ラグビー選手における外傷性肩関節前方不安定症
－関節内鏡視所見と Bristow 変法の手術成績－

抄録

The purpose of this study was to investigate background, arthroscopic findings and clinical results of traumatic anterior shoulder instability for rugby players. This study included 49 rugby players (54 shoulders) who underwent surgery for traumatic anterior shoulder instability. All patients were men, and the mean age at the surgery was 20.1 years old. The mean follow-up period was 21.4 months. In all patients, arthroscopy was performed first to evaluate and treat intraarticular pathology. After arthroscopy, Modified Bristow procedure was undertaken. Backgrounds were evaluated concerning the position of players and cause of injury. Arthorscopic findings were evaluated concerning the pathology of glenohumeral instability and the presence of superior labrum injury. Clinical results were evaluated concerning JSS Shoulder Instability Score(JSS SIS), JSS Shoulder Sports Score(JSS SSS), the recurrence of dislocation(subluxation), return to game after surgery, the range of motion and complications. 59% of players were backs players and 70% of causes of injury were tackling. Arthroscopic findings revealed Bankart lesion in 48 patinets (89%), humeral avulsion of the glenohumeral ligament in 4, capsular tear in 2. Superior labrum injury was seen in 19 (35%). The mean JSS SIS was 93.9 points, and the mean JSS SSS was 90.3 points at the final follow-up. Recurrence of dislocation did not occur in any patients. The range of motion particularly for external rotation was decreased by 5.7 degree with the dropped arm position, 4.4 degree at 90 degree of abduction. In 1 patient, the screw displaced just after the surgery. Modified Bristow procedure provided satisfactory results for traumatic anterior shoulder instability for rugby players regardless of the intraarticular lesions on arthroscopic evaluations.