上腕骨大結節骨折後のインピンジメント症候群に対する鏡視下手術

抄録

We assessed the clinical outcome of arthroscopic decompression and G-T plasty for impingement syndrome after fracture of the humeral greater tuberosity. 5 cases of impingement syndrome after fracture of the humeral greater tuberosity were treated since 2003. The cases were 3 male and 2 female, with an averaged age of 47 years old. The mean follow up period was 14 months. The duration from trauma to surgery ranged from 8 to 25 months. 3 shoulders were fracture of the humeral greater tuberosity alone and two shoulders were 3 part fractures. Preoperatively, impingement tests (Neer,Hawkins,Ellman) were positive in all cases. All cases were treated by arthroscopic subacromial decompression and 2 shoulders were associated with removal of exostosis of the great tuberosity. The clinical evaluation was performed using the JOA score, impingement sign and range of motion. The average postoperative JOA score increased from 62 points to 87 points significantly. The clinical results were excellent in 2 cases, good in 2, fair in 1. The average score of pain improved from 15.1 points to 26.8 points. Postoperatively, impingement tests (Neer,Hawkins, Ellman) were negative in all cases. Arthroscopic decompression and G-T plasty for impingement syndrome after fracture of the humeral greater tuberosity can provide good pain relief and improve the functional results.