Sessions William C, Lawrence Rebekah L, Steubs J Tyler, Ludewig Paula M, Braman Jonathan P
Medical School, University of MinnesotaMinneapolis, MN.
Department of Rehabilitation Medicine Divisions of Physical Therapy & Rehabilitation Science University of MinnesotaMinneapolis, MN.
Iowa Orthop J. 2017;37:85-89.
With a substantial portion of the population experiencing rotator cuff pathology, the importance of understanding mechanisms of rotator cuff disease remains critical. Current research aimed at understanding relationships between shoulder movement and cuff injuries has been hindered by our limited knowledge of the thickness of soft tissue structures within the shoulder. Therefore, the purpose of this study is to measure the thicknesses of all four rotator cuff tendons at the articular margin.
An anatomic study of 21 cadaveric shoulders was conducted. The thicknesses of the four rotator cuff tendon insertions were measured by caliper at the articular margin.
The mean thickness of the supraspinatus at the articular margin was 4.9 mm ± 2.1 (median: 4.2 mm, range: 2.9-12.7 mm). The mean thickness of the infraspinatus tendon was 4.9 mm ± 1.3 (median: 4.8 mm, range: 3.0-7.2 mm). The mean thickness of the teres minor tendon was 3.20 mm ± 1.14 (median: 2.9 mm, range: 1.7-5.7 mm). Finally, the mean thickness of the subscapularis tendon at the articular margin was 5.5 mm ± 1.3 (median: 5.5 mm, range: 3.5-9.3 mm).
This current study provides needed objective data about the thickness of the rotator cuff tendons at the articular margin. Data regarding the infraspinatus, teres minor and teres major, which have been largely understudied, are particularly important. In addition, the current study demonstrates that rotator cuff thicknesses can vary substantially between individuals. There are likely natural age related changes as well as changes from etiologies that are not yet elucidated. Clinical Relevance: Data from this study will allow for improved modelling accuracy of soft tissue structures specific to the shoulder. Eventually knowledge gained through study of shoulder mechanics can be used to pursue prevention of rotator cuff tears and improve targeted treatment planning.
由于相当一部分人群患有肩袖病变，了解肩袖疾病的发病机制至关重要。目前旨在了解肩部运动与肩袖损伤之间关系的研究，因我们对肩部软组织结构厚度的了解有限而受到阻碍。因此，本研究的目的是测量关节边缘处所有四条肩袖肌腱的厚度。
对21具尸体肩部进行解剖学研究。通过卡尺测量关节边缘处四条肩袖肌腱附着点的厚度。
关节边缘处冈上肌的平均厚度为4.9 mm±2.1（中位数：4.2 mm，范围：2.9 - 12.7 mm）。冈下肌腱的平均厚度为4.9 mm±1.3（中位数：4.8 mm，范围：3.0 - 7.2 mm）。小圆肌腱的平均厚度为3.20 mm±1.14（中位数：2.9 mm，范围：1.7 - 5.7 mm）。最后，关节边缘处肩胛下肌腱的平均厚度为5.5 mm±1.3（中位数：5.5 mm，范围：3.5 - 9.3 mm）。
本研究提供了关于关节边缘处肩袖肌腱厚度所需的客观数据。关于冈下肌、小圆肌和大圆肌的数据，此前大多未被充分研究，尤为重要。此外，本研究表明，个体之间肩袖厚度可能存在显著差异。可能存在与年龄相关的自然变化以及尚未阐明的病因导致的变化。临床意义：本研究数据将提高肩部特定软组织结构的建模准确性。最终，通过对肩部力学的研究获得的知识可用于预防肩袖撕裂并改进靶向治疗方案。
