{"created":"2023-05-15T09:57:43.159947+00:00","id":1561,"links":{},"metadata":{"_buckets":{"deposit":"053eae54-5644-4d00-bdf1-cb65ed112f31"},"_deposit":{"created_by":5,"id":"1561","owner":"5","owners":[5],"pid":{"revision_id":0,"type":"depid","value":"1561"},"status":"published"},"_oai":{"id":"oai:miyazaki-u.repo.nii.ac.jp:00001561","sets":["72","72:30"]},"author_link":["7983","8731","8097","9318","8698","7830","8729","9899"],"item_10001_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2010-05-25","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"2","bibliographicPageEnd":"85","bibliographicPageStart":"78","bibliographicVolumeNumber":"32","bibliographic_titles":[{"bibliographic_title":"宮崎県医師会医学会誌","bibliographic_titleLang":"ja"},{"bibliographic_title":"The Journal of the Miyazaki Medical Association","bibliographic_titleLang":"en"}]}]},"item_10001_description_5":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"反復性肩関節前方脱臼は初回脱臼時,関節唇靱帯複合体が関節窩から剥離したこと（Bankart病変）による前下関節上腕靱帯の機能不全で生じる。近年Bankart病変を直接,関節鏡視下に解剖学的修復する鏡視下修復術の良好な成績が報告されている。しかし,肩甲骨関節窩前下方の骨片と共に複合体が剥離した骨性Bankart病変に対しては固定性,手術手技の困難さから鏡視下修復術の適応ではないとされてきた。骨性Bankart病変に対して鏡視下修復術を行い,関節窩骨形態が改善し良好な成績を得たので報告する。2006年6月から2007年11月まで骨性Bankart病変に対し鏡視下修復術を施行し9ヵ月以上経過観察した5例を対象とした。全例男性で右1肩,左4肩。手術時年齢は18～33歳,平均25.6歳,術後観察期間は9～18ヵ月,平均12.6ヵ月であった。術前と術後のJSS（日本肩関節学会）shoulder instability scoreにて評価した。JSS shoulder instability scoreは術前40～49点,平均43.6点が術後92～98点,平均95.4点に改善した。再脱臼例はなかった。手術は4mm径の関節鏡を使用し環流液で関節腔を満たしながら半座位で行っている。後方鏡視を基本とし前方,前上方のportalをworking portalとし計3個のportalを使用している。まず肩甲上腕関節に関節鏡を挿入し,骨片を含んだ複合体を肩甲下筋がみえるまで十分剥離する。アンカーを関節窩に挿入し,複合体と共に骨片にまわすように糸を通す。上方かつ関節窩側へのアドバンスメントし縫合する。術前認めた関節窩の欠損部には術後,骨片と共に複合体が持ち上げられる。以前行なわれていたopen法は展開の際,正常組織に大きな侵襲を加え,正常組織である烏口突起や共同腱を犠牲にし前下関節上腕靱帯の機能を代用させる姑息的手術であった。一方,本法は病変部へ低侵襲で到達でき,病変部を直接解剖学的に修復できる根治的手術である。また,骨性の癒合が得られ,関節窩の骨形態が改善する。骨性Bankart病変を持つ反復性肩関節脱臼に対して,鏡視下修復術は現段階では最良の手術である。","subitem_description_language":"ja","subitem_description_type":"Abstract"}]},"item_10001_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"宮崎県医師会","subitem_publisher_language":"ja"}]},"item_10001_source_id_11":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AN00236117","subitem_source_identifier_type":"NCID"}]},"item_10001_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"03898288","subitem_source_identifier_type":"ISSN"}]},"item_10001_version_type_20":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"石田, 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