Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
J Shoulder Elbow Surg. 2013 Jul;22(7):986-92. doi: 10.1016/j.jse.2012.09.010. Epub 2013 Jan 11.
In this study, we aim to test whether scapular winging results in a significant change in glenohumeral translation in the initial phase of the throwing motion.
Six shoulders underwent an abbreviated throwing motion (ATM) from late cocking to the end of acceleration by use of a validated robotic system. The intact specimens were tested to establish a baseline. The position of the scapula was then affected to simulate scapular winging by placing a cylindrical wedge under the inferior angle of the scapula, and the ATM was performed again. For both conditions, the average glenohumeral translations and scapular rotations were plotted over time to calculate the area under the curve, as a representative of the overall glenohumeral translations and scapular rotations observed during the ATM.
Throughout the motion, the winged scapulae showed, on average, 7.7° more upward rotation, 1.6° more internal rotation, and 5.3° more anterior tipping as compared with the baseline. The scapular position relative to the hanging arm was significantly different between the baseline and scapular winging conditions in all arm positions, except for maximal external rotation and the neutral position. Comparing the area under the curve at baseline and with scapular winging indicated that scapular winging significantly increased anterior translation of the glenohumeral joint whereas translation in the superior/inferior and medial/lateral directions did not result in a change in translation.
These results may suggest a more important role of abnormalities in scapular position in predisposing throwing athletes to shoulder injuries of the anterior capsulolabral structures and consecutive glenohumeral instability.
在这项研究中，我们旨在测试肩胛骨翼状是否会导致投掷运动初始阶段盂肱关节平移发生显著变化。
使用经过验证的机器人系统，六例肩部进行了缩短投掷运动（ATM），从晚期扣球到加速结束。对完整标本进行测试以建立基线。然后，通过在下肩胛骨的下角放置一个圆柱形楔形物来模拟肩胛骨翼状，然后再次进行 ATM。对于两种情况，将盂肱关节的平均平移和肩胛骨的旋转随时间绘制出来，以计算曲线下的面积，作为在 ATM 期间观察到的整体盂肱关节平移和肩胛骨旋转的代表。
在整个运动过程中，与基线相比，翼状肩胛骨的平均上旋转增加了 7.7°，内旋转增加了 1.6°，前倾斜增加了 5.3°。肩胛骨相对于悬挂臂的位置在基线和肩胛骨翼状条件下在所有手臂位置都存在显著差异，除了最大外旋和中立位置。比较基线和肩胛骨翼状的曲线下面积表明，肩胛骨翼状显著增加了盂肱关节的前向平移，而在上下和内外方向的平移没有导致平移变化。
这些结果可能表明，肩胛骨位置的异常在易患肩前部囊状盂唇结构和连续盂肱关节不稳定的投掷运动员中具有更重要的作用。
