Natsis K, Tsikaras P, Totlis T, Gigis I, Skandalakis P, Appell H J, Koebke J
Department of Anatomy, Medical School, Aristotle University of Thessaloniki, Greece.
Clin Anat. 2007 Apr;20(3):267-72. doi: 10.1002/ca.20320.
The purpose of this study was to correlate the four types of acromial shape with the existence of enthesophytes, which together comprise two important parameters for subacromial impingement syndrome and rotator cuff tears. In addition, a review of the literature was carried out. Four hundred twenty-three dried scapulas were studied at the Department of Anatomy in the University of Cologne, Germany. Four types of acromion were found: the three classical ones as described by Bigliani et al. ([1986] Orthop Trans 10:216) and a fourth one, where the middle third of the undersurface of acromion was convex (Gagey et al. [1993] Surg Radiol Anat 15:63-70). The correlation between the four types of acromion and the presence of enthesophytes at its anterior undersurface was also recorded. The distribution of acromial types was as follows: type I, flat, 51 (12.1%); type II, curved, 239 (56.5%); type III, hooked, 122 (28.8%); and type IV, convex, 11 (2.6%). Enthesophytes were found in 1 of type I (2%), in 19 of type II (7.9%), in 46 of type III (37.7%), and in 0 (0%) of type IV acromions. Overall, 66 (15.6%) out of 423 scapulas had enthesophytes. In all cases, they were localized at the site of the coracoacromial ligament insertion on the acromion. Enthesophytes were significantly (P < 0.05) more common in type III acromions and this combination is particularly associated with subacromial impingement syndrome and rotator cuff tears. In type I and in type IV acromions, the incidence of enthesophytes is very small and, according to other studies, with these two acromial types rotator cuff tears are also rare.
本研究的目的是将四种肩峰形态与骨赘的存在相关联，这两者共同构成了肩峰下撞击综合征和肩袖撕裂的两个重要参数。此外，还进行了文献综述。在德国科隆大学解剖学系对423块干燥肩胛骨进行了研究。发现了四种肩峰类型：Bigliani等人（[1986]《矫形外科学报》10:216）描述的三种经典类型，以及第四种类型，即肩峰下表面中三分之一处呈凸形（Gagey等人[1993]《外科放射解剖学》15:63 - 70）。还记录了四种肩峰类型与其前下表面骨赘存在之间的相关性。肩峰类型的分布如下：I型，扁平型，51块（12.1%）；II型，弯曲型，239块（56.5%）；III型，钩型，122块（28.8%）；IV型，凸型，11块（2.6%）。在I型中有1块（2%）发现骨赘，II型中有19块（7.9%），III型中有46块（37.7%），IV型肩峰中未发现（0%）。总体而言，423块肩胛骨中有66块（15.6%）有骨赘。在所有病例中，它们都位于肩峰上喙肩韧带附着处。骨赘在III型肩峰中显著更常见（P < 0.05），并且这种组合特别与肩峰下撞击综合征和肩袖撕裂相关。在I型和IV型肩峰中，骨赘的发生率非常低，并且根据其他研究，这两种肩峰类型的肩袖撕裂也很少见。
