肩腱板断裂術後にみられた反射性交感神経性ジストロフィー様症状の検討

Reflex Sympathetic Dystrophy Associated with Postoperative Rotator Cuff Tears

　腱板断裂術後67例72肩を対象に，同側手指の腫脹，疼痛，拘縮といったRSD様症状の合併頻度，経過，術後成績を調査した．13肩にRSD様症状がみられた．RSD様症状あり群となし群を比較すると，あり群では術後の肩屈曲・外旋可動域がなし群に比べ有意に小さかった．しかし，手術時間，断裂面積に有意差はなく，術後成績も差がなかった．このことから，RSD様症状の合併する例で肩の可動域制限が出現する可能性が考えられ，腱板修復術後に同症状がみられた場合には早期に治療を開始し，肩の可動域訓練に注意する必要がある．

　The incidence and duration of symptoms in reflex sympathetic dystrophy (RSD) after rotator cuff repair were retrospectively examined in 72 shoulders (67 patients). The effect of RSD associated with rotator cuff repair on the results of the surgery was also examined. Symptoms of RSD were observed in 13 shoulders within less than 8 weeks after the operation, and they were remitted in all cases within 1 year after the operation. However the flexion and external rotation range of shoulders at follow up in the RSD group were significantly smaller than those in the non-RSD group. The duration of pain or limited shoulder motion associated with rotator cuff tears in the RSD group were significantly longer than those in the non-RSD group. Therefore we consider that RSD contributes to a decrease in shoulder motion after rotator cuff repair, and early diagnosis and treatment are necessary to prevent prolonged symptoms of RSD associated with rotator cuff repair.