Warner J J, Deng X, Warren R F, Torzilli P A, O'Brien S J
From the Sports Medicine Institute, University of Pittsburgh, Department of Orthopaedic Surgery, Pittsburgh, Pa.; The Sports Medicine and Shoulder Service, the Hospital for Special Surgery; and the Department of Biomechanics, the Hospital for Special Surgery, New York, N.Y.
J Shoulder Elbow Surg. 1993 Mar;2(2):99-105. doi: 10.1016/1058-2746(93)90007-4. Epub 2009 Feb 25.
The purpose of this investigation was to measure inferior translation in the intact and vented shoulder in different positions of abduction and rotation. Fifteen shoulders from adult cadavers were tested before and after venting of the joint capsule on an apparatus that permitted unconstrained translation when a 50 N inferior force was applied to the humeral shaft. The greatest inferior translation in the intact shoulder occurred at 45° abduction in neutral rotation. Venting the capsule significantly increased inferior translation in all positions but 45° abduction, and the greatest effect was seen at 0° glenohumeral abduction in neutral rotation. The so-called "sulcus sign" is the result of intraarficular vacuum effect and capsular laxity. Venting the capsule results in a significant increase in inferior translation. This is an important effect to consider during procedures for repairing instability of the shoulder, because failure to appreciate the normal "play" in inferior glenohumeral translation might lead the surgeon to believe that perceived laxity represents actual instability.
本研究的目的是测量完整和有通气孔的肩关节在不同外展和旋转位置时的下方移位情况。在一个当对肱骨干施加50N向下的力时允许无约束移位的装置上,对15个成年尸体的肩关节在关节囊通气前后进行测试。完整肩关节的最大下方移位发生在中立旋转45°外展时。除了45°外展位置,通气孔显著增加了所有位置的下方移位,在中立旋转0°盂肱关节外展时效果最为明显。所谓的“沟征”是关节内真空效应和关节囊松弛的结果。关节囊通气导致下方移位显著增加。这是在修复肩关节不稳定手术过程中需要考虑的一个重要影响因素,因为如果没有认识到正常的盂肱关节下方移位“活动度”,可能会使外科医生认为察觉到的松弛代表实际的不稳定。