Endo K, Ikata T, Katoh S, Takeda Y
Department of Orthopedic Surgery, School of Medicine, The University of Tokushima, Japan.
J Orthop Sci. 2001;6(1):3-10. doi: 10.1007/s007760170017.
This study presents an objective evaluation of both scapular upward and axial rotational tilts in shoulder impingement syndrome, using a scapular spine line defined on antero-posterior (AP) radiographs of the shoulder as the referential line. Twenty-seven patients with unilateral shoulder motion pain, who were diagnosed as having chronic shoulder impingement syndrome, were enrolled in the study. Scapular upward and axial rotational tilts were compared between the affected and contralateral shoulders. AP radiographs were obtained at shoulder abduction angles of 0 degrees, 45 degrees, and 90 degrees, and the X-ray films were digitized by computer. The upward and axial rotational tilts of the scapula were then evaluated on the digital images. In shoulder impingement syndrome, both upward and axial external rotations of the scapula were impaired at the painful arc angle of abduction. This tended to be more apparent for the axial rotation of the scapula than for the upward rotation. These reductions in scapular rotations reduce available clearance for the rotator cuff and humeral greater tuberosity as the shoulder is abducted.
本研究使用在肩部前后位（AP）X线片上定义的肩胛冈线作为参考线，对肩峰撞击综合征中肩胛骨的向上和轴向旋转倾斜进行了客观评估。27例单侧肩部运动疼痛且被诊断为慢性肩峰撞击综合征的患者纳入本研究。比较患侧和对侧肩部的肩胛骨向上和轴向旋转倾斜情况。在肩部外展角度为0度、45度和90度时获取AP X线片，并通过计算机将X线片数字化。然后在数字图像上评估肩胛骨的向上和轴向旋转倾斜。在肩峰撞击综合征中，在疼痛的外展弧角度时，肩胛骨的向上和轴向向外旋转均受损。这在肩胛骨的轴向旋转方面往往比向上旋转更明显。随着肩部外展，肩胛骨旋转的这些减少会降低肩袖和肱骨大结节的可用间隙。
