São João University Hospital, Porto, Portugal.
Primary Health Care Unit Saúde em Família, Porto, Portugal.
J Shoulder Elbow Surg. 2019 Sep;28(9):1723-1727. doi: 10.1016/j.jse.2019.01.012. Epub 2019 Apr 20.
Subscapularis (SS) lesions are often underdiagnosed because of an incomplete understanding of contributing factors but also because of a greater difficulty in SS tear diagnosis with magnetic resonance imaging or physical examination. In this setting, predicting factors can be useful tools in these injuries' management. The goal of this study was to determine the influence of the coracohumeral distance (CHD) and coracoid overlap (CO) in anterior rotator cuff lesions, as well as to determine the CHD and CO values that can accurately predict SS and long head of the biceps (LHB) injuries.
We performed a retrospective, controlled, single-blinded study. We analyzed 301 patients with rotator cuff pathology and magnetic resonance imaging studies; patients with SS lesions represented the study group. The CHD and CO were measured.
We found that lower CHD and higher CO values were progressively related to more serious injuries of the SS and LHB. The CHD was a very strong predictor of SS injury and tear and a good predictor of LHB injuries. A CHD of 7.6 mm had a sensitivity of 84.4% and specificity of 88.6% for SS tears. The CO was also a very strong predictor of SS tears and a good predictor of LHB injury, with a CO of 16.6 mm reaching a sensitivity of 77.8% and specificity of 68.3% for SS tears.
The CHD is an excellent predictor of SS tears and a good predictor of LHB lesions, with the CO also being a very strong predictor of SS tears and a good model for LHB injuries.
由于对发病因素认识不足，且肩胛下肌（SS）撕裂的磁共振成像或体格检查诊断较为困难，SS 病变常常漏诊。在此背景下，预测因素可能是这些损伤管理的有用工具。本研究旨在确定肩盂肱距离（CHD）和喙突重叠（CO）在前肩袖病变中的影响，并确定可准确预测 SS 和肱二头肌长头（LHB）损伤的 CHD 和 CO 值。
我们进行了一项回顾性、对照、单盲研究。我们分析了 301 例肩袖病变和磁共振成像研究患者；SS 病变患者为研究组。测量 CHD 和 CO。
我们发现，较低的 CHD 值和较高的 CO 值与 SS 和 LHB 更严重的损伤呈渐进性相关。CHD 是 SS 损伤和撕裂的强预测因子，也是 LHB 损伤的良好预测因子。CHD 为 7.6mm 时，对 SS 撕裂的敏感性为 84.4%，特异性为 88.6%。CO 也是 SS 撕裂的强预测因子，也是 LHB 损伤的良好预测因子，CO 为 16.6mm 时，对 SS 撕裂的敏感性为 77.8%，特异性为 68.3%。
CHD 是 SS 撕裂的良好预测因子，也是 LHB 损伤的良好预测因子，CO 也是 SS 撕裂的强预测因子，也是 LHB 损伤的良好预测模型。
