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肩肱关节外展角度对完整、部分撕裂和修复的冈上肌腱条件下冈上肌和冈下肌肌腱之间力学相互作用的影响。

Effect of glenohumeral abduction angle on the mechanical interaction between the supraspinatus and infraspinatus tendons for the intact, partial-thickness torn, and repaired supraspinatus tendon conditions.

机构信息

McKay Orthopaedic Research Laboratory, University of Pennsylvania, 424 Stemmler Hall, Philadelphia, Pennsylvania 19104, USA.

出版信息

J Orthop Res. 2010 Jul;28(7):846-51. doi: 10.1002/jor.21068.

Abstract

Rotator cuff tears are difficult to manage because of the structural and mechanical inhomogeneity of the supraspinatus tendon. Previously, we showed that with the arm at the side, the supraspinatus and infraspinatus tendons mechanically interact such that conditions that increase supraspinatus tendon strain, such as load or full-thickness tears, also increase infraspinatus tendon strain. This suggests that the infraspinatus tendon may shield the supraspinatus tendon from further injury while becoming at increased risk of injury itself. In this study, the effect of glenohumeral abduction angle on the interaction between the two tendons was evaluated for supraspinatus tendon partial-thickness tears and two repair techniques. Principal strains were quantified in both tendons for 0 degrees , 30 degrees , and 60 degrees of glenohumeral abduction. Results showed that interaction between the two tendons is interrupted by an increase in abduction angle for all supraspinatus tendon conditions evaluated. Infraspinatus tendon strain was lower at 30 degrees and 60 degrees than at 0 degrees abduction angle. In conclusion, interaction between the supraspinatus and infraspinatus tendons is interrupted with increase in abduction angle. Additionally, 30 degrees abduction should be further evaluated for management of rotator cuff tears and repairs as it is the angle at which both supraspinatus and infraspinatus tendon strain is decreased.

摘要

肩袖撕裂很难处理,因为冈上肌腱的结构和力学不均匀。此前,我们发现,当手臂处于体侧时,冈上肌和冈下肌肌腱的力学相互作用,导致增加冈上肌腱应变的情况,如负荷或全层撕裂,也会增加冈下肌腱应变。这表明,冈下肌腱可能会在冈上肌腱进一步受伤时起到保护作用,而自身受伤的风险也会增加。在这项研究中,评估了肩肱外展角度对冈上肌腱部分撕裂和两种修复技术的两种肌腱相互作用的影响。对冈上肌腱在 0 度、30 度和 60 度肩肱外展时的两种肌腱进行了主应变的量化。结果表明,所有评估的冈上肌腱情况下,随着外展角度的增加,两种肌腱之间的相互作用被中断。在 30 度和 60 度外展时,冈下肌腱的应变低于 0 度外展角度。结论是,随着外展角度的增加,冈上肌和冈下肌肌腱之间的相互作用被中断。此外,30 度外展应进一步评估肩袖撕裂和修复的管理,因为这是冈上肌和冈下肌肌腱应变都降低的角度。

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