反復性肩関節前方脱臼における肩甲骨関節窩骨欠損の形成

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概要

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• The purpose of this study is to clarify the progress of the glenoid osseous defect and fragment in recurrent anterior instablity. From 2006 to 2009, 33 patients who underwent preoperative three-dimensional computed tomography (3D-CT) were investigated. The average age at surgery and at first dislocation in the shoulder was 26.0 (17-39) and 20.1 (14-32) years old, respectively. The average number of dislocation was 14.3 (2-50) times. We evaluated the glenoid osseous defect and the clinical factors influencing it. The evaluation by 3D-CT indicated that there were 6 large (> 15%), 10 medium (5 - 15%), 5 small (< 5%) and 12 with no osseous defects. They consisted of 11 shoulders with bony Bankart fragments and 22 shoulders without them. The significant risk factors for larger glenoid bone loss were being male, instability being not in the dominant arm and age at both first dislocation and surgery. The significant risk factors for bony Bankart fragments were both being male and having a collision sports injury at the first dislocaion. In 11 shoulders with bony Bankart fragment, the average osseous defect was 10.5 % if the number of dislocations was less than 6 times, and was 11.5 % if it was more than 6 times. In 22 shoulders without bony Bankart fragment, the average osseous defect was 1.1 % if the number of dislocations was less than 6 times, and was 7.0 % if it was more than 6 times. These results suggested that the osseous defect with bony Bankart didnt enlarge, but the defect without bony Bankart enlarged after more than 6 times of dislocation.

著者

• 野寄 浩司

  小田原市立病院整形外科

• 藤井 淳平

  相模原協同病院整形外科

• 伊藤 岳史

  神奈川県立汐見台病院整形外科

• 中井 大輔

  小田原市立病院整形外科

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• 反復性肩関節前方脱臼における肩甲骨関節窩骨欠損の形成
• 腱板大断裂に対する鏡視下修復術後の固定期間が修復と拘縮に与える影響

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