Department of Orthopaedics and Trauma Surgery, Faculty of Medicine, Fayoum University, Fayoum, Egypt.
Department of Shoulder Surgery, Sanatorio Allende, Córdoba, Argentina.
Orthop Traumatol Surg Res. 2021 Sep;107(5):102934. doi: 10.1016/j.otsr.2021.102934. Epub 2021 Apr 15.
The purpose of the present study was to analyze the ability to create a subscapularis split by passive rotation of the arm during dynamic anterior stabilization (DAS) and to analyze the new geometry of the long head of the biceps LHB.
The hypothesis was that this passive simple technique can create subscapularis split without additional dissection giving rise to new position of LHB with a new stabilization function.
A technique of subscapularis split using the LHB was used in 12 fresh-frozen human cadaveric shoulders. A subscapularis split was created by passive rotation of the arm after the LHB is shuttled into the joint during DAS. The length of the subscapularis split, post-DAS position and length of the LHB, and the angulation of the LHB relative to bicipital groove were measured after DAS and if this new geometry can give a new dynamic effect on subscapularis muscle.
The mean length of the subscapular split after maximal rotation was 20.4±6.0mm (range: 10-32mm). The mean elongation of the LHB was 0.6±1.4mm (range: -1 to +3mm). The final angle of the LHB relative to the bicipital groove was 45±5 degrees (range: 41 to 55 degrees).
There is no need to create a distinct split prior to DAS. Additionally, DAS maintains the length-tension relationship of the LHB. The post-procedure medial angulation of the LHB relative to the bicipital groove may provide a lowering of the subscapularis, helping explain the anterior reinforcement of this technique.
Basic science study, cadaver study.
本研究旨在分析在动态前稳定（DAS）过程中通过手臂被动旋转创造肩胛下肌分裂的能力，并分析肱二头肌长头（LHB）的新几何形状。
假设是这种被动简单技术可以在不进行额外解剖的情况下创建肩胛下肌分裂，从而产生新的 LHB 位置，并具有新的稳定功能。
在 12 个新鲜冷冻的人体尸体肩部使用 LHB 的肩胛下肌分裂技术。在 DAS 过程中 LHB 被 shuttle 到关节后，通过手臂的被动旋转创建肩胛下肌分裂。在 DAS 后测量肩胛下肌分裂后的长度、DAS 后的 LHB 位置和长度以及 LHB 相对于二头肌沟的角度，如果这种新的几何形状可以对肩胛下肌肌肉产生新的动态效应。
最大旋转后肩胛下肌分裂的平均长度为 20.4±6.0mm（范围：10-32mm）。LHB 的平均伸长量为 0.6±1.4mm（范围：-1 至+3mm）。LHB 相对于二头肌沟的最终角度为 45±5 度（范围：41 至 55 度）。
在进行 DAS 之前无需创建明显的分裂。此外，DAS 保持了 LHB 的长度-张力关系。LHB 相对于二头肌沟的术后内侧角度可能会降低肩胛下肌的高度，这有助于解释该技术的前向增强作用。
基础科学研究，尸体研究。
