Urayama M, Itoi E, Hatakeyama Y, Pradhan R L, Sato K
Department of Orthopedic Surgery, Akita University School of Medicine, Japan.
J Shoulder Elbow Surg. 2001 Nov-Dec;10(6):589-94. doi: 10.1067/mse.2001.119391.
The stabilizing function of the inferior glenohumeral ligament of the anterior band and posterior band has been investigated, but little is known about the function of the axillary pouch. The strain of the 3 portions of the inferior glenohumeral ligament in 17 fresh-frozen cadaveric shoulders was measured with use of linear transducers. The measurements were performed under the following conditions: 0 degrees, 30 degrees, 45 degrees, and 60 degrees of glenohumeral elevation in the coronal, scapular, and sagittal planes and internal to external rotations in 10 degrees increments. The anterior band and axillary pouch showed significant strain increases when the arm was elevated and externally rotated in the coronal and scapular planes but no increase in the sagittal plane. The posterior band showed no strain in the coronal and scapular planes, but a significant strain increase with the arm elevated and internally rotated in the sagittal plane. We conclude that the anterior band and axillary pouch, which showed the greatest strain in abduction and external rotation, are anterior stabilizers, whereas the posterior band, which showed the greatest strain in flexion and internal rotation, is a posterior stabilizer. We recommend that the 6 o'clock position be firmly repaired during the Bankart procedure.
肩胛下肌下韧带前束和后束的稳定功能已得到研究,但关于腋袋的功能却知之甚少。使用线性换能器测量了17例新鲜冷冻尸体肩关节中肩胛下肌下韧带3部分的应变。测量在以下条件下进行:在冠状面、肩胛面和矢状面内,肩关节外展0度、30度、45度和60度,以及内旋至外旋以10度递增。当手臂在冠状面和肩胛面内抬高并外旋时,前束和腋袋的应变显著增加,但在矢状面内没有增加。后束在冠状面和肩胛面内没有应变,但当手臂在矢状面内抬高并内旋时,应变显著增加。我们得出结论,在外展和外旋时应变最大的前束和腋袋是前方稳定器,而在屈曲和内旋时应变最大的后束是后方稳定器。我们建议在Bankart手术中牢固修复6点位置。