スポーツによる上腕骨近位骨端線離開の治療成績

抄録

We reported on the clinical outcomes of the epiphyseal separation in the proximal humerus due to sports activities. Forty-seven patients including forty-five males and two females, whose average age was twelve years old (nine-sixteen years old), were enrolled as subjects. Sports activities were baseball in forty-one patients, softball in three, tennis in two and volleyball in one. The X-ray images revealed partial separation of the lateral epiphysis in thirty-six patients, full separation of the epiphysis in seven and slipping in four. All the patients took a rest from their sports and were subjected to conservative treatments. Medical checks such as examination of joint instability and ROM or muscle balance of the whole body were performed on all the patients. Complete improvement of the separated epiphysis was observed in all the patients. Forty-six patients could return to their previous sports. One patient who could not return to his previous sports activity had complications of SLAP lesion and little league elbow. In twenty-five patients, other sports injuries included those of the elbow, lower back, knee and so on. All the forty-seven patients had posterior capsular tightness of the shoulder joint. Some patients also experienced muscle tightness as tight hamstrings or motion restriction of the other joints. Therefore, the epiphyseal separation of the proximal humerus may not be only due to the problem of the shoulder joint but also due to muscle imbalance or tightness of the body. Proper training programs and early diagnosis are important to prevent and treat an epiphyseal separation. Moreover, detailed medical checks of the whole body should be regularly performed on adolescent athletes.