スポーツ選手の外傷性肩関節前方不安定症に対する Bankart & Bristow 変法の治療成績
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概要
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<B>Background:</B> The purpose of this study was to evaluate the clinical results in sports players after modified Bankart and Bristow procedure for traumatic anterior shoulder instability.<BR><B>Methods:</B> Seventy-four shoulders of 68 sports players were enrolled in this study, overthrowing sports (groupT): 11 shoulders, overhead sports (groupO); 7, collision sports (groupCL): 24, contact sports (groupCT): 22, and winter sports (groupW):11. Our surgical indication of modified Bankart and Brisrow procedure was that glenoid bone loss was more than 25% or we cannot lift up AIGHL to articular surface. We evaluated clinical outcomes by JSS-SIS and JSS-SSS score, level of return to sports activities, the recurrence rate of dislocation and satisfaction level.<BR><B>Results:</B> Postoperative JSS-SIS and JSS-SSS score were improved significantly in all groups. Although all patients returned to pre-injury sports, the complete return rate was group T: 81%, O: 57%, CL: 85%, CT: 84%, W: 81%. Especially, return to pre-injury sports of dominant hand in group T and O was low (44%). Recurrence occurred in 1 shoulder in group CL, recurrence rate in all were 1.7%. Satisfaction was group T: 37%, O: 86%, CL:91%, CT: 76%, W: 73%.<BR><B>Discussion:</B> In this study, recurrence rate was low and all players returned to pre-injury sports. 91% of collision sports players were satisfied with the outcome of their surgery, so we think B procedure is indicated for collision sports players. But clinical results in overthrowing and overhead sports players when it involved their dominant hand, were worse than that in collision sports players, and limitation of ROM remained. We think a procedure that can preserve ROM is indicated for overthrowing and overhead sports players when it involved their dominant hand.
- 日本肩関節学会の論文
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