Overhand sports選手と柔道選手の反復性肩関節前方不安定症術後の外旋制限が競技復帰に与える影響(Modified Inferior Capsular Shift法)

抄録

The purpose of this study was to compare the limitations between the external rotation (ER) of athletes in overhand sports players (OS) and judo players (JP) with traumatic anterior shoulder instability after a modified inferior capsular shift (MICS)procedure. Thiryt-two shoulders of OS and 38 shoulders of JP were operated on using MICS and were observed for more than 12 months postoperatively.
Twenty-six dominant and 6 nondominant shoulders were examined directly. There were 21 “tsurite” (lapel grip) and 17 “hikite” (sleeve grip) shoulders in JP. The average ages at surgery of OS and JP were 22.9 and 21.5 years old, respectively.
All the patients had had an episoders of sports injury. There were no recurrences in OS, but 3 (8%)in JP. In OS,12% of the dominant shoulders and 67% of the no ndominant sides after MICS could perform better their sports activities than preoperatively. The ratios of JP which showed a better performance were 15% of operated “tsurite” and 52% of the operated “hikite” sides. The average decrease of ER motion in dominant shoulders of OS was 18.8°in the hanging position and 14.5°in 90°of abduction. In JP, “tsurite” sides had 3.3°and 4.8°of limitation on 0°and 90°of abduction, respectively. There was on other limitation of ROM in either OS or JP, postoperatively. Based on comparisons of ER motion between OS and JP showing better sport activity, ER at 90°abduction should be 80°for the dominant side of OS and 85°for the “tsurite” side of JP in order to get a better performance, postoperatively. Thus, the “tsurite” side in JP should be treated in the same manner as that of the dominant side of OS.