Jerosch J, Marquardt M, Winkelmann W
Heinrich-Heine Universität Düsseldorf, Orthopädische Klinik.
Z Orthop Ihre Grenzgeb. 1990 Jan-Feb;128(1):41-5. doi: 10.1055/s-2008-1039859.
In a prospective study we evaluated diagnostic ultrasound investigation for shoulder instabilities. We measured the passive aptranslation In 150 healthy persons in relation to the dorsal glenoid as well as the inferior subluxation in relation to the acromion. After establishing normative datas we measured 23 patient with unidirectional instabilities and 34 with multidirectional instabilities. The humeral head position of a normal joint is 8 to 10 mm dorsally to the glenoid. In the control group the anterior translation of the dominant shoulder is significantly higher as in the nondominant shoulder (student-t-test; p less than 0.0045). Patients with anterior instabilities showed a significant increase of anterior translation in the injured shoulder (student-t-test; p less than 0.0001). In comparison with the control group there is a significant increase of downward subluxation in patients with multidirectional instabilities (chi 2 alpha less than 0.05). In habitual or voluntary dislocations the relation of the humeral head to the glenoid can be judged statically and dynamically. Secondary signs of dislocation (Hill-Sachs lesions, joint effusion) are evident.
在一项前瞻性研究中,我们评估了诊断性超声检查对肩部不稳定的作用。我们测量了150名健康人相对于肩胛盂背侧的被动前向平移以及相对于肩峰的下半脱位情况。在建立了正常数据后,我们测量了23名单向不稳定患者和34名多向不稳定患者。正常关节的肱骨头位置相对于肩胛盂背侧为8至10毫米。在对照组中,优势肩的前向平移明显高于非优势肩(学生t检验;p小于0.0045)。前向不稳定患者受伤肩部的前向平移显著增加(学生t检验;p小于0.0001)。与对照组相比,多向不稳定患者的向下半脱位显著增加(卡方检验α小于0.05)。在习惯性或自愿性脱位中,肱骨头与肩胛盂的关系可通过静态和动态方式判断。脱位的继发性体征(希尔-萨克斯损伤、关节积液)很明显。