著者

鈴木 一秀 筒井 廣明 三原 研一 牧内 大輔 西中 直也

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.31, no.3, pp.489-492, 2007

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The purpose of this study was to clarify the condition of reattachment of the labrum to the glenoid rim after an arthroscopic Bankart procedure using suture anchors with an MR arthrography (MRA). We studied 48 cases ( 35 males and 13 females) after surgery with a recurrent anterior dislocation or subluxation. The patients ranged in age from 16 to 53 years old (average, 24.7). An MRA was performed at an average 11.8 months after the operation. In the MRA with an axial image and an oblique axial image in abduction and external rotation (ABER) position, we evaluated the invasion of contrast materials between the labrum and glenoid rim using the inferior 6 slice images of the glenoid rim. The 576 slices were categorized into 1 of 3 groups : good, fair, and poor. We used the JSS Shoulder Instability Score (Instability Score) for clinical evaluation. Axial images (total of slices : 288) revealed good (83.3%), fair (14.9%), and poor (1.7%). Oblique axial images in the ABER position (total of slices : 288) revealed good (77.43%), fair (19.8%), and poor (2.8%). The clinical results using the Instability Score had no significant differences between the group that had all good results in six slices and the group that had fair or poor results more than 1 slice in 6 slices of axial images and oblique axial image in the ABER position. The healing of IGHL-LC to the medial glenoid neck was recognized in 97-98% of the total slices. A non-union or re-avulsion of the labrum to articular cartilage of the glenoid were recognized in 15 to 20 % of the total slices, however the clinical results of arthroscopic Bankart repair were satisfactory.

著者

奥脇 透

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.22, no.2, pp.359-362, 1998

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[Purpose] We evaluated the shoulder alignment by measuring the sloping angles of shoulders. Materials and Methods: Photos were taken of 362 male sloping anglesof their shoulders were measured on the photos. The angle was measured by two lines; one line was drawn from the neck to the acromion. The other line was drawn between bilateral acromions. All the athletes were evaluated their shoulder type by three methods. First, they gave their impressions of their own shoulders. Secondly, they were evaluated by seven trainers. Thirdly, Iseki's method of measuring sloping shoulders was used to evaluate the position of the acromion in relation to the upper edge of the sternum. The athletes were also questioned about their shoulder injury history and the sports they played.<BR>[Results] The average sloping angle was 24.2 &plusmn;3.6&deg; on the right side,25.1 &plusmn;3.7&deg; on the left side. There was no lateralization. According to the trainers evaluation 42 cases (12%) displayed sloping sh oulders, the so called nadegata type; 98 cases(27%) had square shoulders, ikarigata; and the remaining 222(61%) were classified as namigata. The sloping angle was 28.2&plusmn;2.6&deg; in nadegata,25.0&plusmn;2.7&deg; in namigata and 20.9&plusmn;3.1&deg; in ikarigata. The angles of the three groups were all significantly different. The angles of the gymnasts were the greatest and the angles of the swimmers and the volleyball and soccer players were the smallest. There was no difference between the angles of athletes with shoulder injuries and those with no injuries.<BR>[Conclusion]The measurement of the sloping angle of shoulders is useful for the evaluation of shoulder alignment.

著者

木戸 忠人 井樋 栄二 今野 則和 佐野 晃久 浦山 雅和

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.22, no.2, pp.169-172, 1998

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The purpose of this study was to determine the in vivo function of the biceps as an active depressor of the humeral head. Thirty-eight shoulders were examined: 19 shoulders with rotator cuff tears (RCT, avg age 59 yrs) and 19 shoulders with normal MRI findings of the rotator cuff (Control, avg age 55yrs). A special arm brace which was fixed to the upper arm was used to keep the biceps in active contraction (biceps loading) during arm elevation. The subjects were asked to grasp a rubber band attached to the distal end of the brace, pull it proximally, and keep the elbow flexed against the resistant force producted by the band. The x-ray were obtained with the arm elevated at 0,45,90 degrees in the scapular plane with and without pulling the band. The center of the humeral head was determined using NTH image and compared between the groups with and without biceps loading. Without biceps loading, the positions of the humeral head at 0,45 degrees were significantly higher in RCT than those in Control (p=0.0101, p=0.0020, respectively). After loading the biceps, the humeral head was depressed significantly at each degree in RCT (P=0.0082, p=0.0259, p=0.0059, respectively). As a result of biceps loading, there were no more significant differences in the positions of the humeral head between RCT and Control (p=0.3285). The positions of the humeral head in RCT with biceps loading were similar to the positions in Control without biceps loading. This is the first study to show the in vivo function of the biceps as an active depressor. From these results, we conclude that the biceps is an active depressor of the humeral head in cuff-defficient shoulders.

著者

渡辺 公三 玉井 和哉 吉田 耕志郎

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.16, no.1, pp.47-49, 1992

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We set up Isometric exercises for patients with a glenohumeral joint contracture to do. The series of exercises consists of an abduction and an external rotation every 5 seconds, and internal rotation movements with a 5-second-rest interposed between each movement.<BR>The patients were ordered to keep their shoulders in the neut r al position while doing these exercises. We demanded that they do these exercises for about 10 minutes, twice a day at least.<BR>No patients had any local analgesics injected into their subacromial bursanor glenohumeral joint during this 4-week-isometric contraction exercise period.<BR>Loxoprofen sodium was prescribed as a painkiller when the patients wanted it.4 weeks later, we investigated the effects of these exercises in the relief of pain and recovery of motion.3 levels of pain were used in this study: better, no change, worse, compared with the pain the patients had when they started these exercises. The range of motion was indicated in total degrees of flexion, abduction and external rotation.<BR>Considering a margin of error, a 20-degree-increase or even from the beginning was considered as an -Improvement- and a 20-degree-decrease or even was considered as an -Aggravation-.<BR>We investigated 29 patients' 30 shoulders aged 56.9 years old on average. A relief of pain was observed in 64% of the patients and a recovery of motion in 67%.

著者

平野 真子 野村 一俊

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.24, no.3, pp.387-393, 2000

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We examined the relationship between effusion of MRI findings and the clinical symptoms. Materials and methods: We examined MRI findings in patients with periarthritis scapulohumeralis. We excluded cuff tears, calcified tendinitis, instability of the shoulder fractures and impingement syndrome in young patients. The subjects comprised 75 cases 77 shoulders (45 men and 30 women), with an average age of 58.3 years (range 40-78). Scanning was performed on a Gyroscan T5- II 0.5-T (Philips). T1-weighted and T2-Weighted sequences in the coronal oblique plane, T2-weighted sequences in the coronal sagittal plane and horizontal plane were taken.<BR>Results: Degeneration of the rotator cuff was observed in 34 shoulders. Joint effusion was observed in 68.8% of glenohumeral joints, and 23.4% of subacromial bursa.69.4% had effusion in the sheath of the long head of the biceps long tendon. We studied the relationship between the MRI findings and the clinical symptoms.<BR>Conclusion: Glenohumeral joint effusion was observed in 68.8%. This suggested that there was arthritis in cases of periarthritis scapulohumeralis. We could not find a clear relationship between the effusion the clinical symptoms.

著者

保坂 正人 町田 拓也 山崎 郁哉 下形 光彦 堤本 高宏

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.19, no.2, pp.360-363, 1995

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We wish to present a tabulation of the shoulder joint disorders we encountered in the last two years. The degenerative Changes in the rotator cuff which consist of a wide variety of diseases, which we consider important to differentiate.<br>The subjects were 406 outpatients with shoulder joint disorders. In cases of impingement syndrome, elevation disturbance without contracture, impingement signs and the impingement test were used as a diagnostic criteria. Frozen shouldrs were taken into account only in cases with contracture.<br>There were 170 cases (average age of 57.3) of the impingement syndrome. Rotator cuff tears were observed in 23 of the cases resistant to treatment. There were 77 cases (average age of 58.5) with a frozen shoulder. There were 55 cases (average age of 64.2) of rotator cuff tear or 78 cases when the 23 cases were corrected from the impingement syndrome were included. Then there were 36 cases (average age of 55.2) of calcified tendinitis, 10 cases (average age of 49.8) of bicipital tendinitis and 8 cases (average age of 71.5) of osteoarthrosis of the shoulder joint. There were 50 other cases.<br>The findings of a survey on the patients' backgrounds revealed the existence in many cases with the impingement syndrome and the rotator cuff tear to be among farm and blue-collar workers and that of many cases with calcified tendinitis among females.<br>When treating an impingement syndrome and a rotator cuff tear, we limited the patients' work and encouraged rest. Kinetic therapy was the basic therapy for a frozen shoulder. Steroid injections into the subacromial bursa proved efficacious in cases of impingement syndrome. Attention ought to be paid to the advance of degenerative changes in the rotator cuff and the existence of its tears. Conservative therapy was not satisfactory enough for more than half of the cases with a rotator cuff tear, and about one third of all the cases required surgery. Satisfactory results were obtained with steroid injections into the subacromial bursa for calcified tendinitis.

著者

村上 元庸 小島 保二 前田 敏博 牧川 方昭 福田 眞輔

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.15, no.1, pp.4-8, 1991

被引用文献数

2

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Sensory nerve endings in the monkey shoulder joint capsule were observed by light microscopy. The nerve staining technique was based upon Tago's method which was very sensitive for acetylcholinesterase (Ach E) existing in the peripheral nerve.<BR>Three distinct sensory nerve endings have b een identified: free nerve endings, Ruffini-type corpuscles, and Pacini-type corpuscles.<BR>Ruffini-typc corpuscles a n d Pacini-type corpuscles, which were thought to act as mechanoreceptors, were mainly localized in the transitional portion between the labrum and the capsule, but not within the labrum.<BR>Free ne r ve endiings, which may function as nociceptors (Pain), were distributed widely in the capsule and also in th labrum.<BR>As the results demo n strated that may mechanoreceptors exist in the capsule, it is presumed that the capsule acts not only as a static stabilizer, but also as a sensory apparatus for stress, and plays an important role in the dynamic stabilizing system. It seems that the location of the mcchanoreceptors is the optimum place for sensors to respond to the resultant force which dislocates the humeral head.<BR>Finally, we hypothesize that the dynamic stabilizing effect is performed by a series of reflex effects from the capsule to the surrounding muscle of the shoulder.

著者

筒井 廣明 山本 龍二 安楽 岩嗣 三原 研一 今里 有紀彦 保刈 成

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.15, no.1, pp.13-17, 1991

被引用文献数

3

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The shoulder joint is the most mobile joint in the body combined with a small glenoid and a large humeral head. This joint has been thought to be an unstable joint because of its anatomical structure and the recurrence rate from initial dislocations. Our opinion of this joint is that it has most distinguished stabilizing mechanisms for keeping a wide range of motion.<BR>1. The first stabilizing mechanism<BR>This mechanism is the bony combination of the radius between the glenoid cavity and the humeral head. The anatomical study showed the radius of a cross section of the glenoid was 16.8 mm and of the humeral head 22 mm. The computation of the maximum permissible kinetic vector that enables the humeral head to be on the glenoid was 43&deg;.<BR>2. The second stabilizing mechanism<BR>The second mechanism is the function of the anterior capsule including the inferior glenohumeral ligament.<BR>The anterior capsule works involuntary in both its tension and direction as the centripetal force does against the shear force.<BR>3. The disadvantages of these two stabilizing mechanisms<BR>The disadvantages of these two stabilizing mechanisms are; - Inefficiency against the increased anterior kinetic vector during the positioning of the upper extremities vertically against the glenoid<BR>- The decrease of bony structural intensity compared with other joints such as the hip joint.<BR>4. The third stabilizing mechanism<BR>The third stabildzing mechanism is the function of the shoulder girdle.<BR>Its first function is the mobility of the scapula working as shock ab s orber against the share force that falls on the glenohumeral joint.<BR>The second is the function of the shoulder girdle muscles such as the pectoralis major and the deltoid.<BR>In conclusion, therefore, a normal shoulder joint should be the most distinguished joint with these stabilizing mechanisms physically and anatomically maintaining a wide range of motion.

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

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

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

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

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

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.