Harryman D T, Walker E D, Harris S L, Sidles J A, Jackins S E, Matsen F A
Department of Orthopaedics, University of Washington, Seattle, Wash.
J Shoulder Elbow Surg. 1993 Nov;2(6):275-85. doi: 10.1016/1058-2746(93)90073-P.
The purpose of this study was to characterize humerothoracic motion and function after glenohumeral or scapulothoracic arthrodesis and to compare those results with those from normal shoulders. We evaluated 12 shoulders in 11 patients at an average of 71 months after glenohumeral arthrodesis and seven shoulders in six patients at an average of 32 months after scapulothoracic arthrodesis. The residual motion of the unfused articulation was measured with a spatial position sensor. Various activities of daily living and standard clinical range-of-motion tests were performed. Nearly all humerothoracic motions were significantly decreased in patients after either type of shoulder arthrodesis. Patients with a glenohumeral fusion maintained their scapulothoracic motion at levels comparable with that of normal subjects. Residual glenohumeral extension and external rotation after scapulothoracic fusion were significantly decreased; internal rotation remained unchanged compared with motion in subjects with normal shoulders. Glenohumeral fusion decreased the patients' ability to perform personal care activities requiring extremes of internal rotation or elevation. Although glenohumeral arthrodesis limited total humerothoracic motion considerably, the majority of patients were improved functionally and were relatively free from pain. Most personal care activities were performed successfully by all patients with scapulothoracic fusion.
本研究的目的是描述盂肱关节或肩胛胸壁关节融合术后的肩胸运动及功能，并将这些结果与正常肩部的结果进行比较。我们评估了11例患者的12个肩部，这些患者在盂肱关节融合术后平均71个月；还评估了6例患者的7个肩部，这些患者在肩胛胸壁关节融合术后平均32个月。使用空间位置传感器测量未融合关节的残余运动。进行了各种日常生活活动及标准临床活动范围测试。在两种类型的肩关节融合术后患者中，几乎所有肩胸运动均显著减少。盂肱关节融合患者的肩胛胸壁运动维持在与正常受试者相当的水平。肩胛胸壁融合术后盂肱关节的残余伸展和外旋显著减少；与正常肩部受试者的运动相比，内旋保持不变。盂肱关节融合降低了患者进行需要极度内旋或抬高的个人护理活动的能力。尽管盂肱关节融合术显著限制了总的肩胸运动，但大多数患者的功能得到改善且相对无痛。所有肩胛胸壁融合的患者大多能成功完成个人护理活动。
