Aluisio Frank V, Osbahr Daryl C, Speer Kevin P
Greensboro Orthopaedic Center, Greensboro, North Carolina, USA.
Am J Orthop (Belle Mead NJ). 2003 Mar;32(3):124-9.
Management of irreparable massive rotator cuff tears remains a challenging and controversial problem. Defining glenohumeral force relations may allow for the development of treatment strategies based on biomechanical principles. Five fresh-frozen adult human cadaveric shoulder specimens were dissected to determine fiber length, mass, and lever arm of (a) the 3 bellies of the deltoid and (b) the rotator cuff muscles (supraspinatus, infraspinatus, teres minor, subscapularis). From these data, physiologic cross-sectional areas and moment relations were calculated. These relations provide evidence for a balanced axial force couple between the anterior and posterior rotator cuff. Demonstration of an axial force couple across the glenohumeral joint may have clinical significance for treatment of irreparable massive rotator cuff tears and may explain why many patients with full-thickness rotator cuff tears can regain acceptable shoulder function.
不可修复的大面积肩袖撕裂的治疗仍然是一个具有挑战性且存在争议的问题。明确盂肱关节力的关系可能有助于制定基于生物力学原理的治疗策略。对五个新鲜冷冻的成年人体肩部尸体标本进行解剖，以确定（a）三角肌的三个肌腹以及（b）肩袖肌肉（冈上肌、冈下肌、小圆肌、肩胛下肌）的纤维长度、质量和力臂。根据这些数据，计算出生理横截面积和力矩关系。这些关系为前后肩袖之间平衡的轴向力偶提供了证据。跨盂肱关节轴向力偶的证明对于不可修复的大面积肩袖撕裂的治疗可能具有临床意义，并且可以解释为什么许多全层肩袖撕裂的患者能够恢复可接受的肩部功能。
