3/7(水)
◆今日の気持ち
(脳外科 2週目)
・先週末からがんばりすぎているようだ。ふらふらする。肩と頭がずきずき痛む。休まないと。
●目指す医師像
まずは、医者
●今の目標
・脳外科を味わいきる
●今日の新患・診断
・腱板断裂
・SLAP lesion
・関節炎
・慢性硬膜下血腫悪化
●今日の病院滞在時間
7時半〜20時半
●今日行ったこと・見たこと・知ったこと
・肩関節鏡下SLAP修復・腱板断裂修復
・肩のope。神経があつまっているせいか、あらゆる手術の中でも非常に痛む部類…。翌日痛みは軽減するが
・SLAP lesion (superior labrum anterior and posterior)
上腕二頭筋長腱の上腕骨への付着部にある関節唇が剥がれたもの。手術は、剥がれたところをむき(邪魔でみえないし、動くとき引っかかる)、腱を骨に固定する。デブリだけ、という手術方法もあるが、修復したほうがよい
・mirror lesion
バレーの選手とか、腱板不全断裂とSLAP lesionという上腕骨をはさんで向かい合う外傷を合併しやすい
・投手の肩
SLAP lesionや炎症はあっても、実は投げる動作は伸展だけで内外旋というねじれはないのでそれだけではいたくはない。腱の断裂や筋の障害などでバランスが崩れる結果として、肩関節がねじれ、痛みが生じる。Internal impingement。
・関節唇の新鮮な外傷ならば、母床、骨に赤みがある
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