全层冈上肌撕裂对外展力矩的影响：中央肌腱的重要性。
The influence of full-thickness supraspinatus tears on abduction moments: the importance of the central tendon.
作者信息
Thompson Simon M, Prinold Joe A I, Hill Adam M, Reilly Peter, Emery Roger J H, Bull Anthony M J
机构信息
Imperial College London, St Mary's Hospital, Praed Street, Paddington, London, UK.
Imperial College London, Department of Bioengineering, South Kensington Campus, London, UK.
出版信息
Shoulder Elbow. 2019 May;11(1 Suppl):19-25. doi: 10.1177/1758573217717104. Epub 2017 Jul 10.
BACKGROUND
Detachment of the central tendon of the supraspinatus from its insertion is considered to be crucial to functional deficit. The aim of the present study was to assess the function of the supraspinatus in terms of abduction moments by introducing different tear configurations to assess the functional effect of the central tendon insertion.
METHODS
Ten fresh frozen shoulders from five cadavers were prepared for testing. A testing protocol was established to measure the abduction moment of the supraspinatus under physiological loading tailored to the anthropometrics of each specimen. Four conditions were tested: intact supraspinatus; complete detachment of portion of the supraspinatus tendon anterior to the main central tendon; detachment of the main central tendon; and detachment of the region of the supraspinatus posterior to the main central tendon.
RESULTS
There was a significant and large reduction in abduction moment when the central tendon was sectioned ( < 0.05). A smaller reduction in abduction moment was found when the regions anterior and posterior to the main central tendon were sectioned ( < 0.05).
CONCLUSIONS
The central tendon is vital in the role of functional arm abduction through force transmission through the intact rotator cuff. Reinsertion of the central tendon in the correct anatomical location is desirable to optimize functional outcome of surgery.
背景
冈上肌中央肌腱与其附着点的分离被认为是导致功能缺陷的关键因素。本研究的目的是通过引入不同的撕裂形态来评估冈上肌中央肌腱附着点的功能影响，从而根据外展力矩来评估冈上肌的功能。
方法
准备了来自五具尸体的十个新鲜冷冻肩部用于测试。建立了一个测试方案，以测量在根据每个标本的人体测量学定制的生理负荷下冈上肌的外展力矩。测试了四种情况：冈上肌完整；冈上肌腱在主要中央肌腱前方的部分完全分离；主要中央肌腱分离；以及主要中央肌腱后方的冈上肌区域分离。
结果
当切断中央肌腱时，外展力矩有显著且大幅的降低（<0.05）。当切断主要中央肌腱前后的区域时，外展力矩有较小程度的降低（<0.05）。
结论
中央肌腱在通过完整的肩袖进行力传递以实现功能性手臂外展方面起着至关重要的作用。将中央肌腱重新植入正确的解剖位置对于优化手术的功能结果是可取的。
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