Jerosch J, Castro W H, Sons H U, Moersler M
Beitr Orthop Traumatol. 1989 Sep;36(9):411-8.
Eight fresh shoulder specimen were dissected and the functional relationship of the rotator cuff tendons to the acromion was demonstrated through various arcs of shoulder motion. The scapula was fixed and the arm was elevated, rotated, and abducted by pulling the muscle tendon according to EMG activities. Using FUJI compression films the subacromial compression of the rotator cuff was measured. Different forms of acromion were tested. While moving the shoulder with normal relationship of deltoid to rotator cuff, there is no -or at least less than 0.1 mPa compression of the rotator cuff in the subacromial space. Weakness of the rotator cuff results in a moderate compression of 0.6 mPa. In type III acromion there was significant increase up to 1.0 mPa between the acromion and the rotator cuff. This study suggests, that a mechanical subacromial compression only occurs in shoulder joints with a Bigliani acromion type III and/or in joints with a imbalance of the deltoid/rotator cuff relation. Thus an acromioplasty should be primarily undertaken only if the pathology affects the acromion. If there is a muscle imbalance, we recommend a special rehabilitation program in order to strengthen the cuff-muscles the first place.
对八个新鲜的肩部标本进行了解剖，并通过肩部运动的不同弧度展示了肩袖肌腱与肩峰之间的功能关系。固定肩胛骨，根据肌电图活动通过牵拉肌腱来抬高、旋转和外展手臂。使用富士压力膜测量肩袖的肩峰下压力。测试了不同形态的肩峰。在三角肌与肩袖关系正常的情况下移动肩部时，肩袖在肩峰下间隙的压力为零或至少小于0.1毫帕。肩袖无力会导致0.6毫帕的中度压力。在III型肩峰中，肩峰与肩袖之间的压力显著增加至1.0毫帕。这项研究表明，机械性肩峰下压力仅发生在具有比利亚尼III型肩峰的肩关节和/或三角肌/肩袖关系失衡的关节中。因此，只有在病理情况影响肩峰时才应首先进行肩峰成形术。如果存在肌肉失衡，我们建议首先进行特殊的康复计划以加强袖带肌肉。
