上方関節唇損傷を合併した外傷性肩関節前方不安定症

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The purpose of this study was to evaluate the arthroscopic findings in shoulders with superior labrum anterior and posterior (SLAP) lesions combined with traumatic anterior glenohumeral instability.118 patients (118 shoulders) who underwent arthroscopic surgery for anterior glenohumeral instability were investigated. There were 100 males and 18 females and the mean age at surgery was 21.7 years old. Arthroscopic findings were evaluated concerning the type of SLAP lesions, pathology of glenohumeral instability, property of the anterior inferior glenohumeral ligament (AIGHL) and the middle glenohumeral ligament (MGHL), and the presence of Hill-Sachs lesion. The shoulders with obvious detachment of the superior labrum were 37 (S group), and others were 81 (N group). There were no significant differences among the two groups about the age, sex, number of dislocation history or the type of sports activity. Among the S group, superior labrum lesions were classified as Type II in 31 and Type II + III in 6 shoulders according to Snyders classification, and 33 of them had a continuation with Bankart lesion. The pathology of glenohumeral instability was classified according to Kumagais classification, and ligament-labrum complex detachment type were seen in 26, small bony fragment type in 10 and glenoid bony defect type in 1 shoulder. AIGHL was found well developed in 25 and poorly defined in 12. MGHL was detected in 28 shoulders including 5 with cord-like MGHL. On the contrary, among the N group, AIGHL was poorly defined in 63 and MGHL was absent in 39. Anterior glenohumeral instability with detachment of the superior labrum likely had well developed AIGHL and continuation with Bankart lesion. According to these results, we hypothesized that traumatic traction force during shoulder dislocation might extend the Bankart lesion superiorly.
日本肩関節学会の論文
2008-06-30

上方関節唇損傷を合併した外傷性肩関節前方不安定症

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