野球選手の肘尺側側副靱帯損傷に対する靭帯再建術（両側スーチャーアンカー固定法）の臨床成績
野球選手の肘関節尺側側副靱帯（UCL）損傷に対し，長掌筋腱を用い尺骨・上腕骨の両側をスーチャーアンカーで固定するUCL再建術を行い臨床成績を調査した．対象は全例男性，36例36肘，手術時年齢は平均19.4歳，投手27例，捕手4例，野手5例で，術後経過観察期間は平均18.5ヶ月であった．手術はUCL前方線維上のFDSの剥離とUCLレムナントの尺骨側の剥離を最小限とし，尺骨側は鉤状結節部に1つの浅い骨孔，上腕骨側は内側上顆を貫通する骨孔を空け，両側をスーチャーアンカーで縫着した．全例が平均10.2ヶ月で野球競技復帰を果たし，Conway-Jobe ratingはexcellent：29例，good...
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| Published in | 日本肘関節学会雑誌 Vol. 29; no. 2; pp. 182 - 185 |
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| Main Authors | , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本肘関節学会
2022
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1349-7324 2434-2262 |
| DOI | 10.24810/jelbow.29.2_182 |
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| Abstract | 野球選手の肘関節尺側側副靱帯（UCL）損傷に対し，長掌筋腱を用い尺骨・上腕骨の両側をスーチャーアンカーで固定するUCL再建術を行い臨床成績を調査した．対象は全例男性，36例36肘，手術時年齢は平均19.4歳，投手27例，捕手4例，野手5例で，術後経過観察期間は平均18.5ヶ月であった．手術はUCL前方線維上のFDSの剥離とUCLレムナントの尺骨側の剥離を最小限とし，尺骨側は鉤状結節部に1つの浅い骨孔，上腕骨側は内側上顆を貫通する骨孔を空け，両側をスーチャーアンカーで縫着した．全例が平均10.2ヶ月で野球競技復帰を果たし，Conway-Jobe ratingはexcellent：29例，good：5 例，fair：1例であった．JOA-JESスポーツスコアは術前46.1点から術後93.4点に有意に改善した．本法はUCLレムナントを温存でき簡便にUCL再建できる有用な方法と思われた． |
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| AbstractList | 野球選手の肘関節尺側側副靱帯（UCL）損傷に対し，長掌筋腱を用い尺骨・上腕骨の両側をスーチャーアンカーで固定するUCL再建術を行い臨床成績を調査した．対象は全例男性，36例36肘，手術時年齢は平均19.4歳，投手27例，捕手4例，野手5例で，術後経過観察期間は平均18.5ヶ月であった．手術はUCL前方線維上のFDSの剥離とUCLレムナントの尺骨側の剥離を最小限とし，尺骨側は鉤状結節部に1つの浅い骨孔，上腕骨側は内側上顆を貫通する骨孔を空け，両側をスーチャーアンカーで縫着した．全例が平均10.2ヶ月で野球競技復帰を果たし，Conway-Jobe ratingはexcellent：29例，good：5 例，fair：1例であった．JOA-JESスポーツスコアは術前46.1点から術後93.4点に有意に改善した．本法はUCLレムナントを温存でき簡便にUCL再建できる有用な方法と思われた． |
| Author | 梶田, 幸宏 伊藤, 岳史 川島, 至 岩堀, 裕介 |
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| References | 2) 伊藤恵康，鵜飼康二，綾部敬生，ほか：スポーツ障害としての肘関節尺側側副靭帯損傷．10年間163例の治療経験．日整外スポーツ医会誌．2002; 22: 210-6. 5) Paletta G Jr, Klepps S, DiFelice GS, et al: Biomechanical evaluation of 2 techniques of ulnar collateral ligament reconstruction of the elbow. AmJ Sports Med. 2006; 34: 1599-603. 6) Ahmed C, Lee TQ, EIAtttache N, et al: Biomechanical evaluation of a new ulnar collateral ligament reconstruction technique with interference screw fixation. Am J Sports Med. 2003; 31: 332-7. 9) 正富隆：尺側側副靱帯再建術－Jobe法の改良．越智隆弘ほか編．New Mook 整形外科11 肘の外科，金原出版，東京，2002, 131-40. 13) Otoshi K, Kikuchi S, Shishido H, et al: The proximal origins of the flexor-pronator muscles and their role in the dynamic stabilization of the elbow joint: an anatomical study. Surg Radiol Anat. 2014; 36: 289-94. 10) Conway JE, Jobe FW, Glousman RE, et al: Medial instability of the elbow in throwing athlets. Treatment by repair reconstruction of the ulnar collateral ligament. J Bone Joint Surg Am. 1992; 74: 67-83. 4) Rohrbough J, Altcheck D, Botts J: Medial collateral ligament reconstruction of the elbow using the docking technique. Am J Sports Med. 2002; 30: 541-8. 7) 田中寿一：肘関節側副靱帯再建術－TJ screw systemによる．関節外科．2005; 24: 28-36. 3) 伊藤恵康：内側（尺側）側副靭帯損傷．肘関節外科の実際，南江堂，東京，2011, 228-42. 8) Dines J, EIAtttache N, Ahmed C, et al: Clinical outcome of the DANE TJ technique to treat ulnar collateral ligament insufficiency of the elbow. Am J Sports Med. 2007; 35: 2039-40. 11) Smith GR, Altchek DW, Keely J: A muscle splitting approach to the ulnar collateral ligament of the elbow. Am J Sports Med. 1996; 24: 575-80. 1) Jobe FW, Stark H, Lombardo SJ: Reconstruction of the ulnar collateral ligament in athletes. J Bone Joint Surg Am. 1986; 68: 1158-63. 12) Morrey BF, An KN: Functional anatomy of the ligaments of the elbow. Clin Orthop Relat Res. 1985; 201: 84-90. |
| References_xml | – reference: 8) Dines J, EIAtttache N, Ahmed C, et al: Clinical outcome of the DANE TJ technique to treat ulnar collateral ligament insufficiency of the elbow. Am J Sports Med. 2007; 35: 2039-40. – reference: 11) Smith GR, Altchek DW, Keely J: A muscle splitting approach to the ulnar collateral ligament of the elbow. Am J Sports Med. 1996; 24: 575-80. – reference: 1) Jobe FW, Stark H, Lombardo SJ: Reconstruction of the ulnar collateral ligament in athletes. J Bone Joint Surg Am. 1986; 68: 1158-63. – reference: 2) 伊藤恵康，鵜飼康二，綾部敬生，ほか：スポーツ障害としての肘関節尺側側副靭帯損傷．10年間163例の治療経験．日整外スポーツ医会誌．2002; 22: 210-6. – reference: 13) Otoshi K, Kikuchi S, Shishido H, et al: The proximal origins of the flexor-pronator muscles and their role in the dynamic stabilization of the elbow joint: an anatomical study. Surg Radiol Anat. 2014; 36: 289-94. – reference: 4) Rohrbough J, Altcheck D, Botts J: Medial collateral ligament reconstruction of the elbow using the docking technique. Am J Sports Med. 2002; 30: 541-8. – reference: 9) 正富隆：尺側側副靱帯再建術－Jobe法の改良．越智隆弘ほか編．New Mook 整形外科11 肘の外科，金原出版，東京，2002, 131-40. – reference: 12) Morrey BF, An KN: Functional anatomy of the ligaments of the elbow. Clin Orthop Relat Res. 1985; 201: 84-90. – reference: 6) Ahmed C, Lee TQ, EIAtttache N, et al: Biomechanical evaluation of a new ulnar collateral ligament reconstruction technique with interference screw fixation. Am J Sports Med. 2003; 31: 332-7. – reference: 7) 田中寿一：肘関節側副靱帯再建術－TJ screw systemによる．関節外科．2005; 24: 28-36. – reference: 10) Conway JE, Jobe FW, Glousman RE, et al: Medial instability of the elbow in throwing athlets. Treatment by repair reconstruction of the ulnar collateral ligament. J Bone Joint Surg Am. 1992; 74: 67-83. – reference: 5) Paletta G Jr, Klepps S, DiFelice GS, et al: Biomechanical evaluation of 2 techniques of ulnar collateral ligament reconstruction of the elbow. AmJ Sports Med. 2006; 34: 1599-603. – reference: 3) 伊藤恵康：内側（尺側）側副靭帯損傷．肘関節外科の実際，南江堂，東京，2011, 228-42. |
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| Title | 野球選手の肘尺側側副靱帯損傷に対する靭帯再建術（両側スーチャーアンカー固定法）の臨床成績 |
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