反復性肩関節前方脱臼に対するBankart&Bristow変法

contact sportsへの復帰

抄録

In cases of recurrent aterior dislocation of the shoulder caused by contact sports, i. e. football, rugby, Judo, and wrestling, bony defects of the anterior glenoid rim and damage to the glenohumeral ligament are often obserbed. Especially, in contact sports athletes, the glenohumeral joint suffers more excessive force at the moment of its dislocation. So, a secure surgical technique which provides anterior stability of the shoulder is needed for such cases. Since 1981, we have performed Bankart's procedure augmented with a coracoid transfer on contact sports athletes with recurrent anterior dislocation of the shoulder.47 shoulders were treated using this procedure and follow-up for more than two years. The average age at surgery was 26 years ( range: 16-46 years) and the follow-up terms ranged from two to ten years, with an average of four and half years. According to the shoulder-rating system of Rowe et al., the clinical results were graded as follows: 29 excellent,14good, and 4 fair. The overall clinical results were satisfactory in 91 % of the cases. There was no recurrence, but four shoulders that were graded fair could not return to contact sports because of discomfort. With regards to the range of motion, only external rotation was ten degrees inferior to the opposite side on an average.