関節窩周囲構造の解剖－鏡視下手術ラーニングカーブ向上のために
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<B>Background:</B> It is difficult for young shoulder arthroscopists to get accurate orientation. The purpose of this anatomical study was to propose several spots around the glenoid as landmarks for the shoulder arthroscopy compensating for its narrow view field.<BR><B>Methods:</B> The scapula of 15 embalmed shoulders was removed and the clock time positions of several structures around the glenoid were recorded in units of 30 minutes by two independent examiners. Interobserver variability was evaluated by κ statistic.<BR><B>Results:</B> The average position of each structure between the two examiners were shown in order as viewed in the right shoulder; center of the attachment of the long tendon 11:59, anterior edge of the supraspinatus 11:59, border of the supra and infraspinatus 10:27, superior edge of the subscapularis 1:03, border of the infraspinatus and teres minor 7:43, inferior edge of the teres minor 6:21, inferior edge of the subscapularis 5:27, anterior edge of the coracoid process 1:25, posterior edge of the coracoid process 12:13, center of the scapula spine 10:06. κ statistic of the structures were ranged from 0.45 to 0.88 and the results were considered reproducible.<BR><B>Discussion:</B> The results of this study showed the standard about the area of the rotator interval, borders of rotator cuff muscles and some osseous landmarks. These facts are useful, for example, in detaching torn rotator cuff from the scapula neck. This study would help beginners of shoulder arthroscopy to improve their learning curve.
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