臨床整形外科48巻2号

2013年02月発行

誌上シンポジウム 高齢者の腱板断裂

腱板広範囲断裂症例のX線分類と臨床的特徴

著者： 濱田一壽¹ 山中芳² 内山善康³ 三笠貴彦⁴ 三笠元彦⁵

所属機関： ¹町田慶泉病院整形外科 ²山中整形外科 ³東海大学医学部整形外科 ⁴新横浜整形外科・リウマチ科 ⁵松戸整形外科病院

ページ範囲：P.131 - P.140

　腱板広範囲断裂のX線分類(grade 1－5)改訂版に沿って75症例(うち41例は手術例)の腱板広範囲断裂症例を検討した．初診時年齢，肩甲下筋の脂肪変性の程度，肩甲下筋腱断裂・棘下筋腱断裂の合併率はgrade 3－5がgrade 1，2よりも有意に高かった．発症から最終経過観察期間までの長さが，grade 1，2症例のgrade 3以上への進行のリスクファクターであった．手術例の術後再断裂率はgrade 2がgrade 1よりも高かった．以上から，腱板修復手術は肩峰骨頭間距離が狭小化する前に行うべきである．本研究はBurkhart，Hansen，von Eisenhart-Rotheらの提唱した腱板広範囲断裂の肩関節自動挙上メカニズムを支持する．

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