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肩胛盂的版本和倾斜度是肩关节前脱位的危险因素。

Glenoid version and inclination are risk factors for anterior shoulder dislocation.

作者信息

Hohmann Erik, Tetsworth Kevin

机构信息

Department of Orthopaedic Surgery, Clinical Medical School, University of Queensland, Brisbane, QLD, Australia; Musculoskeletal Research Unit, Central Queensland University, Rockhampton, QLD, Australia.

Department of Orthopaedic Surgery, Royal Brisbane Hospital, Herston, QLD, Australia; Department of Surgery, School of Medicine, University of Queensland, Brisbane, QLD, Australia.

出版信息

J Shoulder Elbow Surg. 2015 Aug;24(8):1268-73. doi: 10.1016/j.jse.2015.03.032. Epub 2015 May 7.

Abstract

HYPOTHESIS

Although the contribution of the capsuloligamentous structures and dynamic muscle balance to shoulder stability has been well documented, the role of the osseous anatomy of the glenoid has not been thoroughly evaluated. This study investigated glenoid version and inclination in patients with a documented anterior shoulder dislocation and compared it with a control group. We hypothesized that patients with a prior anterior dislocation would have more anterior version and increased inferior inclination of the glenoid.

MATERIALS AND METHODS

Patients aged younger than 40 years who underwent arthroscopic shoulder stabilization (study group) were compared with patients (control group) who had previously undergone magnetic resonance imaging (MRI) for a different shoulder condition. Version was measured on axial images, and inclination was measured on coronal images of a T2-weighted spin-echo scan. The MRIs of 128 study group patients (mean age, 24.5 ± 8.6 years) with a confirmed traumatic anterior shoulder dislocation were compared with the MRIs of 130 control group patients (mean age, 30.9 ± 7 years).

RESULTS

The mean version in the study group was -1.7° ± 4.5° (retroversion); the mean inclination was 1.6° ± 5.9° (inferior). The mean version in the control group was -5.8° ± 4.6° (retroversion); the mean inclination was -4.0° ± 6.8° (superior). The between-group differences were significant for version (P = .00001) and inclination (P = .00001).

CONCLUSIONS

The results of this study strongly suggest that glenoid version and inclination are significantly increased in patients with established anterior shoulder instability compared with a matched control group.

摘要

假设

尽管关节囊韧带结构和动态肌肉平衡对肩部稳定性的作用已有充分记录,但肩胛盂的骨性解剖结构的作用尚未得到充分评估。本研究调查了有明确前肩脱位记录的患者的肩胛盂扭转和倾斜情况,并与对照组进行比较。我们假设既往有前脱位的患者会有更多的前向扭转和肩胛盂下倾角增加。

材料与方法

将年龄小于40岁接受关节镜下肩部稳定手术的患者(研究组)与因其他肩部疾病先前接受过磁共振成像(MRI)检查的患者(对照组)进行比较。在轴位图像上测量扭转,在T2加权自旋回波扫描的冠状位图像上测量倾斜。将128例确诊为创伤性前肩脱位的研究组患者(平均年龄24.5±8.6岁)的MRI与130例对照组患者(平均年龄30.9±7岁)的MRI进行比较。

结果

研究组的平均扭转角度为-1.7°±4.5°(后倾);平均倾斜角度为1.6°±5.9°(下倾)。对照组的平均扭转角度为-5.8°±4.6°(后倾);平均倾斜角度为-4.0°±6.8°(上倾)。扭转角度(P = .00001)和倾斜角度(P = .00001)的组间差异具有统计学意义。

结论

本研究结果强烈表明,与匹配的对照组相比,已确诊的前肩不稳定患者的肩胛盂扭转和倾斜角度显著增加。

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