棘下筋腱の肉眼解剖および組織学的研究 −delamination の発生部位の検討−

概要

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The purpose of this study was to estimate the pathology of the delamination in the infraspinatus tear by the anatomical and histological study of normal specimens. 27 shoulders of 15 cadavers were used for this study. 17 specimens were observed macroscopically. The rest of the 10 specimens were used for histological sections and were investigated histologically especially around the humeral insertion of the infraspinatus. The transverse muscular portion from the inferior surface of the spine and the oblique muscular portion from the infraspinatous fossa merged into the tendinous portion and inserted to the greater tuberosity. The oblique muscular portion contained most of the tendinous portion of the infraspinatus. On the other hand, the transverse muscular portion had almost no tendinous tissues but aponeurosis macroscopically and histologically. The tendinous portion of the infraspinatus was a dense layered structure, however the diffusible gap could be observed in that layered structure of the tendinous portion of the infraspinatus in all specimens. This study suggested that the delamination in the infraspinatus tear may occur not between the transverse and oblique muscular portion, but in the layered structure of the tendinous portion from the transverse muscular portion.
日本肩関節学会の論文