Kwon Young W, Hurd Jason, Yeager Keith, Ishak Charbel, Walker Peter S, Khan Sami, Bosco Joseph A, Jazrawi Laith M
Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, 301 E. 17th Street, New York, New York 10003, USA.
Bull NYU Hosp Jt Dis. 2009;67(4):337-40.
The subscapularis tendon, coracohumeral ligament, and transverse humeral ligament are all believed to contribute to biceps tendon stability within the bicipital groove. In order to examine the relative contribution of these soft tissue structures to proximal biceps tendon stability, 11 fresh frozen cadaveric shoulder specimens were prepared and mounted onto a custom jig. A three-dimensional digitizer was utilized to record biceps tendon excursion in various shoulder positions. In sequential order, these structures were then sectioned, and biceps tendon excursion was again recorded. We found that sectioning of the subscapularis tendon significantly increased biceps tendon excursion, compared to intact specimens (8.1 +/- 4.1 mm vs. 4.3 +/- 3.6 mm; p < 0.006). In contrast, isolated sectioning of the transverse humeral ligament or the coracohumeral ligament did not significantly increase biceps excursion (5.4 +/- 2.5 mm, p = 0.26; 5.6 +/- 1.3 mm, p = 0.24). When two structures were sectioned, significant excursion in the biceps tendon only occurred in specimens where the subscapularis tendon was one of the sectioned structures. The preliminary data suggest that, of the three tested soft tissue structures, the subscapularis tendon is the most important stabilizer of the proximal biceps and that clinically significant lesions of the proximal biceps tendon may be associated with a defect in the subscapularis tendon.
肩胛下肌腱、喙肱韧带和肱骨横韧带都被认为对肱二头肌肌腱在肱二头肌沟内的稳定性有作用。为了研究这些软组织结构对肱二头肌近端肌腱稳定性的相对作用，制备了11个新鲜冷冻的尸体肩部标本，并安装在定制夹具上。使用三维数字化仪记录肱二头肌肌腱在各种肩部位置的偏移。然后按顺序切断这些结构，并再次记录肱二头肌肌腱的偏移。我们发现，与完整标本相比，切断肩胛下肌腱显著增加了肱二头肌肌腱的偏移（8.1±4.1毫米对4.3±3.6毫米；p<0.006）。相比之下，单独切断肱骨横韧带或喙肱韧带并没有显著增加肱二头肌的偏移（5.4±2.5毫米，p=0.26；5.6±1.3毫米，p=0.24）。当切断两个结构时，肱二头肌肌腱的显著偏移仅发生在肩胛下肌腱是被切断结构之一的标本中。初步数据表明，在测试的三种软组织结构中，肩胛下肌腱是肱二头肌近端最重要的稳定器，并且肱二头肌近端肌腱的临床显著损伤可能与肩胛下肌腱的缺陷有关。
