血管柄付肩甲骨移植後の肩の筋力評価

Cybex IIを用いて

抄録

Since 1983; we have performed free vascularized scapular bone graft for such conditions as severe osteomyelitis, pseudoarthrosis, or large segmental bone defects. However, the effects of the removal of the lateral part scapula have not been published. This investigation attempted to assess the function of the donor site of the shoulder. In this study, twenty-seven patients who had undergone the surgical procedure more than a year previously, were investigated as to pain and disabilities by the questionnaire method and were evaluated according to the JOA shoulder scale. Isokinetic strength of the shoulder was measured in fourteen patients by Cybex II dynamometer. The strength of the shoulder that had been operated on was compared with that of the contralateral side. In the questionnaire study, eighteen of the twenty-seven patients had no pain, seven had tenderness, one had slight pain in daily work, and the remaining one had frequent night pain. In the isokinetic evaluation of the muscle strength, the peak values were expressed as percentage against the normal shoulder. For the entire study population, the decrease of strength was significant (p<0.05) in external rotation (80.9±27.4%) and in extension (85.1±18.0%). No statistically significant difference was found between the dominant and nondominant shoulders. We grouped the patients according to whether the grafted bone size was large (>5 cm) or small (<5 cm). The donor side strength of the large graft group was statistically significantly reduced (75.6±21.5%) in internal rotation at slow torque arm speed.