補強Caspair法術後の固定肢位の検討

[Purpose]An arthroscopic Bankart repair for anterior shoulder instability had a relatively high rate of recurrence but the limitations of external rotation were small comapared to an open Bankart repa ir. We performed transglenoid multiple suture (Caspari) technique reinforced with subscapularis to get better stability. However, the limitation of external rotation remained in the internal rotation arm fixation position. So, we changed the arm position to neutral rotation position with arm at the side. The purpose of this study was to evaluate the effects of the neutral rotation position with arm at the side.<BR>[Materials and Methods] We retrospectively studied 31 patients after reinforced Caspari procedure more than one year postoperatively. The average age at the operation was 24 years old. ROM exercises were started after 3 weeks immobilization.17 shoulders were fixed in the internal rotation position with arm at the side, and 14 shoulders were in the neutral position.<BR>[Results] As to the postoperative external rotation, affected/unaffected side ratio (%) at 3 months postoperatively,48±24% in the internal group (IR),66±20% in the neutral group (NR) (Mann-Whitney U, P<0.05). At 6 months,64±23% in the (IR),84±23% in the ( NR), at 12 months 78±21% in the (IR),86±9 % in the (NR) (N. S).2 patients in the IR Group complained of pain 12 months after the operation, but in the NR group, patients did not complain of pain.<BR>[Conclusion] In the immobilization at neutral rotation position after a reinforced Caspair procedure, patients got a larger external rotation angle, ant complainer less of pain in the earlier period. How ever, over a long period, we could not obtain a significant difference between internal and neutral ro ttation.