Bayley J C, Cochran T P, Sledge C B
J Bone Joint Surg Am. 1987 Jun;69(5):676-8.
The cases of ninety-four patients who had complete paraplegia were studied to determine whether they had complaints about the shoulder during transfer activities. Thirty-one patients reported pain on transferring, and twenty-three of these patients were found to have a chronic impingement syndrome with subacromial bursitis. Arthrography of the shoulder was done for each of these twenty-three patients, and fifteen were found to have a tear of the rotator cuff. Five of the thirty-one patients were found to have aseptic necrosis of the head of the humerus. We also measured the intra-articular pressure in the shoulder in five patients during different activities, including transfer from wheelchair to bed, and found that this pressure exceeded the arterial pressure by two and one-half times. We believe that this high pressure, in conjunction with abnormal distribution of stress transmitted across the subacromial area during transfer or propulsion of a wheelchair, contributes to the high rate of problems about the shoulder in paraplegics.
对94例完全性截瘫患者的病例进行了研究，以确定他们在转移活动期间是否有肩部不适。31例患者报告在转移时有疼痛，其中23例患者被发现患有伴有肩峰下滑囊炎的慢性撞击综合征。对这23例患者均进行了肩部关节造影，发现其中15例有肩袖撕裂。31例患者中有5例被发现有肱骨头无菌性坏死。我们还对5例患者在包括从轮椅转移到床上等不同活动期间的肩部关节内压力进行了测量，发现该压力超过动脉压两倍半。我们认为，这种高压，再加上在轮椅转移或推进过程中经肩峰下区域传递的应力分布异常，导致截瘫患者肩部问题发生率较高。
