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1 Differences in SLAP lesion between volleyball and baseball players
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1
Abstracts
J Shoulder Elbow May/June
DIFFERENCES IN SLAP LESION BETWEEN VOLLEYBALL AND BASEBALL PLAYERS K. Fukushima, MD, A. Saito, MD, & S. Funami, MD, Dept of Orthpedic Sugery, Nihon Univ. Sch. of Med., Tokyo During the 23rd Meeting, we reported the mechanism of SLAP lesion occurring in volleyball players. This time we compared the clinical and arthrosco ic findings of this disorder between volleyball an cr baseball players. 377 athletes complaining of shoulder pain, 15 volleyball players (V-G) and 34 baseball players (B-G) entered the study. After evaluating the history in playing, assigned osition, and clinical findings, surgery was perPormed in 6 patients (V-G) and 1 1 patients (B-G) and their arthroscopic findings were compared. All patients have been playing for over 5 years with approximately 60% in the V-G and over 80% in the B-G having more than 10 years of experience. The majority of players in the V-G was attackers and in the B-G pitchers. While more patients in the B-G showed impingement sign, speed test and Yargason test were found in the V-G. Shoulder instability was more apparent in female players of the V-G. Arthroscopy revealed SLAP lesion in all V-G patients with severe damage of BLC and many also showing looseness of anterior capsule. In B-G, changes of SAB and C-A lig., as well as damaged posterior capsule and Bennett lesion, were apparent. Many patients of the V-G demonstrated damage around BLC, indicating shoulder instability involvement, while impingement syndrome was the maior symptom of the B-G, also showing damaged posterior capsule and Bennett lesion.
2
THE PROBLEM IN SHOULDER DENT SUM0 WRESTLERS Y. Nakagawa, Nakamura, gery, Faculty
JOINTS
MD, Y. Matsusue, MD, MD, Department of Orthopaedic of Medicine, Kyoto University,
FOR STUand
T. SurKyoto,
Japan Purpose: We
previously reported that the shoulder pain was the forth, and disability was the second problem for sumo wrestlers. We examined sumo wrestlers directly in order to study the shoulder problem for sumo. Materials and Methods: Forty-three sumo wrestlers who belonged to the major league in Western Japanese Student Sumo Federation were examined from February to April in 1997. Their mean height was 174.4 cm, weight 106.2 kg, body mass index 34.9, age 19.3 years old and sumo career 9.5 years. We obtained the past histories, present disabilities, physical examination, range of motion and shoulder joint laxity. Results: Twenty-two cases (5 1%) had past histories of the shoulder:shoulder dislocation 10 cases (23%), contusion 5 cases (12%), acromioclavicular joint dislocation 4 cases (9%) and so on. Seven
Surg I998
cases (16%) had present disability:shoulder dislocation 2 cases, acromioclavicular joint dislocation 2 cases and so on. The sumo wrestler who had less weight tended to injure and dislocate his shoulder, and the number of them who complained shoulder problems increased as the had longer sumo cainflureer, according to this stu J y. No significant ence was shown between the range of motion, shoulder joint laxity and shoulder problems. Conclusion: The sumo wrestler whose weight was lighter tended to iniure and dislocate his shoulder. Some of them who had previously dislocated their shoulder interfered with their sumo playing.
3
SIGNIFICANCE OF NOTCHES OF THE GREATER TUBEROSITY IN THE SHOULDER OF BASEBALL PLAYERS S. Nakagawa, M. Yoneda*, H. Seki”, K. Kagaya” & K. Hayashida**, Dept. of Orthop. Surg., Hoshigaoka Kosei-nenkin Hosp., *Osaka Koseinenkin Hosp. & **Osaka Univ. Med. School The purpose of this study was to clarify the significance of notches of the greater tuberosity (GT notches) in the shoulder of baseball pla ers. Fortynine baseball players who iniured theirs tI oulders through repetitive throwing and underwent shoulder arthroscopy were studied retrospectively. They ranged in age from 14 to 48 years (average: 23 years). The location and size of GT notches were determined from the arthroscopic recordings. Then the relationship between GT notches and several other factors was examined, such as the history of baseball, history of pitching, gleno-humeral joint laxity and ROM on examination under anesthesia, the location, depth and width of articular-side partial rotator cuff tears (APRCTs), and labral tears. Statistical analyses were done using the chi-square test. In result, the formation of GT notches was recognized in 32 shoulders (65%). All of them faced the posterior rotator interval (post. RI) between the supraspinatus tendon (SSP) and infraspinatus tendon (ISP), and extended to the ISP side as they became larger. Therefore, they were classified into 4 groups according to the size of them; Group 1: no notch (17 shoulders), Group 2: small notches restricted to the post. RI (12 shoulders), Group 3: medium notches smaller than l/4 of ISP insertion (1 1 shoulders), Group 4: large notches larger than l/4 of ISP insertion (9 shoulders). The existence of an APRCT was strongly correlated with the formation of GT notches (p < 0.001). The width and depth of the APRCT also significantly influenced the size of the GT notch (p < 0.001). The other factors showed no significant influence on the formation of GT notches. In conclusion, the formation of GT notches seen in throwing shoulders is strongly correlated with the existence of APRCTs. The size of a GT notch recognized in plain X-ray is thought to be an important sign suggesting the severity of an APRCT.
1
Abstracts
J Shoulder Elbow May/June
DIFFERENCES IN SLAP LESION BETWEEN VOLLEYBALL AND BASEBALL PLAYERS K. Fukushima, MD, A. Saito, MD, & S. Funami, MD, Dept of Orthpedic Sugery, Nihon Univ. Sch. of Med., Tokyo During the 23rd Meeting, we reported the mechanism of SLAP lesion occurring in volleyball players. This time we compared the clinical and arthrosco ic findings of this disorder between volleyball an cr baseball players. 377 athletes complaining of shoulder pain, 15 volleyball players (V-G) and 34 baseball players (B-G) entered the study. After evaluating the history in playing, assigned osition, and clinical findings, surgery was perPormed in 6 patients (V-G) and 1 1 patients (B-G) and their arthroscopic findings were compared. All patients have been playing for over 5 years with approximately 60% in the V-G and over 80% in the B-G having more than 10 years of experience. The majority of players in the V-G was attackers and in the B-G pitchers. While more patients in the B-G showed impingement sign, speed test and Yargason test were found in the V-G. Shoulder instability was more apparent in female players of the V-G. Arthroscopy revealed SLAP lesion in all V-G patients with severe damage of BLC and many also showing looseness of anterior capsule. In B-G, changes of SAB and C-A lig., as well as damaged posterior capsule and Bennett lesion, were apparent. Many patients of the V-G demonstrated damage around BLC, indicating shoulder instability involvement, while impingement syndrome was the maior symptom of the B-G, also showing damaged posterior capsule and Bennett lesion.
2
THE PROBLEM IN SHOULDER DENT SUM0 WRESTLERS Y. Nakagawa, Nakamura, gery, Faculty
JOINTS
MD, Y. Matsusue, MD, MD, Department of Orthopaedic of Medicine, Kyoto University,
FOR STUand
T. SurKyoto,
Japan Purpose: We
previously reported that the shoulder pain was the forth, and disability was the second problem for sumo wrestlers. We examined sumo wrestlers directly in order to study the shoulder problem for sumo. Materials and Methods: Forty-three sumo wrestlers who belonged to the major league in Western Japanese Student Sumo Federation were examined from February to April in 1997. Their mean height was 174.4 cm, weight 106.2 kg, body mass index 34.9, age 19.3 years old and sumo career 9.5 years. We obtained the past histories, present disabilities, physical examination, range of motion and shoulder joint laxity. Results: Twenty-two cases (5 1%) had past histories of the shoulder:shoulder dislocation 10 cases (23%), contusion 5 cases (12%), acromioclavicular joint dislocation 4 cases (9%) and so on. Seven
Surg I998
cases (16%) had present disability:shoulder dislocation 2 cases, acromioclavicular joint dislocation 2 cases and so on. The sumo wrestler who had less weight tended to injure and dislocate his shoulder, and the number of them who complained shoulder problems increased as the had longer sumo cainflureer, according to this stu J y. No significant ence was shown between the range of motion, shoulder joint laxity and shoulder problems. Conclusion: The sumo wrestler whose weight was lighter tended to iniure and dislocate his shoulder. Some of them who had previously dislocated their shoulder interfered with their sumo playing.
3
SIGNIFICANCE OF NOTCHES OF THE GREATER TUBEROSITY IN THE SHOULDER OF BASEBALL PLAYERS S. Nakagawa, M. Yoneda*, H. Seki”, K. Kagaya” & K. Hayashida**, Dept. of Orthop. Surg., Hoshigaoka Kosei-nenkin Hosp., *Osaka Koseinenkin Hosp. & **Osaka Univ. Med. School The purpose of this study was to clarify the significance of notches of the greater tuberosity (GT notches) in the shoulder of baseball pla ers. Fortynine baseball players who iniured theirs tI oulders through repetitive throwing and underwent shoulder arthroscopy were studied retrospectively. They ranged in age from 14 to 48 years (average: 23 years). The location and size of GT notches were determined from the arthroscopic recordings. Then the relationship between GT notches and several other factors was examined, such as the history of baseball, history of pitching, gleno-humeral joint laxity and ROM on examination under anesthesia, the location, depth and width of articular-side partial rotator cuff tears (APRCTs), and labral tears. Statistical analyses were done using the chi-square test. In result, the formation of GT notches was recognized in 32 shoulders (65%). All of them faced the posterior rotator interval (post. RI) between the supraspinatus tendon (SSP) and infraspinatus tendon (ISP), and extended to the ISP side as they became larger. Therefore, they were classified into 4 groups according to the size of them; Group 1: no notch (17 shoulders), Group 2: small notches restricted to the post. RI (12 shoulders), Group 3: medium notches smaller than l/4 of ISP insertion (1 1 shoulders), Group 4: large notches larger than l/4 of ISP insertion (9 shoulders). The existence of an APRCT was strongly correlated with the formation of GT notches (p < 0.001). The width and depth of the APRCT also significantly influenced the size of the GT notch (p < 0.001). The other factors showed no significant influence on the formation of GT notches. In conclusion, the formation of GT notches seen in throwing shoulders is strongly correlated with the existence of APRCTs. The size of a GT notch recognized in plain X-ray is thought to be an important sign suggesting the severity of an APRCT.