Department of Orthopaedics and Trauma Surgery, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany.
Department of Sports Orthopaedics, St. Vinzenz Hospital, Düsseldorf, Germany.
J Ultrasound Med. 2022 Feb;41(2):409-415. doi: 10.1002/jum.15719. Epub 2021 May 6.
Dynamic horizontal instability is considered to be the main reason for poor outcome after treatment for acromioclavicular (AC) joint instability. In this study, we describe a simple technique to quantify this pathology via sonography.
Thirty-six shoulders from 18 patients with ac joint instabilities were examined using modified Alexander views and a standardized sonographic examination. On the Alexander views, overlap of acromion and clavicle (OLAC), glenoid center to posterior clavicle distance (GCPC), and lateral extension (LE) were measured. Afterwards, the results were analyzed and compared with sonography. Posterior translation of the clavicle and the difference of translation between healthy and injured shoulder were evaluated.
The mean age of the patients was 39 ± 14 years (range 19-61 years). We included 4 (22%) Rockwood type 3, 1 (6%) Rockwood type 4, and 13 (72%) Rockwood type 5 lesions. Four (22%) patients were female and 14 (78%) male patients. Posterior clavicle translation of the injured shoulder correlated strongly between OLAC and sonography (r = -0.514, P = .029), and the difference of translation between healthy and injured shoulder correlated very strongly between LE and sonography (r = 0.737, P < .001).
The sonographic measurement technique for horizontal instability presented in this work could help detect horizontal instabilities. While the observation of dynamic horizontal displacement is a strength of this technique, measurements are hindered in cases of high coracoclavicular distances.
Level III-retrospective cohort study.
动态性水平不稳定性被认为是肩锁关节（AC）不稳定治疗后效果不佳的主要原因。本研究通过超声描述了一种量化该病理学的简单技术。
对 18 例 AC 关节不稳定患者的 36 个肩部进行改良的亚历山大视图和标准化超声检查。在亚历山大视图上，测量肩峰和锁骨的重叠（OLAC）、肩胛盂中心到锁骨后缘的距离（GCPC）和外侧延伸（LE）。然后，分析并与超声结果进行比较。评估锁骨的后移位以及健康侧和患侧之间的差异。
患者的平均年龄为 39±14 岁（范围 19-61 岁）。包括 4 例（22%）Rockwood 3 型、1 例（6%）Rockwood 4 型和 13 例（72%）Rockwood 5 型损伤。4 例（22%）为女性，14 例（78%）为男性患者。患侧锁骨的后移位在 OLAC 和超声之间具有很强的相关性（r=-0.514，P=0.029），而健康侧和患侧之间的差异在 LE 和超声之间具有很强的相关性（r=0.737，P<0.001）。
本研究提出的水平不稳定性超声测量技术可以帮助检测水平不稳定性。虽然观察动态水平位移是该技术的优势，但在喙锁间距较高的情况下，测量会受到阻碍。
III 级-回顾性队列研究。
