Nyffeler Richard W, Meyer Dominik C
Orthopädie Sonnenhof, Buchserstrasse 30, 3006 Bern, Switzerland.
Balgrist University Hospital, Forchstrasse 340, 8008 Zürich, Switzerland.
EFORT Open Rev. 2017 May 11;2(5):141-150. doi: 10.1302/2058-5241.2.160076. eCollection 2017 May.
The shape of the acromion differs between patients with degenerative rotator cuff tears and individuals without rotator cuff pathology.It can be assessed in the sagittal plane (acromion type, acromion slope) and in the coronal plane (lateral acromion angle, acromion index, critical shoulder angle).The inter-observer reliability is better for the measurements in the coronal plane.A large lateral extension (high acromion index or high critical shoulder angle) and a lateral down-sloping of the acromion (low lateral acromion angle) are associated with full-thickness supraspinatus tears.The significance of glenoid inclination for rotator cuff disease is less clear.The postulated patho-mechanism is the compression of the supraspinatus tendon between the humeral head and the acromion. Bursal side tears might be caused by friction and abrasion of the tendon. Articular side tears could be due to impairment of the gliding mechanism between tendon fibrils leading to local stress concentration. Further research is needed to understand the exact pathomechanism of tendon degeneration and tear. Cite this article: 2017;2. DOI: 10.1302/2058-5241.2.160076. Originally published online at www.efortopenreviews.org.
在患有退行性肩袖撕裂的患者与无肩袖病变的个体之间，肩峰的形状存在差异。可以在矢状面（肩峰类型、肩峰斜率）和冠状面（外侧肩峰角、肩峰指数、临界肩角）进行评估。观察者间对于冠状面测量的可靠性更好。肩峰的大外侧延伸（高肩峰指数或高临界肩角）以及肩峰的外侧向下倾斜（低外侧肩峰角）与冈上肌全层撕裂相关。盂肱关节倾斜度对肩袖疾病的意义尚不太明确。假定的病理机制是肱骨头与肩峰之间对冈上肌腱的挤压。滑囊侧撕裂可能由肌腱的摩擦和磨损引起。关节侧撕裂可能是由于肌腱纤维之间滑动机制受损导致局部应力集中。需要进一步研究以了解肌腱退变和撕裂的确切病理机制。引用本文：2017；2。DOI：10.1302/2058 - 5241.2.160076。最初在线发表于www.efortopenreviews.org。
