著者

前田 朗 成田 陽二郎 米田 稔 広岡 淳

出版者

Japan Shoulder Society

雑誌

肩関節 = Shoulder joint (ISSN:09104461)

巻号頁・発行日

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

参考文献数

10

被引用文献数

1

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

著者

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

建道 寿教 橋本 淳 橋本 卓 駒井 正彦 中村 真里 信原 克哉 中村 康雄

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.28, no.3, pp.427-431, 2004

被引用文献数

2

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The Purpose of this study was to analyze the articular contact pattern of the normal glenohumeral joint. There are few previous papers concerning the dynamic contact patterns, although the studies of using the cadaver or the tracking device have been reported. The subjects consisted of 10 normal volunteers. The subjects were fixed on a tilted stand with free motion around the scapula.3D MRI images were extracted at the scapular plane at every 30&deg; between 30&deg; and 150&deg; in the supine position. The images obtained at each position were transmitted to a personal computer and the description of the bony frame by digitizing methods using the analyzing software were developed. Three dimensional reconstruction of the glenohumeral joint were performed. The items of measurement were the following (1)The contact area; the distances between the humeral head and the glenoid surface were calculated and the distribution set at the distances were considered to be the contact area. The shortest distance was regarded as the proximity of the joint. The change of the center of the distribution was investigated. (2)The center of the humeral head (3) Kinematics of the humerus; (from the aspect of the scapula) Results: (1)In the contact area; the minimum contact area had shifted superiorly up to 90 or 120&deg; elevation, but after 120&deg; it shifted inferiorly. Concerning the antero-posterior direction of the glenoid, it shifted antero-inferiorly at the elevated position compared to that of the 30Thlevation. (2)In the center of the humeral head; it shifted superiorly at 120&deg; or 150&deg; compaired to the 30&deg; elevation. Its change was within 3mm. (3)In the Kinematics of the humerus; although the glenohumeral movement was totally 66&deg;, it was only 17' after 90&deg; elevation. We conclude that although the contact area shifted superior until 90&deg;, it shifted to the central part of the glenoid over 120&deg;, because the centripetal force might have worked at the elevated position. The distribution of the contact area was assumed to be reflected as a result of seeking a good congruity of the humeral head and the glenoid.

著者

青木 光広

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.29, no.3, pp.621-624, 2005

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Periarthritis of the shoulder is characterized by freezing phase, frozen phase, and thawing phase. However, the pathology of its clinical course is not clarified. Recent development of shoulder open surgery, arthroscopy, MRI and PET demonstrated that shoulders with persisting pain and contracture had hyperemia and edema of the joint capsule and subacromial bursa. Thus, we tried to elucidate clinical phases of frozen shoulder based on connective tissue repair and remodeling.<br>Early freezing phase of the shoulder is consistent with acute inflammatory phase of connective tissue repair. In this period, edema and hyperemia of the shoulder joint capsule appears with occurrence of shoulder pain (0 to 1 month from the onset). Late freezing phase of the shoulder is consistent with fibroplasias of connective tissue repair. In this period, infiltration of fibroblasts and new vessels in the capsule appears with progressive pain and reduction of range of motion (1 to 2 months from the onset). Freezing phase of the shoulder is consistent with consolidation stage of remodeling of connective tissue repair. In this period, fibrosis and thickening of the joint capsule appears with progressive contracture (2 to 6 months from the onset). Thawing phase of the shoulder is consistent with maturation stage of remodeling of connective tissue repair. In this period, remodeling of joint capsule appears with gradual relief from joint contracture (6 month to 1 year from the onset).<br>Joint capsule of the shoulder is known to have enough redundancy. However, if the inflammation of the capsule spreads all over the shoulder joint, fibrosis and production of collagen fibers in the capsule develops. Subsequent relief form joint contracture with remodeling of the capsule explains characteristic features of clinical staging of periarthritis of the shoulder. Comparing clinical stage and extent of connective tissue repair, theoretical back ground of physical therapy and surgical treatment is evident.

著者

小竹 俊郎 山川 知之 岡本 幸大

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.29, no.3, pp.629-632, 2005

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The purpose of this study was to evaluate 4 patients with marked atrophy of the shoulder girdle muscles caused by degenerative processes of cervical spine.4 patients presented themselves with deltoid paresis with the absence of sensory deficits or myelopathy. The patients were 3 males and one female. Their age at treatment was from 49 to 74 years-old with an average of 61.7 years old. Their mean follow-up period was 17months (17-29).3 cases underwent a cervical anterior decompression and one case was treated conservatively. The severity of deltoid paralysis was classified into five grades according to the manual motor power test and swallow tail sign. Theclinical outcome of each case was evaluated at pretreatment and at followup with JOA scores. Of 4 patients, three had C4/5 cervical spondylosis and one had C4/5 and C5/6. In the all cases, muscle power had improved significantly from MMT 2 to MMT 5. The JOA scores averaged 65.8 points at pretreatment and 98.8 points at follow-up. It is important for the differential diagnosis of shoulder girdle damage in cervical spondylotic syndrome of rotator cuff tears. The swallow tail sign in diagnosis and treatment was effective for a cervical spondylotic amyotrophy.

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

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.