Edwards Scott G
Department of Orthopaedics, Georgetown University Medical Center, Greater Metropolitan Orthopaedics, Washington, DC, USA.
Arthroscopy. 2003 Dec;19(10):1079-84. doi: 10.1016/j.arthro.2003.10.018.
The purpose of the study was to compare the laxity of the acromioclavicular (AC) joint in the superior, posterior, and anterior planes after isolated acromioplasty and after acromioplasty with inferior clavicular coplaning.
In vitro (cadaveric) analysis.
Eight fresh-frozen cadaveric shoulders were evaluated using a hydraulic actuator. While the scapula was stabilized, a 30-N force was applied to the distal clavicle perpendicular to the AC joint in the superoinferior plane and parallel to the joint in the anteroposterior plane. Laxity of the AC joint in the superior, anterior, and posterior directions was evaluated via load-displacement analysis after acromioplasty and after acromioplasty with coplaning.
Coplaning the distal clavicle increased superior AC laxity by 53% compared with acromioplasty alone (P =.012). With regard to anteroposterior laxity, coplaning increased anterior translation by 19% (P =.047) and increased posterior translation by 16% (P =.237). Bony impingement was seen to limit posterior translation in 3 specimens.
Acromioplasty with coplaning increases AC laxity significantly in the superior and anterior directions as compared with acromioplasty alone. A trend toward increased posterior translation was found; posterior bony impingement may limit posterior laxity.
本研究旨在比较单纯肩峰成形术后以及肩峰成形术联合锁骨下平面修整术后肩锁关节在上方、后方和前方平面的松弛度。
体外（尸体）分析。
使用液压致动器对8个新鲜冷冻尸体肩部进行评估。在稳定肩胛骨的同时，在上下平面垂直于肩锁关节、在前后平面平行于肩锁关节向锁骨远端施加30 N的力。通过负荷-位移分析评估单纯肩峰成形术后以及联合平面修整术后肩锁关节在上方、前方和后方方向的松弛度。
与单纯肩峰成形术相比，锁骨远端平面修整使肩锁关节上方松弛度增加53%（P = 0.012）。在前后松弛度方面，平面修整使前向平移增加19%（P = 0.047），后向平移增加16%（P = 0.237）。在3个标本中可见骨撞击限制后向平移。
与单纯肩峰成形术相比，联合平面修整的肩峰成形术在上方和前方方向显著增加了肩锁关节的松弛度。发现有后向平移增加的趋势；后方骨撞击可能会限制后向松弛度。
