田中基貴, 菅谷啓之, 高橋憲正, 河合伸昭, 北山総一郎, 渡海守人, 岩本航, 笹沼秀幸, 大西和友, 上田祐輔, 森石丈二, 梶山史郎
肩関節 37(3) 945-948 2013年10月11日
Background: Preoperative assessment including the glenoid morphology and soft tissue pathology is a key to success for surgical intervention for traumatic anterior glenohumeral instability. Although examination under anesthesia is still a standard procedure for the measurement of the instability, we incidentally detected the anterior shift of humeral head in the routine modified Bernageau view in patients with anterior glenohumeral instability. The purpose of this study is to investigate the effectiveness of this method for the assessment of anterior instability.<BR>Methods: 302 patients underwent an arthroscopic stabilization for anterior glenohumeral instability between 2010 and 2011. Exclusion criteria were as follows: Patients who have multidirectional instability, instability in both shoulders, history prior surgery, Patients unable to take the modified Bernageau view for apprehensive sensation. Therefore 169 patients were included in this study, with an average age of 25.7 years. We calculated the average ratio of anterior translation of the center of humeral head in both shoulders. The values were compared between the normal side (G/R) and the affected side (G'/R'). Mann-Whitney's U test was utilized for statistical analysis. The significant value was established at p ‹ 0.05.<BR>Results: The average ratio of anterior translation of the humeral head was 0.319 on the affected side and 0.252 on the contralateral side. The value in affected side was significantly higher than that on the contralateral side (p ‹ 0.01).<BR>Conclusion: The modified Bernageu view shows significant anterior translation in patients with traumatic anterior glenohumeral instability. These results suggest the modified Bernageu view is a useful procedure to evaluate anterior instability by a simple X-ray.