一次修復不可能な腱板広範囲断裂を伴った反復性肩関節脱臼に対する棘下筋移行術

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We had satisfactory results with infraspinatus muscle transfer for recurrent anterior shoulder dislocation with massive irreparable rotator cuff tears. Case 1 was a 74 years old male. He had been affected by anterior shoulder dislocation four times in the last two years. He had dislocated his shoulder again while he elevated his upper arm. MRI was showed Bankert lesion and massive rotator cuff tears with suprasupinatus and infrasupinatus muscle atrophy. A month after his shoulder was reduced, active-ROM (a-ROM) of his right shoulder was under 40 degrees. He received arthroscopic bankert repair and mini-open infrasupinatus muscle transfer. A-ROM of flexion/abduction/external rotation improved 165°/175°/60°, suprasupinatus test was negative, JOA score improved to 98 twenty-six months after surgery. Case 2 was 79 years old female. When she fell down, she suffered anterior shoulder dislocation. After her shoulder was reduced, she had dislocated her shoulder again while she was asleep. MRI was showed Bankert lesion and massive rotator cuff tears with suprasupinatus and infrasupinatus muscle atrophy. Three months after conventional therapy, a-ROM of her right shoulder was under 45 degrees. She received arthroscopic infrasupinatus muscle transfer. A-ROM of flexion/abduction/external rotation improved 110°/120°/55°, and suprasupinatus test was negative in five months after surgery. Infrasupinatus muscle transfer is an effective method for treating recurrent anterior shoulder dislocation with massive irreparable rotator cuff tears.

一次修復不可能な腱板広範囲断裂を伴った反復性肩関節脱臼に対する棘下筋移行術

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