Department of Mechanical Engineering, University of Melbourne, Parkville, Victoria 3010, Australia.
J Orthop Res. 2011 May;29(5):658-67. doi: 10.1002/jor.21269. Epub 2010 Nov 9.
The objective of the present study was to determine the instantaneous moment arms of 18 major muscle sub-regions crossing the glenohumeral joint in axial rotation of the humerus during coronal-plane abduction and sagittal-plane flexion. The tendon-excursion method was used to measure instantaneous muscle moment arms in eight entire upper-extremity cadaver specimens. The results showed that the inferior subscapularis was the largest internal rotator; its rotation moment arm peaks were 24.4 and 27.0 mm during abduction and flexion, respectively. The inferior infraspinatus and teres minor were the greatest external rotators; their respective rotation moment arms peaked at 28.3 and 26.5 mm during abduction, and 23.3 and 22.1 mm during flexion. The two supraspinatus sub-regions were external rotators during abduction and internal rotators during flexion. The latissimus dorsi and pectoralis major behaved as internal rotators throughout both abduction and flexion, with the three pectoralis major sub-regions and middle and inferior latissimus dorsi displaying significantly larger internal rotation moment arms with the humerus adducted or flexed than when abducted or extended (p < 0.001). The deltoid behaved either as an internal rotator or an external rotator, depending on the degree of humeral abduction and axial rotation. Knowledge of moment arm differences between muscle sub-regions may assist in identifying the functional effects of muscle sub-region tears, assist surgeons in planning tendon transfer surgery, and aid in the development and validation of biomechanical computer models.
本研究的目的是确定在冠状面外展和矢状面屈曲时肱骨轴向旋转过程中穿过肩肱关节的 18 个主要肌肉亚区的瞬时力臂。采用腱移行法测量了 8 个完整上肢尸体标本的瞬时肌肉力臂。结果表明,下肩胛下肌是最大的内旋肌;其旋转力臂峰值在 24.4mm 和 27.0mm 时分别在外展和屈曲时。下小圆肌和小圆肌是最大的外旋肌;它们的旋转力臂峰值分别在 28.3mm 和 26.5mm 时外展,在 23.3mm 和 22.1mm 时屈曲。两个冈上肌亚区在 23.3mm 和 22.1mm 时外展时是外旋肌,在 23.3mm 和 22.1mm 时是内旋肌。背阔肌和胸大肌在整个外展和屈曲过程中均表现为内旋肌,三个胸大肌亚区以及中、下背阔肌的内旋力臂明显大于内收或屈曲时(p<0.001)。三角肌的作用可以是内旋肌,也可以是外旋肌,这取决于肱骨的外展程度和轴向旋转。了解肌肉亚区之间力臂的差异可以帮助识别肌肉亚区撕裂的功能影响,帮助外科医生规划肌腱转移手术,并有助于生物力学计算机模型的开发和验证。