自衛官のBankart、Bristow変法術後成績と内外旋筋力比の関連

抄録

Excellent or good clinical outcomes of modified Bristow and Bankart procedure have been reported in our series of recurrent anterior dislocation of the glenohumeral joint for Japan Self Defense Force personnel. However, we experienced some cases that were not satisfied with their shoulder function to resume their military duties. We hypothesized that stronger muscle power recovery would be required for the soldiers to return to their military training. This study was designed to investigate the relationship between the surgical results of Bankart & modified Bristow procedure and shoulder rotational muscle strength. Isokinetic concentric shoulder rotational strength was evaluated in 14 patients treated with Bankart & modified Bristow procedure. They were all male Japan Self Defense Force personnel, and the average age at the surgery was 25.4 years old. The clinical grading of muscle strength was compared postoperatively with objective testing using a Biodex dynamometer, with functional assessment of physical strength testing, and with the ability of the patients to return to their military affairs. All patients could return to their military duties without a history of re-dislocation. The mean peak torque ratios at 60 deg/sec were recovered to 93% in the external rotation and 96% in the internal rotation. The postoperative functional scores were correlated with the internal rotational muscle strength (r=0.597, p<0.05). Surgical results were correlated with the isokinetic rotational muscle strength. Stronger rotational muscle power would be required for the patients treated with a Bankart & modified Bristow procedure to return to their military affairs.