肩甲下筋腱の断裂サイズと修復後の肩甲上腕関節可動域

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Background: In patients with subscapularis tendon tears, tear size appears to affect shoulder joint motion after tendon repair, but no studies have investigated the details. The purpose of this study was to evaluate the range of glenohumeral joint motion after repairs of various sizes of subscapularis tendon tears. Methods: Eight fresh-frozen human cadaveric shoulders were used. The scapula was fixed to the jig. Three sizes of subscapularis tendon tear were simulated and then repaired. In this experiment, we measured 1) the end range of glenohumeral joint motion and 2) the end range of external and internal rotation with the arm at the variously designed positions of elevation, flexion, abduction and extension. The end-range of motion was measured with passive movement applied through 1.0 Nm torque in the directions of elevation, flexion, abduction, extension, horizontal abduction, and horizontal adduction. A 3SPACE was used to measure the ROM of the glenohumeral joint. One-way repeated measure ANOVA and the Bonferroni post hoc tests were used. Results: As tear size increased, end-range of motion in horizontal abduction after repair decreased gradually and was significantly decreased with the largest tear (P<0.01). The end-range of external rotation decreased progressively with increasing tear size in every glenohumeral position. The passive range of glenohumeral elevation, flexion, abduction, extension and horizontal adduction were not significantly influenced by tear size. Conclusion: In shoulders with a subscapularis tendon tear, it is necessary to consider the operative procedure and postoperative physiotherapy according to tear size.

肩甲下筋腱の断裂サイズと修復後の肩甲上腕関節可動域

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