肩挙上困難な腱板広範囲断裂に対する長掌筋腱を用いた腱板再建術

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Some elderly patients with a massive rotator cuff tear have severe impairment of the shoulder joint elevation. When the rotator cuff is severely degenerated and fragile, tear is very likely to occur during rehabilitation after surgery by the McLaughlins method alone. In this study, we investigated the usefulness of Palmaris longus graft in elderly patients with a massive rotator cuff tear accompanied by impaired elevation of the shoulder joint. The subjects were 13 patients with 13 impaired shoulders incapable of active elevation of the shoulder joint from the lowered position for 3 months or longer due to a rotator cuff tear, and diagnosed with massive rotator cuff tear by MRI before surgery. The age at the time of surgery was 62-81 years old. 12 patients had no clear cause of injury. 2 patients had rheumatoid arthritis, and 1 patient had Parkinsons Disease. Rotator cuff repair and Palmaris longus graft were performed on these patients. The postoperative acquisition of shoulder joint function was investigated. The average point of the post-operative JOA score was 85.7 points. 9 patients became capable of active elevation of the shoulder joint for more than 150 after surgery. 2 patients with a poor outcome had rheumatoid arthritis and Parkinsons Disease. Palmaris longus graft may be effective for a massive rotator cuff tear in elderly patients with advanced impairment of the shoulder joint, but caution of complications such as rheumatoid arthritis is necessary, and application of the procedure should be carefully selected.
日本肩関節学会の論文

肩挙上困難な腱板広範囲断裂に対する長掌筋腱を用いた腱板再建術

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