Department of Orthopedics, Occupational Injury Rehabilitation Center, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China.
Department of Orthopedics, Sport Medicine Center, Chinese PLA General Hospital, No.28 fuxing Road, Haidian District, Beijing, China.
Int Orthop. 2019 Aug;43(8):1909-1916. doi: 10.1007/s00264-018-4078-5. Epub 2018 Aug 29.
To define and compare the coracohumeral index (CHI) and coracoglenoid inclination (CGI) in patients with different types of the subscapularis tendon tears.
Patients were divided into two groups: articular-sided lesion group (group A) and bursal-sided lesion group (group B). All the patients were examined using a 3.0-T magnetic resonance imaging scanner pre-operatively. The morphometric parameters of the coracoids, including the coracohumeral distance (CHD), CHI, and CGI, were measured on MRI.
There were 165 (70.2%) and 70 (29.8%) patients in groups A and B, respectively. There was no significant difference in the average CHD (7.98 ± 1.7 mm vs 7.82 ± 2.1 mm, respectively) and CGI (50.5° ± 16.6° vs 44.9° ± 17.4°, respectively; P = 0.427) between the two groups. Conversely, there was a significant difference in the CHI between them (0.32 ± 0.08 vs 0.57 ± 0.11, respectively; P = 0.0001). According to the CHI and CGI, the coracoid process was divided into three types, and nearly half of the patients (46.8%) had standard coracoids with a hook tip, which are vulnerable to injury on the articular side. However, with overlapping coracoids and hook tips, the patients (16.2%) tended to experience injury on the bursal side. There was a significant difference in the incidence of articular or bursal side tear between the two groups.
The CHI and CGI are potential valuable predictors of the types of degenerative subscapularis tendon tears. With standard hook coracoids, the lesions tend to appear on the articular side initially; otherwise, with overlapping hook coracoids, the subscapularis tendon tears are commonly seen on the bursal side.
定义并比较不同类型肩胛下肌腱撕裂患者的肩峰肱骨关节指数（CHI）和肩峰肩胛盂倾斜角（CGI）。
患者分为两组：关节侧病变组（A 组）和滑囊侧病变组（B 组）。所有患者均在术前使用 3.0-T 磁共振成像扫描仪进行检查。MRI 上测量喙突的形态参数，包括肩峰肱骨关节距离（CHD）、CHI 和 CGI。
A 组和 B 组分别有 165 例（70.2%）和 70 例（29.8%）患者。两组间平均 CHD（分别为 7.98±1.7mm 和 7.82±2.1mm）和 CGI（分别为 50.5°±16.6°和 44.9°±17.4°；P=0.427）无显著差异。相反，两组间 CHI 存在显著差异（分别为 0.32±0.08 和 0.57±0.11；P=0.0001）。根据 CHI 和 CGI，喙突可分为三型，近一半（46.8%）患者的喙突具有标准钩状尖端，容易在关节侧受伤。然而，对于重叠的喙突和钩状尖端，患者（16.2%）更倾向于滑囊侧损伤。两组间关节或滑囊侧撕裂的发生率存在显著差异。
CHI 和 CGI 是预测退行性肩胛下肌腱撕裂类型的潜在有价值指标。具有标准钩状喙突时，病变往往首先出现在关节侧；否则，当钩状喙突重叠时，肩胛下肌腱撕裂通常发生在滑囊侧。
