抄録
Though rotator interval lesion(RIL) is known as one of the causes of throwing shoulder, the way of thinking about its diagnosis and treatment has not been made clear. We treated throwing shoulder patients complicated RIL by conservative(CT) and surgical treatment(ST). The clinical observation before treatment, clinical results and the arthroscopic findings were investigated, and examined about the indication of surgical treatment and the pathogenesis. 38 throwing shoulder patients (36 men, 2 women, average age 23.2) in which pooling of contrast media at RI area was seen in arthrography were investigated. The details of the players were softball players:3, rubber baseball players:12 and hard baseball players:23. 20 patients were treated by conservative treatment (CT) and 18 were treated by surgical treatment (ST). CT included NSAIDs, joint injection, rehabilitation and joint distension. RIL was repaired by the anterior approach. Debridement of the labrum(10), repair of the anterior labrum(3), SLAP(2), rotator cuff repair(2) were arthroscopically done before RI repair. The ability of throwing, the area of pain at apprehension position(APP), supra-spinatus test were compared between CT and ST groups. Clinical results were evaluated according to JSS sports score. The average follow-up period was 31 months. In ST group, before treatment throwing performance was inferior to CT group, pain in APP was often seen at both anterior and posterior in ST group. JSS improved from 72.6 to 94.4 points in CT and 59.6 to 91.3 points in ST. SGHL injury, MGHL injury, antero-superior labrum injury, and ISP injury were often seen in arthroscopy. The RIL in a throwing shoulder should be carefully diagnosed. Surgical treatment was needed for the patients who lost their throwing ability and the repair of RI was effective for recovery of the throwing performance.
