肩峰下滑液包に対する注射手技 : 前外側アプローチ

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To assess the accuracy of shoulder infiltrations in the SAB by an anterolateral approach with loss of resistance technique, 30 patients with clinical signs of subacromial impingement of the shoulder were chosen at random and injected in the SAB. (14 men,16 women, average age 61.6 years old:range 28 to 79 years old).1st, we palpate the anterolateral corner of the acromion with the thumb. The examiner inserted a 23rd-gauge needle at a right angle of the rotator cuff, it went through :the skin, a deltoid, a subacromial space, the SAB and the rotator cuff where after the needle tip reached the foot-print. Pulled the needle back slowly until the resistance decreased. The resistance disappeared the moment we entered the SAB and we could then inject the contrast material smoothly. The fluid was injected into the SAB and subacromial space in all cases.The SAB was contrasted as bursography findings in 23patients. In the bursography findings fluid extended from the SAB into the subdeltoid bursa (SDB) in 19 patients (82.5%). In 1 case (5%) fluid was only found in the SAB. In 3 cases the fluid diffused from the SAB into the subacromial space. In 4 cases done arthrography had complete tear of the rotator cuff. After the intradeltoid and subcutaneous injection it did not. The anterolateral approach for the SAB is a method that can inject fluid to the SAB and subacromial space at a high rate. Also the connection between the SAB and the SDB was very significant.
2009-07-27

肩峰下滑液包に対する注射手技 : 前外側アプローチ

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