腱板不全断裂の保存的治療に影響を及ぼす因子の検討

Factors Influencing the Outcome of Nonsurgical Treatment for Partial-thickness Rotator Cuff Tears

　腱板不全断裂の保存的治療に影響する因子について検討した．症例は保存的治療を行った腱板不全断裂105例である．治療が奏効した有効群43例と無効群62例の両群間で各種因子について比較検討した．統計はロジスティック回帰分析を用いオッズ比を算出した．各群間で有意差を認めた因子は年齢，肩峰下骨棘の大きさ，滑液包面断裂などで，各因子のオッズ比は年齢3.33，骨棘の大きさ2.63，滑液包面断裂33.33，外旋可動域1.11，挙上可動域1.11であった．年齢の若い滑液包面断裂で，肩峰下骨棘が大きい症例では保存的治療が奏効しない可能性が示唆された．

　The purpose of this study was to identity factors that influence the outcome of nonsurgical treatment for partial-thickness rotator cuff tears (PTRCTs). There were 105 patients, and their average age was 58.6 years. All patients were treated nonsurgically. Satisfactory results were achieved in 43 patients, and the 62 patients with unsatisfactory results eventually required surgery. Factors in these two groups were compared. All data were statistically evaluated by a logistic analysis. Factors identified as significantly different were age, size of the subacromial spur, bursal-sided tear, and range of forward elevation and external rotation, and the odds ratios were 3.33, 2.63, 33.33, 1.11, and 1.11, respectively. The results of this study suggested that age, bursal-sided tear, large subacromial spur, and restriction of shoulder motion are factors that induce a poor outcome of nonsurgical treatment for PTRCTs.