2001 年 25 巻 3 号 p. 401-404
[Purpose] The purpose of this study is to confirm the pathogenesis and treatment of small and incomplete rotator cuff tears by evaluating the clinical and operative findings.
[Material and methods] Fifteen patients (9 small,6 incomplete,12 men,3 women) who underwent surgical treatment were evaluated in clinical findings (painful arc sign, impingement sign, MMT, JOA score etc. ), operative findings and compared the size tears (10 medium,12 large,10 massive). The average age of these patients was 50.5 years. They were followed-up for 12 to 36 months (average 18months) after surgery. Arthroscopy was performed in all cases preoperatively and repaired by the Mc Laughlin method. The surgical results were evaluated according to the JOA score.
Result: In the clinical findings, there were no obvious differences excluding the MMT and contracture. In the arthroscopies, we could not evaluate the condition of the tears more precisely than in direct observation. Intra-tendinous tears were seen in 10 cases and joint side tears were seen in all cases. In almost all of the cases, joint side stump had retracted severely. After open surgery, the JOA score averaged 93.6 points (before surgery: 51.7 points).
[Consideration] In this study cuff tears seemed to occur from articular side. In the clinical findings there were no obvious differences between the small and incomplete tears and other size tears. In the surgical treament the cuff repair is most important, so open surgery using Mc Laughlin method should be selected.
[Conclusion]Care must be taken about advanced intra-tendinous and joint side tears in its treatment. The disorder of a rotator cuff occurs even in small and incomplete tears.