肩峰下面の病理学的変化から捉えた腱板断裂の病因に関する解剖学的研究
1989 年 13 巻 2 号 p. 172-177
詳細
1989 年 13 巻 2 号 p. 172-177
The pathogenesis of a tear of the rotator cuff in the shoulder has long been a controversial subject.
Codmanc oncluded that cuff tears are degenerative by nature, while Neer stated that 95%of them are caused by impingement and that they start on the bursa' side of the cuff because of the wear and tear of movement of the cuff relative to the acromion.
In 200 specimens from 100 cadavers, we studied the pathological changes on the undersurface of the acromion as associated with tears of the rotator cuff. The ages of the specimens ranged from 38 to 95 (average,72.3 years). There were 104 normal cuffs,69 with incomplete tears and 27 with complete tears.
By roentgenographical and histological analysis we resolved that in specimens with imcomplete cuff tears the acromial undersurface was almost intact. Lesions in the anterior 1/3 of the acromial undersurface were always associated with cuff tears, but not vice versa. We concluded that the pathogenesis of most cuff tears probably is a degenerative process and that extrinsic causes play a secondary role.
