オーバーヘッドスポーツ選手の肩肘痛における胸郭出口症候群の関与と治療成績

概要

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Background: The purpose of this study is to investigate clinical characteristics of thoracic outlet syndrome (TOS) in baseball shoulder and elbow cases and the clinical results of treatment. Methods: A diagnosis of TOS was made, when the patient had tenderness over the scalene muscle, costoclavicular interstice, or pectoralis minor tendon, and positive for Wright, Adson, Eden, Roos test. We studied 44 cases with this lesion. Results: There were 37 males and 7 females with a mean age of 13.8 years old. They all participated in overhead sports. They all presented with pain and limited motion in throwing shoulder or elbow in daily activity, and posterior shoulder tightness. All patients underwent the following conservative treatment,; suspension of sports participation, administration of NSAID and vitamin B12 compound, reconditioning of the whole body, throwing form correction, and tender point block. We performed a resection of the 1st rib on 2 patients who had been resistant to conservative treatment for a minimum of 3 months. After our treatment they could return to sports activity with the complete recovery rate of 85.1%. Japan Shoulder Society shoulder sports score improved significantly from 41 points on the first visit to 89 points on the final visit. Conclusion: TOS are not so rare in throwing athletes and should not be missed.
日本肩関節学会の論文