腱板広範囲断裂に対する McLaughlin 法の治療成績 : 上腕骨頭頂部に骨溝を作成した症例の検討

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We have performed McLaughlins procedure for massive rotator cuff tears if the torn tendon could reach the top of the humeral head. The purpose of this study was to investigate the clinical and roentgenological results of the cases with a bone trough made at the top the humeral head. Twenty-five patients treated by the current procedure were examined. There were 15 males, and their age at the operation averaged 62.2 years old (range : 39 to 74 years old.). The clinical results were evaluated by the shoulder score of the Japanese Orthopedic Association (JOA score). Osteoarthritis (OA) of the glenohumeral joint was classified with four grades. Superior migration of the humeral head was classified from grade 0 to III. The follow-up period averaged 44 months (range : 24 to 80 months). The JOA score at the final follow-up averaged 90.2 points. Fourteen cases were classified as excellent, 9 good, 1 fair, and 1 poor. ROM of the shoulder at the follow-up was 120°∼170° in flexion, -10°∼75° in external rotation, and T4∼L4 in internal rotation. The OA changes had progressed in 7 cases (28%), and the superior migration of the humeral head had progressed in 6 cases (24%). Superior migration of the humeral head had improved in only 3 cases. Successful clinical results were obtained when the torn tendon was repaired just distal to the top of the humeral head. However, long-term follow up is necessary to evaluate this procedure because the progression of OA changes of the glenohumeral joint were found in some cases.
日本肩関節学会の論文
2002-01-01

腱板広範囲断裂に対する McLaughlin 法の治療成績 : 上腕骨頭頂部に骨溝を作成した症例の検討

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