外傷性肩関節前方不安定症術後の肩筋力の推移

-Bankart法とBristow変法の併用とCaspari変法との比較-

抄録

The recovering process of shoulder strength was investigated in patients who had been treated for a traumatic anterior shoulder instability. The patients were divided into two groups. Arthroscopic group consisted of 20cases that underwent Caspari's transglenoid multiple suture technique, while the open group consisted of 19 cases that underwent Bankart procedure augmented by a coracoid transfer. The average age at surgery was 26 years old in the arthroscopic group, and 29 years old in the open group. The same postoperative regimen was done for all patients. Complete immobilization was maintained for 3 weeks. After that, passive ROM exercises were started, and muscle strengthening exercise were started at 8 weeks. The strength in the following muscles was measured with a hand-dynamometer: the abductor at 45 and 90 degrees and the external and internal rotators at the hanging arm. The measurement was taken three times and averaged. The strength was measured at preoperation and every six months after surgery. The abductor at 90 and the external rotators at 6 months after surgery were significantly less than those at preoperation in arthroscopic group. Then, the abductor at 90 recovered to its preoperative strength at 12 months, while the external rotators recovered at 18 months. On the other hand, the abductors at 45 and 90, and the external rotators at 6months after surgery were significantly less than those at preoperation in the open group. Those strengths recovered to its preoperative strength at 12 months. Regarding to comparison between two groups, both abductors and internal rotators at 6 months in the open group were significantly less than those in the arthroscopic group. However, there were no differences in strengths at 12 months both groups.