外傷性肩関節前方不安定症に合併した腱板断裂の部位および重症度

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The purpose of this study was to investigate the location and severity of rotator cuff tears in traumatic anterior shoulder instability with Bankart lesion or capsular tear. 145 patients who underwent arthroscopic Bankart or capsular repair were investigated regarding the articular-side of rotator cuff arthroscopically. Most of the rotator cuff tears were partial and their locations were divided into three types, those were the anterior part, posterior part, and both parts of the supraspinatus tendon. Their depth was also estimated. Several factors influencing their tears were investigated in 139 shoulders using the preoperative patient profiles and arthroscopic findings. There were 2 complete and 80 partial tears in the supraspinatus tendon, and their location was anterior in 62, posterior in 10, and both in 8 cases. Severe partial tears deeper than Grade 2 were seen in 20 shoulders, and 2 complete tears and 4 partial tears were repaired arthroscopically. A factor influencing the occurrence of 21 severe partial tears in the anterior part of the supraspinatus tendon was that their age of first time dislocation was significantly older. Their older age at operation, the episode of first time dislocation including dislocation with the fracture of glenoid edge, and throwing shoulder slightly influenced their occurrence. In conclusion, articular-side partial rotator cuff tears in the anterior part of the supraspinatus tendon were frequently seen in patients with traumatic anterior shoulder instability. As severe tears requiring arthroscopic rotator cuff repair were sometimes seen, careful observation should be done in patients with older age, first time dislocation, and throwing shoulders.

外傷性肩関節前方不安定症に合併した腱板断裂の部位および重症度

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