日本リウマチ・関節外科学会雑誌
Online ISSN : 1884-9059
Print ISSN : 0287-3214
ISSN-L : 0287-3214
腱板および肩峰下滑液包の病態からみた五十肩の治療
三笠 元彦
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ジャーナル フリー

1989 年 8 巻 3 号 p. 451-456

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Many authors have postulated various opinions about the etiology of glenohumeral Periarthritis. Based on our histological study of the rotator cuff in necropsy, and surgical and bursographical findings, we consider glenohumeral periarthritis to be in most cases subacromial bursitis secondary to the degeneration of the rotator cuff and subclinical tears in the cuff that are in the process of healing naturally.
A consecutive series of 127 shoulders in this category which were treated with local injection, acupuncture and physiotherapy from May, 1984, through April, 1988, were reviewed. Of those, 103 shoulders (81%) predominantly had symptoms of subacromial bursitis, while the other 24 (19%) had symptoms of bicipital tenosynovitis. Sixty-six shoulders (52%) were frozen with contracture while 61 (48%) were subject to freezing with. less contracture.
The average period from onset of treatment to clinical cure for the shoulders with predominant symptoms and signs of subacromial bursitis and bicipital tenosynovitis was 14.9 weeks and 22.9 weeks, respectively. The shoulders frozen with contracture required a longer treatment period, one of 22.3 weeks, than the less cntracted shoulders which required 10.3 weeks on the average. Eight shoulders (6%) remained moderately disabled in ADL at follow-up due to persisting pain or limited motion.
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