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20 Isometric strength of the small tears of the rotator cuff
326
Abstracts
J Shoulder Elbow May/June
form of rotator cuff tear. Finding of the rotator cuff tear was grasped and diagnosed too much with a subjective judgement of surgeons. It is necessary to express the pathologic states of the rotator cuff more accurately, adding augument findings such as form and shape and involved tendons.
20
ISOMETRIC STRENGTH OF THE SMALL TEARS OF THE ROTATOR CUFF I Soito, PT*, H Minagawa, MD*, E /to;, MD* *, T Nishi, MD*, M Oba, MD*, *Dept of Orthop Surg, Ugo Municipal Hosp, **Dept of Orthop Surg, Akita Univ Schl of Med, Akita, Japan The purpose of this study was to clarify the isometric strength of the shoulder abduction and external rotation in small tears of the rotator cuff. Among 18 symptomatic shoulders with small tears of the rotator cuff (area < 4 cm2 on MRI), 11 shoulders (1 1 patients) without a history of shoulder pain on the contralateral side were enrolled in this study. The atients were grouped according to the location o the tear; six had the isolated superaspinatus (SSP) tears (mean age 61 years, mean size 1.3 1 cm2) and six had the SSP-infraspinatus (BP) tears (mean age 65 years, mean size 1.52 cm’). We measured the isometric strength of abduction and external rotation of both shoulders using Micro FET II (Nihon Medics). A preliminary session was followed by three maximum efforts after injection 5 ml of 1% mepivacaine into the subacromial bursa of the tear side to relieve pain. The peak torque which was the highest torque value seen from all repetitions were measured and expressed percentages of those of the contralateral side. The external rotation strength of the isolated SSP tears was almost equal to the SSP-ISP tears (100.311 1 .O%, 107.8 + 12.6%, respectively). On the other hand, the abduction strength of the isolated SSP tears was significantly smaller than the SSP-ISP tears (65.0 2 30.3% 129.3 t 26.4%, respectively; p = 0.042). The abduction strength in small tears was affected by the location of the tear.
tion. The subjects comprised 591 men and 138 women (average age: 56.0 years). Among those patients where there was a long period between the time of injury or symptom onset and surgery, many experienced pain, muscle stren th tended to be close to normal, and a signi 9icant number had abduction of 90 degrees or more. In the maiority of cases, rotator cuff tears do not require operations if a certain degree of improvement in symptoms, particularly range of motion and muscle strength, can be achieved by conservative treatment implemented soon after injury or symptom onset. However, the results presented indicate that in some patients, pain will become a problem if there is a long period between injury and surgery, despite improvement
22
AN IMPROVEMENT OF ZERO-POSITION SHOULDER BRACE Y. Iwata, MD, M. Kurokawa, MD, K. Miura, MD, K. Yanaga, MD, M. lamai, MD and Y. Hirasawa, MD, Dept. of Orthop. Surg., Kyoto Prefectural Univ. of Medicine, Kyoto, Japan Adjustment of a shoulder brace can be difficult, especially in internal and external rotation. In 1986, we developed the design for shoulder brace Markl, which could maintain the shoulder in the zero-position, and we have used this device in rehabilitation after rotator cuff repair. Mark1 differs from other braces with regard to two points. One is that the center of abduction is placed in front of the shoulder and the other is that the ad’ustor rotates the upper arm. However, there are stil I three problems with the mark1 brace; 1. Individual fit and manufacture is required. 2. It is heavy. 3. it is difficult to adjust the appropriate osition of shoulder. we designed a new shoulder lz race, the Mark2 in order to be adiustable, readymade and lighter. The Mark2 shoulder brace can be adjusted easily from 30” to 150” in 10 degree units: Adduction and abduction limits can be set up in relation to each other, so the Mark2 allows more flexible ROM. The axis of internal and external rotation can be put along the humerus with two parallel bars to the humerus. Compared with the Mark1 , the Mark2 fits more comfortably and easily. However, Mark2 can not be lighter and be a ready-made product.
23
CLINICAL FEATURES OF THE RUPTURE OF THE SUBSCAPULARIS TENDON Sakata Jakeshi, Hashimoto fun, Shirakawa Taizan, Murai Satoshi, Nobuhara Kafsuya, Nobuhara Hospital and Institute of Biomechanics urpose The of this study was to compare the clinica P features of the subscapularis tendon avulsed from the lesser tuberosity with those of the
f
21
PAIN AND INDICATIONS FOR SURGERY IN ROTATOR CUFF TEARS M. Komai, MD, Kie. Mimori, MD, 1. Nagai, MD, S. Maruo, MD*, & K. Nobuhara, MD, ** *Dept of Orthop. Surg. Hyogo Colleg of Medicine, **Dept of Orthop. Surg. Nobuhara Hospital To investigate when surgery is indicated for rotator cuff tears, focusing on pain. Period before surgery, pain before and after surgery, range of motion and muscle strength were studied in 729 shoulders selected from among IO37 rotator cuff tear cases repaired at the Nobuhara Hospital over a 26-year period from 1970. Those selected had undergone through investiga-
Surg 1998
Abstracts
J Shoulder Elbow May/June
form of rotator cuff tear. Finding of the rotator cuff tear was grasped and diagnosed too much with a subjective judgement of surgeons. It is necessary to express the pathologic states of the rotator cuff more accurately, adding augument findings such as form and shape and involved tendons.
20
ISOMETRIC STRENGTH OF THE SMALL TEARS OF THE ROTATOR CUFF I Soito, PT*, H Minagawa, MD*, E /to;, MD* *, T Nishi, MD*, M Oba, MD*, *Dept of Orthop Surg, Ugo Municipal Hosp, **Dept of Orthop Surg, Akita Univ Schl of Med, Akita, Japan The purpose of this study was to clarify the isometric strength of the shoulder abduction and external rotation in small tears of the rotator cuff. Among 18 symptomatic shoulders with small tears of the rotator cuff (area < 4 cm2 on MRI), 11 shoulders (1 1 patients) without a history of shoulder pain on the contralateral side were enrolled in this study. The atients were grouped according to the location o the tear; six had the isolated superaspinatus (SSP) tears (mean age 61 years, mean size 1.3 1 cm2) and six had the SSP-infraspinatus (BP) tears (mean age 65 years, mean size 1.52 cm’). We measured the isometric strength of abduction and external rotation of both shoulders using Micro FET II (Nihon Medics). A preliminary session was followed by three maximum efforts after injection 5 ml of 1% mepivacaine into the subacromial bursa of the tear side to relieve pain. The peak torque which was the highest torque value seen from all repetitions were measured and expressed percentages of those of the contralateral side. The external rotation strength of the isolated SSP tears was almost equal to the SSP-ISP tears (100.311 1 .O%, 107.8 + 12.6%, respectively). On the other hand, the abduction strength of the isolated SSP tears was significantly smaller than the SSP-ISP tears (65.0 2 30.3% 129.3 t 26.4%, respectively; p = 0.042). The abduction strength in small tears was affected by the location of the tear.
tion. The subjects comprised 591 men and 138 women (average age: 56.0 years). Among those patients where there was a long period between the time of injury or symptom onset and surgery, many experienced pain, muscle stren th tended to be close to normal, and a signi 9icant number had abduction of 90 degrees or more. In the maiority of cases, rotator cuff tears do not require operations if a certain degree of improvement in symptoms, particularly range of motion and muscle strength, can be achieved by conservative treatment implemented soon after injury or symptom onset. However, the results presented indicate that in some patients, pain will become a problem if there is a long period between injury and surgery, despite improvement
22
AN IMPROVEMENT OF ZERO-POSITION SHOULDER BRACE Y. Iwata, MD, M. Kurokawa, MD, K. Miura, MD, K. Yanaga, MD, M. lamai, MD and Y. Hirasawa, MD, Dept. of Orthop. Surg., Kyoto Prefectural Univ. of Medicine, Kyoto, Japan Adjustment of a shoulder brace can be difficult, especially in internal and external rotation. In 1986, we developed the design for shoulder brace Markl, which could maintain the shoulder in the zero-position, and we have used this device in rehabilitation after rotator cuff repair. Mark1 differs from other braces with regard to two points. One is that the center of abduction is placed in front of the shoulder and the other is that the ad’ustor rotates the upper arm. However, there are stil I three problems with the mark1 brace; 1. Individual fit and manufacture is required. 2. It is heavy. 3. it is difficult to adjust the appropriate osition of shoulder. we designed a new shoulder lz race, the Mark2 in order to be adiustable, readymade and lighter. The Mark2 shoulder brace can be adjusted easily from 30” to 150” in 10 degree units: Adduction and abduction limits can be set up in relation to each other, so the Mark2 allows more flexible ROM. The axis of internal and external rotation can be put along the humerus with two parallel bars to the humerus. Compared with the Mark1 , the Mark2 fits more comfortably and easily. However, Mark2 can not be lighter and be a ready-made product.
23
CLINICAL FEATURES OF THE RUPTURE OF THE SUBSCAPULARIS TENDON Sakata Jakeshi, Hashimoto fun, Shirakawa Taizan, Murai Satoshi, Nobuhara Kafsuya, Nobuhara Hospital and Institute of Biomechanics urpose The of this study was to compare the clinica P features of the subscapularis tendon avulsed from the lesser tuberosity with those of the
f
21
PAIN AND INDICATIONS FOR SURGERY IN ROTATOR CUFF TEARS M. Komai, MD, Kie. Mimori, MD, 1. Nagai, MD, S. Maruo, MD*, & K. Nobuhara, MD, ** *Dept of Orthop. Surg. Hyogo Colleg of Medicine, **Dept of Orthop. Surg. Nobuhara Hospital To investigate when surgery is indicated for rotator cuff tears, focusing on pain. Period before surgery, pain before and after surgery, range of motion and muscle strength were studied in 729 shoulders selected from among IO37 rotator cuff tear cases repaired at the Nobuhara Hospital over a 26-year period from 1970. Those selected had undergone through investiga-
Surg 1998