臨床整形外科52巻2号

2017年02月発行

誌上シンポジウム リバース型人工肩関節手術でわかったこと

手術時ならびに後療法のコツ

著者： 櫻井真¹ 柴田陽三¹

所属機関： ¹福岡大学筑紫病院整形外科

ページ範囲：P.119 - P.124

　本稿ではリバース型人工肩関節置換術(RSA)の手術時ならびに後療法のコツについて述べる．RSAは従来の解剖学的な人工肩関節とは異なり，肩甲骨関節窩側に骨頭コンポーネントが，上腕骨側にソケットが設置される．RSA術後の関節安定性や挙上能力は三角筋に依存しているため，三角筋を損傷しないこと，適切な位置にグレノスフェアを設置することが重要である．術後の後療法は，脱臼を生じさせないこと，修復した肩甲下筋腱が癒合するまでは愛護的に扱うこと，肩関節の可動域・機能を改善・維持させるため三角筋や肩甲骨周囲筋群の強化訓練が重要となる．

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