の投球禁止で疼痛は改善した.本骨折は,単純X線にて骨折部が不明瞭で,臨床症状においても特徴的な症状にも乏しく,初診時に診断に至らないことが多い.スポーツ選手における肩関節周囲の痛みでは第1肋骨疲労骨折を念頭に置き診断する必要がある.

著者

井手 淳二 森沢 佳三 山鹿 真紀夫 北川 敏夫

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.1, pp.91-94, 1988-08-10 (Released:2012-11-20)

参考文献数

5

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We have determined the effectiveness of muscular strengthening exercises of the rotator muscles for shoulder instability. These exercises are one of the conservative treatments for shoulder instability.As of y et, there have only been a few reports about the effectiveness of this procedure due to lack of data. So we have attemped to clarify this treatment and its effect. In this study, we will report on 11 cases-19 shoulders with inferior and/or multidirectional instability and 3 cases-3 shoulders with recurrent anterior dislocation.All the patients began isometric rehabilitation exercises and followed up using a Cybex machine and a grading system. As a result, we found muscular strengthening exercises to be effective and useful in 75% of the patients with inferior and/or multidirectional instability. Patients with recurrent anterior dislocation also had a good rate of response. However the success and effectiveness of this technique has certain limitations.We should first try muscular strengthening exercises of the rotator muscles in the treatment of shoulder instability.

著者

中道 憲明 松村 昇 塩野 将平 丹治 敦 戸山 芳昭 池上 博泰

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.477-480, 2007

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There are numerous reports of success with an open Bankart repair, using low recurrence of dislocation. Few studies indicate that subscapularis (SSC) tenotomy may result in postoperative SSC insufficiency. The purpose of this research was to measure the subscapularis muscle strength, muscle area and signal intensity by magnetic resonance imaging after the open Bankart procedure.<BR>A total of 22 patients were observed prospectively for a mean of 33 months (range 17-51 months). There were 11men and 1woman. The mean patient age at the surgery was 22.8 years old (range, 18-36 years old). All patients were right-handed. 8 patients had injured their shoulder of their dominant extremity. Internal rotation (IR) at 45 degrees abduction was at 60 degrees per second. The peak torques of both extremities was measured at the day before the operation, 6 months and 12 months after the operation. We calculated the ratio of the affected side to the unaffected side. The peak torques of ER and IR of the pre-operation were 13.5% and 18.5% respectively lower than those of the unaffected side. The peak torques of ER and IR that were measured at 6 months after the operation were 27.6% and 21.1% respectively lower than those of the unaffected side. The peak torques of ER and IR that were measured at 12 months after the operation were 18.4% and 0.2% respectively lower than those of the unaffected side. The area at 12 months after surgery was not significantly different from the preoperative area. However, the signal intensity at 12 months after surgery was significantly higher than that in the preoperative signal intensity. An open Bankart procedure using an L-shaped tenotomy approach did not decrease SSC muscle strength and volume. This procedure approach may lead to the deterioration of the subscapularis muscle.

著者

幸田 仁志 甲斐 義浩 来田 宣幸 山田 悠司 三浦 雄一郎 福島 秀晃 竹島 稔 森原 徹

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.43, no.2, pp.548-551, 2019 (Released:2019-09-18)

参考文献数

13

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地域在住高齢者を対象に,腱板断裂,肩痛の自覚症状,他覚症状のそれぞれの有無により健康関連QOLを比較検討した.地域在住高齢者363名を対象とした.測定項目は,超音波診断による腱板断裂,アンケートによる肩痛の自覚症状,impingement signによる他覚症状の有無,SF-8の下位尺度およびサマリースコアとした.統計解析はMann-Whitney の U 検定を用い,それぞれの陽性群と陰性群で健康関連項目を比較した.肩痛の自覚症状の陽性群は,身体機能,日常役割機能(身体),体の痛み,全体的健康感,活力,身体的健康感が有意に低値を示した.他覚症状の陽性群は,身体機能,体の痛み,全体的健康感,活力,身体的健康感が有意に低値を示した.腱板断裂の有無では,いずれの項目にも有意差は認められなかった.地域在住高齢者の健康関連QOLには,腱板断裂の有無は直接的に関与せず,肩痛の自覚症状や他覚症状によって低下することが示唆された.

著者

甲斐 義浩 幸田 仁志 山田 悠司 三浦 雄一郎 福島 秀晃 竹島 稔 来田 宣幸 森原 徹

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.43, no.2, pp.411-414, 2019 (Released:2019-09-18)

参考文献数

12

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本研究では,肩関節の総合的な柔軟性を得点化できる肩複合柔軟性テストを考案し,そのテスト法の信頼性と妥当性について検討した.対象は,健常若年者43名,健常高齢者252名,肩病変を有する高齢者111名とした.肩複合柔軟性テストは,外転,内転,外旋,内旋,複合テストの5項目で構成される.各テストには,4段階(0, 1, 2, 3)の判定基準を設定し,5項目の合計得点を0~15点で算出した.分析の結果,本テストの判定一致度(k係数:0.81-1.00)および合計得点(ICC:0.91)ともに,優秀な検者間信頼性が確認された.また,合計得点と肩甲上腕関節可動域との間に有意な正相関が認められた.対象者の合計得点は,健常若年者:12.5 ± 1.7点,健常肩高齢者:10.4 ± 2.5点,病変肩高齢者:8.7 ± 2.8点であり,病変肩群の得点は他の2群と比べて有意に低かった(p < 0.01).これらの知見より,肩関節の総合的な柔軟性を得点化できる尺度として,本法の信頼性と妥当性が示された.

著者

大泉 尚美 末永 直樹 吉岡 千佳 山根 慎太郎 呉屋 五十八

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.43, no.2, pp.619-625, 2019

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近年,ノンセメントステムを用いた人工肩関節置換術ではin-growthステムやショートステムによるradiolucent line (RLL)や骨吸収の減少が期待されている.本研究では,2005-2017年に人工肩関節置換術を施行した105肩を使用機種(スタンダードon-growthステム,スタンダードin-growthステム,ショートin-growthステム)と術式(人工骨頭置換術(HHR),解剖学的全人工肩関節置換術,リバース型全人工肩関節置換術(RSA))別に7群に分類し,術後1年の単純X線にてRLL,ステム先端の骨硬化,spot welds,ステム周囲の骨吸収(Inoue分類Grade 4)を調査した.HHRでは,ショートステムで有意にspot welds出現率が高かった.RSAでは,ショートステムで有意にRLL出現率が低く,spot welds出現率が高かった.骨吸収の出現率は,いずれの術式でも各群間に有意差はなかった.ショートステムでは早期にステム近位の骨のingrowthが得られていた.骨吸収はingrowthステム,ショートステムいずれでも減少は見られず,stress shielding以外の要因が関与している可能性も考えられた.

著者

Judy Seto

出版者

日本肩関節学会

雑誌

第44回日本肩関節学会

巻号頁・発行日

2017-09-25

著者

星野 傑 中川 照彦 佐藤 哲也 八百 陽介 土屋 正光

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.39, no.2, pp.577-579, 2015

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上腕骨骨頭骨折に対し骨釘移植による再接合術が有用であった1例を経験した.オートバイのロードレーサーである20歳男性がレース中に転倒し左肩を受傷,左上腕骨骨頭骨折に対し受傷後8週で肘頭から採取した骨釘および吸収性スクリューを準用し骨接合術施行.術後3年経過し,MRI像にて一部限局した壊死部分を認めるものの骨頭壊死なく骨癒合得られ,痛みなく良好な結果が得られた.

著者

名越 充 橋詰 博行 小西池 泰三 廣岡 孝彦 内田 圭治

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.3, pp.665-667, 2008 (Released:2008-11-21)

参考文献数

4

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Calcified tendinitis is a common shoulder disease accompanied with severe pain. We experienced many cases of calcified tendinitis over some short periods in a year. We examined the correlation between the occurrence of calcified tendinitis and seasons. 212 patients (males 72, females 140) with acute calcified tendinitis visited to 12 hospitals during two years (January. 2005-December. 2006) in the Chugoku and Shikoku area were investigated. The average age was 57.1 years old. The day of the 1st medical examination and the numbers of cases were examined. The correlation between the occurrence and 4 seasons (March-May, June-August, September-November, December-February) and the correlation in the occurrences between each areas were statistically analyzed. The correlation between the occurrence and seasons was not seen (Wilcoxon signed-rank test). In winter, the mean value of the number of cases of calcified tendonitis tended to be fewest. There was a strong correlation in occurrence between the Sanyo West and Shikoku Setouchi areas (Spearman correlation coefficient ; 0.53997, P=0.0065). More cases and analysis in various points of view are needed for evidence of the correlation between the occurrence and season.

著者

吉松 俊紀 吉松 俊一 斎藤 明義 龍 順之助

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.369-373, 2006-08-18 (Released:2012-11-20)

参考文献数

10

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The aim of this study was to identify the features of isokinetic shoulder and trunk muscle strength of volleyball attackers with shoulder problems and to compare them with those of baseball pitchers.18 competitive high school volleyball attackers and 16 competitive high school baseball pitchers were studied.6 of the attackers and 7 of the pitchers were suffering from shoulder pain but the other players had no history of shoulder pain. The tests were conducted using a Biodex system 3 multi-joint dynamometer. The shoulders were tested for their flexion and extension muscle strength on the scapula plane and trunk muscle strength were tested for their flexion, extension and torso-rotational strengths. The results were compared between the normal group (N-G)and the shoulder injured group (S-G) and also between the attackers and the pitchers. We observed weakness of shoulder flexion strength in S-G of both athletes and the flexion to extension muscle strength ratio was significantly lower in S-G of the attackers. We also noticed the decline of trunk torso rotation to shoulder extension muscle strength ratio in the same group. In comparisons between the attackers and pitchers of N-G, trunk flexion to extension muscle strength ratio of attackers was significantly higher. The reason of the above results, we assumed that the force created from lower extremities was used for jumping in volleyball, while in baseball, it is used for pitching. We also considered that force required for spiking is created from the trunk in volleyball. Characteristics of shoulder muscle strength as dynamic stabilizer are similar in both volleyball and baseball. Appropriate proximal kinetic chain rehabilitation for the leg, hip and trunk should be selected in accordance with the characteristics of sports activities to prevent shoulder injuries. Especially for volleyball attackers, trunk muscle training is a prerequisite to prevent shoulder injuries.

著者

石井 壮郎 宮川 俊平

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.939-943, 2011 (Released:2011-12-21)

参考文献数

12

被引用文献数

1

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There were two purposes for this study. One was to identify risk-factors on dynamics which affected humeral head abnormality on MRI using logistic regression analysis. The other was to simulate stress distribution in humeral head at maximum external rotation (MER) of throwing phase using Finite Element Method analysis (FEM). Then we evaluated the validity of the simulation using MRI findings of humeral head abnormality. The subjects were 18 asymptomatic collegiate baseball players who took part in both MRI and pitching motion analysis. The shoulder joint reaction force was calculated using multi-body dynamics analysis with musculoskeletal model analyzed from foot contact to ball release of pitching motion. We did logistic regression analysis to identify whether the force was a risk-factor or not. As a result, the risk-factor of humeral head abnormality on dynamics was the shoulder joint reaction force (shearing force) at the acceleration phase. We simulated the stress distribution in the humeral head at MER using FEM model and input the shoulder reaction force. Stress distribution in the simulation was almost the same as that of humeral head abnormality in MRI. This simulation is expected to be a useful predictor of the humeral head abnormality caused by internal impingement of throwing shoulder injury.

著者

渡辺 幹彦 藤巻 悦夫

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.23, no.3, pp.367-372, 1999-09-30 (Released:2012-11-20)

参考文献数

6

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The purpose of this study was to clear the clinical results of conservative treatment including the correct pitching form and operative treatments.51 baseball players were studied. Their average age was 22. ly. o. Conserative treatment group including the correct pitching form which in the divided into 7steps and proceeded from the wrist to the foot. Elevating the arm and keeping the scapular plane with the forearm pronated and rotating the trunk on the hip joint were most important. Almost all of the cases had contracture in flexion and adduction of the shoulder.19 cases had problems besides the shoulder and scapula.24 baseball players could play as well as before injury. But players with an injured labrum tear and a partial thickness tear of the rotator cuff could not.10 baseball players had arthoscopic treatment including repair of BLC lesions (Biceps tendon/labrum comlex). Average age was 22 y. o.7 cases had BLC lesions and 8 cases had partial thickness joint side tears. Debridment of the labrum and rotator cuff were performed and repaired BLC lesion with the ROC fastener system in 5 cases.7 cases could play as well as before and all the this cases treatment with repaired BLC recovered completely. Thus we recommend this treatment.