40歳未満に発生した腱板断裂の特徴

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The purpose of this study was to clarify the clinical feature of rotator cuff tears occurred in a relatively younger population. Among patients who underwent arthroscopic rotator cuff repair, 19 patients younger than 40 years old were investigated. Regarding their injured mechanism, 6 shoulders in the overuse group were injured through repetitive overhead activity, and 13 shoulders in the trauma group were injured during a sports activity or a traffic accident, including 10 shoulders injured by a fall. Several clinical features were retrospectively investigated. As a result, there was an articular-side partial tear in 10, a bursal-side partial tear in 3, and an intratendinous horizontal tear in 6, and their mean age was 30.4, 37, and 27.3 years old, respectively. While the overuse group showed 4 articular-sides, 1 bursal-side and 1 intratendinous tear, in the trauma group there were 6, 2 and 5, respectively. Shoulder pain was recognized in all shoulders, and disturbed their daily activity in 15. Moreover, difficulty in elevation was complained of by 8 shoulders in the trauma group, and among them disability of active abduction was recognized in 4. Regarding their location of tears, in the trauma group most tears were recognized at the anterior aspect of the supraspinatus tendon, and 4 of 6 horizontal tears were recognized at the central aspect of the supraspinatus tendon. Posterior capsular tightness and presence of the greater tuberosity notch on the humeral head were not so frequent in the trauma group. While inflammation in the subacromial bursa was rarely seen in either group, granulation tissue was recognized after the exposure of the tear site in 2 in the overuse group and in 3 in the trauma group and it was especially frequently seen in horizontal tears (3 of 6 tears). In conclusion, in relatively younger patients showing recalcitrant shoulder pain after trauma, attention should be paid to the presence of a partial rotator cuff tear, including a horizontal tear.
日本肩関節学会の論文

40歳未満に発生した腱板断裂の特徴

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