動揺性肩関節の長期予後

-非手術例について-

抄録

The purpose of this paper is to report the results of non-operatively treated “loose shoulder”, and to discuss the surgical indication for this lesion.
Thirty-five consecutive patients,46 shoulder joints with “loose shoulder” were followed up from 1 year and 6 months to 7 years (average 4 years and 2 months).
The patients consisted of 14 men and 21 women, and their ages varied from 14 to 67 years, averaging 28.7 years.
Their predominant complaints were dull pain around the joint and instability when they were carrying a load, throwing, or working with the arm elevated.26 patients (74%) had tenderness in the rotator interval region and 18 patients (51%) had luxaty of other joints, such as the elbow or wrist joints. The roentgenological findings revealed that 19 joints (41%) had hypoplasia of the glenoid.
As a conservative treatment, patients were adviced to rest the involved joint, were injected a steroid locally, and had to avoid carrying a load and so on.
At their follow-up consultations,21 patients (60%) had no com plaints of their initial symptoms. Some of them, however, changed their lifestyle or occupations. On the other hand,14 patients (40%) still complained of their initial symptoms.
There was an improvement of symptoms in patients with “loose shoulder” caused by a “rotator interval lesion”. But contrarily, patients with “loose shoulder”, caused by joint laxity or hypoplasia of the glenoid, still complained of their initial symptoms.
As approximately 60% of the patients with “loose shoulder” showed improvement of their initial symptoms, we conclude that the operative indication for “loose shoulder” should be made carefully and be decided based on the pathognomonic factors.