腱板断裂の理学所見による断裂形態の判別

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There are a lot of evaluation methods for a rotator cuff tear, but there are few reports that estimate these findings, generally paying attention to the tear type. The purpose of this study was to examine whether the type of tear in a rotator cuff tear could be distinguished from physical findings. We evaluated 89 cases 89 shoulders who had been surgically diagnosed as a type of tear and had been able to estimate all attempted physical findings. There were 54males and 35 females, 60 right sides and 29 left with an average age of 61.6 years old (35 to 85 years old). The subjects were divided into 3 groups by type of tear : an articular side tear(AST), a bursal side tear(BST), and a full-thickness tear(FTT). 24 values were obtained from the preoperative findings : muscle atrophy (trapezius or supraspinatus, infraspinatus, deltoid), tenderness (coracoid process, supraspinatus tendon, greater tubercle, intertubercular groove, anterior joint space, posterior joint space), muscle weakness (abduction, external rotation), active range of motion (flexion, abduction, external rotation, internal rotation), sulcus of suprasupinatus tendon, crepitus, Neers impingement sign, Hawkins-Kennedy impingement sign, painful arc sign, Speed test, drop arm sign, initial abduction test, and lift off test. Discriminant analysis was carried out to distinguish 3 types of tear from these 24 values. We surgically diagnosed 11 shoulders with AST, 15 shoulders with BST, and 63 shoulders with FTT. Discriminant analysis successfully distinguished three groups [F(24.150)=2.741, >1.91]. The crepitus (partial F=6.5123) and initial abduction test (partial F=3.6880) contributed significantly to the discrimination. This study showed the possibility that we could distinguish the types of tear in a rotator cuff from a suitable choices of clinical findings.
日本肩関節学会の論文

腱板断裂の理学所見による断裂形態の判別

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