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实验性肩胛上神经阻滞对体内肱盂关节主动平移的影响。

Effect of experimental suprascapular nerve block on active glenohumeral translations in vivo.

作者信息

Werner Clément M L, Weishaupt Dominik, Blumenthal Stephan, Curt Armin, Favre Philippe, Gerber Christian

机构信息

Department of Orthopaedics, University of Zurich, Uniklinik Balgrist, Forchstrasse 340, Zurich 8008, Switzerland.

出版信息

J Orthop Res. 2006 Mar;24(3):491-500. doi: 10.1002/jor.20011.

Abstract

Static superior shoulder instability is associated with long-standing rotator cuff tears. Factors or mechanisms which can prevent superior migration of the humeral head, and therefore allow preservation or restoration of shoulder function despite nonanatomical cuff repair, are poorly understood. The question has therefore arisen, whether centering of the humeral head was the result of active shoulder muscle function. It was the goal of this experimental investigation to (1) determine the pattern of glenohumeral translations during active shoulder abduction measured by open-magnetic resonance imaging (MRI) techniques, and to (2) determine the influence of experimental paralysis of the infra- and supraspinatus muscles on these translations. In contrast to prior experimental investigations, the humeral head remained always centered in the glenoid fossa during active abduction. No superior migration of the humeral head could be provoked with experimental paralysis of the supra- and/or infraspinatus muscles. The hypothesis that static or dynamic superior humeral head displacement is prevented by active-supra- and/or infraspinatus muscle function must therefore be rejected, for the shoulder with a structurally intact muscle-tendon-bone unit.

摘要

静态性肩关节上盂不稳与长期存在的肩袖撕裂相关。尽管肩袖修复未达解剖结构,但能阻止肱骨头向上移位、从而保留或恢复肩关节功能的因素或机制,目前仍知之甚少。因此,出现了肱骨头居中是否是肩部主动肌肉功能的结果这一问题。本实验研究的目的是:(1)通过开放式磁共振成像(MRI)技术测定主动肩关节外展过程中盂肱关节平移模式,以及(2)确定冈下肌和冈上肌实验性麻痹对这些平移的影响。与之前的实验研究不同,在主动外展过程中肱骨头始终位于关节盂窝中心。冈上肌和/或冈下肌实验性麻痹未引发肱骨头向上移位。因此,对于肌肉 - 肌腱 - 骨单元结构完整的肩关节,必须摒弃主动冈上肌和/或冈下肌功能可防止静态或动态肱骨头向上移位这一假说。

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