肩関節下方不安定症の自然経過 (大胸筋移行術例との比較)

抄録

There are few reports to discuss the prognosis of the inferior instability of the shoulder. The purpose of this study is to compare the results of natural course and those of the pectoralis major transfer for the inferior instabilty. From 1975 to 1988, 48 patients were diagnosed as inferior instability of the shoulder and were followed from 2 to 11 years. According to the complaints, 19 patients were observed as natural course (natural group) and 29 patients (34 shoulders) were operated on (operated group), and there was no difference in the degree of instability between the two groups.
All patients except two did not improve the inferior instability at their follow-up consultations (average, 4.3 years) in the natural group. And the two patients who were followed for 9.9 years and 11 years respectively, showed no instability. But the number of the patients who complain the feeling of subluxation were decreased among the natural group. The average instability of the operated group were improved from 38% to 16%. Four patients among the natural group and ten patints among the operated group did not complain at the follow-up. The number of patients who complained the shoulder stiffness were increased among the operated group at the follow-up. There were no osteoathrotic changes in the natural group.
These results suggested that the operative indication should be made carefully for the patients who complain the shoulder stiffness and the feeling of subluxation of the shoulder.