交通外傷による肩関節障害の治療経験
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概要
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<B>Background:</B> We often encounter problems in treatment of injuries caused by traffic accident. We experienced cases of rotator cuff injuries in which proper diagnosis and treatment was delayed. The purpose of this study is to investigate the clinical features and background of treatment in those cases.<BR><B>Methods:</B> Twenty three patients (men 16, women 7, mean age 47.4) underwent surgical treatment and were investigated. All patients were drivers and types of accident were 14 rear-end collision, 8 side collision, and 1 fall down into the sea. The rotator cuff injuries included 4 cases of large tears of supraspinatus (SSP) + infrasupinatus + subscapuralis (SSC) tendon, 4 cases of incomplete tears of SSP and SSC, 6 cases of SSC tears, and 11 cases of rotator interval lesions (RIL). All cases were repaired under arthroscopy. The features of accidents, clinical findings, period between occurrence of accidents and diagnosis, and clinical outcomes were investigated. Clinical outcomes were evaluated according to JOA score. The average follow-up period was 2.7 years.<BR><B>Results:</B> The average of period between occurrence of accident and proper diagnosis was 6.2 months. JOA improved from 46.5 to 92.6 points. All the patients with large cuff tears were over 60 years old, whereas patients with SSC teas or RIL were 30 to 50 years old. In 15 cases, more than 6 months was spent to get proper diagnosis.<BR><B>Conclusion:</B> Shoulder injuries may be caused by even minor traffic accidents. Timely and proper diagnosis and treatment are necessary in patients with shoulder pain or functional disturbance.
- 日本肩関節学会の論文
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