腋窩神経麻痺を伴う腱板断裂の治療成績

概要

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We assessed the clinical outcome of treatment for the rotator cuff tears with axillary nerve palsy. 13 cases of rotator cuff tears with axillary nerve palsy were treated since 1995. The cases were 9 male and 4 female, with an average age of 62 years. The mean follow up period was 68 months. The duration from trauma to surgery ranged from 5 to 48 weeks. 5 shoulders had massive rotator cuff tears and 8 shoulders had global rotator cuff tears. 11 shoulders were combined with anterior shoulder dislocation, 8 shoulders were treated by arthroscopic repair and 5 shoulders treated by open repair. 4 shoulders were associated with patch graft of tensor fassia lata. All patients were evaluated by the shoulder score of the Japan Orthopedic Association (JOA score). The average postoperative JOA score increased from 34 points to 82 points. The clinical results were excellent in 4 cases, good in 4, fair in 3, poor in 2. The main factor of a JOA score demerit mark was range of motion, and second was pain. There was a correlation between postoperative JOA score and the duration from trauma to surgery. In the treatment of the rotator cuff tears with axillary nerve palsy, the early repair of rotator cuff tear after improvement of axillary nerve palsy is important to gain satisfactory functional results.