Lin Lin, Yan Hui, Xiao Jian, Ao Yingfang, Cui Guoqing
Institute of Sports Medicine, Peking University Third Hospital, No. 49, North Garden Road, Haidian District, Beijing, 100191, People's Republic of China,
Knee Surg Sports Traumatol Arthrosc. 2015 Apr;23(4):1247-52. doi: 10.1007/s00167-013-2808-1. Epub 2013 Dec 12.
A new clinical test for evaluating subscapularis (SSC) integrity was described, and its diagnostic value was compared with the present SSC tests (the lift-off, belly-press, IRLS and bear-hug tests). The new test is called internal rotation resistance test at abduction and external rotation (IRRT). The test is performed at maximal 90° of abduction and maximal external rotation.
Two hundred and thirty-five consecutive patients suffering from rotator cuff injury were evaluated preoperatively. Six tests were performed to assess the function of the SSC: the lift-off, belly-press, IRLS, the bear-hug, IRRT at 0° abduction and 0° external rotation (IRRT0°) and IRRT at maximal 90° abduction and maximal external rotation (IRRTM). Arthroscopic findings were the reference for diagnosing of SSC lesions.
The IRRTM test showed the greatest sensitivity (76.5 %), and IRLS (31.6 %) test had the lowest sensitivity. The IRRTM had the highest accuracy (79.0 %), and lift-off had the lowest accuracy (65.3 %). Positive IRRTM, bear-hug, belly-press, IRRT0° tests indicate that about one-third of the SSC is torn, and a positive lift-off and IRLS tests predict a severe tear at least two-thirds of the SSC.
The IRRTM represents a sensitive diagnostic test for SSC lesions and improves the chance of finding the upper part of the SSC tears. When the IRRTM is positive, the surgeon should pay particular attention to detecting the SSC tendon during arthroscopy.
Diagnostic study, Level I.
描述一种用于评估肩胛下肌（SSC）完整性的新临床测试，并将其诊断价值与目前的SSC测试（抬离试验、腹部按压试验、IRLS试验和抱熊试验）进行比较。这种新测试称为外展和外旋内旋阻力试验（IRRT）。该测试在最大90°外展和最大外旋时进行。
对235例连续的肩袖损伤患者进行术前评估。进行六项测试以评估SSC的功能：抬离试验、腹部按压试验、IRLS试验、抱熊试验、0°外展和0°外旋时的IRRT（IRRT0°）以及最大90°外展和最大外旋时的IRRT（IRRTM）。关节镜检查结果是诊断SSC损伤的参考标准。
IRRTM测试显示出最高的敏感性（76.5%），而IRLS测试（31.6%）的敏感性最低。IRRTM的准确性最高（79.0%），抬离试验的准确性最低（65.3%）。IRRTM、抱熊试验、腹部按压试验、IRRT0°试验阳性表明约三分之一的SSC撕裂，而抬离试验和IRLS试验阳性预测至少三分之二的SSC严重撕裂。
IRRTM是一种用于SSC损伤的敏感诊断测试，提高了发现SSC上部撕裂的几率。当IRRTM为阳性时，外科医生在关节镜检查期间应特别注意检测SSC肌腱。
诊断性研究，I级。
