当院における肩関節前方脱臼と脱臼後腱板断裂手術症例の検討

抄録

The purpose of this study is to investigate the epidemiology of traumatic anterior dislocations of the shoulder and the short term outcome of operative treatment of rotator cuff tears associated with acute dislocation. We reviewed 58 traumatic anterior dislocations of the shoulder between April 2002 and December 2007 to clarify the age, cause of injury and rotator cuff tears. Magnetic resonance images were performed in patient whose pain, muscle weakness and loss of range of motion persisted over 3 weeks after injury. 5 patients with rotator cuff tears underwent surgical repair. The majority of dislocations were in their 20's (9 patients) and of over 60 years old (30 patients). The main mechanism of injury was sports activities (12 patients) in their 10' to 30's, whereas a fall (26 patients) of over 60 years old. Sports activities included ball games (6 patients), contact sports (2 patients) and others (4 patients). In 5 patients with rotator cuff tears, the average flexion was 60° preoperatively/162° postoperatively, abduction 54°/160°, external rotation 12°/43°,internal rotation T12/T8 and JOA score 42/81 points, respectively. Postoperative rotator cuff integrity was classified into type I in 1, type II in 2 according to Sugaya's classification. The majority of dislocations were in their 20's and over 60 years old. The main mechanisms of injury were sports activities and a fall. Early rotator cuff repair yields successful functional outcomes.