腱板修復術でDeltoid detachmentによる展開が三角筋に及ぼす影響

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Massive and selected large tears of rotator cuff were repaired by open surgery using approach of deltoid detach in our institution. In this procedure, invasion of deltoid muscle (DM) become a problem. The purpose of this study is to clarify what procedures of deltoid detach have an effect on DM after surgery. We studied 21 shoulders in "conventional procedure group" and 48 shoulders in "modified procedure group". In the former, deltoid detach was performed by 2cm detach of DM from acromion and 6cm splitting of DM in the direction of muscle fiber. In the latter, deltoid detach was performed by 2cm detach of deltoid and 3cm splitting of DM. The thickness of DM using MRI images before surgery, and at 6 months and 1 year after surgery was measured. We assessed the changes of thickness of DM and compared the groups after surgery. Also the correlation to clinical result was investigated using UCLA score.No significant changes of anterior thickness of DM after surgery were found in "modified procedure group". On the other hand, significant decrease of thickness of anterior DM at 6 months after surgery was found in "conventional procedure group". At 6 months after surgery, the thickness of anterior DM in "modified procedure group" was significantly larger than in "conventional procedure group". Regarding UCLA score, no significant differences were found between the groups after surgery. The difference of procedure of deltoid detach did not effect the clinical result. However, length of splitting of DM has a strong effect on the thickness of the anterior deltoid muscle.

腱板修復術でDeltoid detachmentによる展開が三角筋に及ぼす影響

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