Hallström E, Kärrholm J
Department of Orthopaedics, Uddevalla Hospital, Sweden.
Clin Orthop Relat Res. 2006 Jul;448:22-7. doi: 10.1097/01.blo.0000224019.65540.d5.
We used dynamic radiostereometry to study the three-dimensional kinematics of the shoulder joint during active abduction. Twenty-five patients experiencing shoulder symptoms (Neer Stage 2) for more than 18 months, without total rotator cuff tears, participated. Eight men and four women without shoulder symptoms constituted controls. The rotation of the humeral head relative to a fixed scapula and the absolute rotation of the humerus (caused by humeral, scapular, and trunk motion) were measured. The rotations were calculated in the order of abduction/adduction (anteroposterior axis), internal/external rotation (longitudinal axis), and flexion/extension (transverse axis). The absolute abduction of the humerus in our patients did not differ from controls, nor did the abduction in the glenohumeral joint. During abduction, the humeral centre displaced medially, proximally, and anteriorly. In the patient group, slightly more (1-1.5 mm) proximal translation was observed. Presence of impingement syndrome was associated with increased proximal translation of the humeral head center, which occurred in the early phase of the arc of motion.
Diagnostic Level I. See Guidelines for Authors for a complete description of Levels of Evidence.
我们使用动态放射立体测量法研究主动外展过程中肩关节的三维运动学。25名有肩部症状（Neer 2期）超过18个月且无肩袖完全撕裂的患者参与了研究。8名无肩部症状的男性和4名无肩部症状的女性作为对照。测量了肱骨头相对于固定肩胛骨的旋转以及肱骨的绝对旋转（由肱骨、肩胛骨和躯干运动引起）。旋转按外展/内收（前后轴）、内旋/外旋（纵轴）和屈曲/伸展（横轴）的顺序计算。我们患者中肱骨的绝对外展与对照组无差异，盂肱关节的外展也无差异。在外展过程中，肱骨中心向内侧、近端和前方移位。在患者组中，观察到稍多（1 - 1.5毫米）的近端平移。撞击综合征的存在与肱骨头中心近端平移增加有关，这发生在运动弧的早期阶段。
诊断性I级。有关证据水平的完整描述，请参阅作者指南。
