Department of Orthopaedics and Traumatology, Konya City Hospital, 42020, Karatay, Konya, Turkey.
Department of Orthopaedics and Traumatology, Necmettin Erbakan University School of Medicine, Konya, Turkey.
Arch Orthop Trauma Surg. 2023 Aug;143(8):5167-5174. doi: 10.1007/s00402-023-04790-5. Epub 2023 Feb 2.
Although the morphological relationship of the scapula and the humeral head has been claimed to be related to shoulder pathologies, few studies examined the relationship between subscapularis (Ssc) tears and lesser tuberosity (LT)-humeral head (HH) and between Ssc tears and HH-glenoid. This study aims to evaluate the relationship of LT with HH and glenoid in patients with Ssc tears and anterior shoulder instability (ASI). We hypothesized that the glenoid, HH, and their combined relationship with LT may impact Ssc tears and ASI.
The study included 34 patients with ASI, 28 patients with isolated Ssc tears, and 40 patients as the control group. The radius of HH (Hr), the distance between the center of HH and LT (LTr), and the glenoid radius (Gr) were measured in shoulder magnetic resonance (MR) images. The LTr to Hr (LTr/Hr) ratio was defined as the lesser tuberosity-humeral head index (LTHHI), whereas the LTr to Gr (LTr/Gr) ratio was defined as the lesser tuberosity-glenoid index (LTGI). The three groups were compared regarding LTHHI, LTGI, LTr, Hr, and Gr.
There was a significant difference between each group concerning LTGI (p < 0.001). LTGI values below 1.99 showed 93.1% sensitivity and 93.3% specificity for Ssc tears, while values above 2.24 showed 86.7% sensitivity and 86.2% specificity for ASI. Also, there was a significant difference when the groups were compared for LTHHI (p < 0.001). This rate was lowest for Ssc tears, and LTHHI values below 1.17 showed 82.8% sensitivity and 80.1% specificity.
LTGI may be a new predictive factor showing 93.1% sensitivity and 93.3% specificity for Ssc tears and 86.7% sensitivity and 86.2% specificity for ASI. In addition, LTHHI may be a new predictive factor showing 82.8% sensitivity and 80.1% specificity for Ssc tears.
III retrospective comparative study.
尽管肩胛骨和肱骨头部的形态关系已被认为与肩部病变有关，但很少有研究探讨肩胛下肌（Ssc）撕裂与小结节（LT）-肱骨头（HH）以及肩胛下肌撕裂与 HH-关节盂之间的关系。本研究旨在评估 Ssc 撕裂和前肩不稳定（ASI）患者中 LT 与 HH 和关节盂的关系。我们假设关节盂、HH 及其与 LT 的综合关系可能会影响 Ssc 撕裂和 ASI。
本研究纳入了 34 例 ASI 患者、28 例单纯 Ssc 撕裂患者和 40 例对照组患者。在肩关节磁共振（MR）图像上测量 HH 的半径（Hr）、HH 中心与 LT 之间的距离（LTr）以及关节盂半径（Gr）。LTr 与 Hr 的比值定义为小结节-肱骨头指数（LTHHI），而 LTr 与 Gr 的比值定义为小结节-关节盂指数（LTGI）。比较三组之间的 LTHHI、LTGI、LTr、Hr 和 Gr。
各组间 LTGI 差异有统计学意义（p<0.001）。LTGI 值<1.99 对 Ssc 撕裂的敏感性为 93.1%，特异性为 93.3%，而值>2.24 对 ASI 的敏感性为 86.7%，特异性为 86.2%。此外，当比较各组之间的 LTHHI 时，差异具有统计学意义（p<0.001）。Ssc 撕裂的 LTHHI 值最低，而 LTHHI 值<1.17 对 Ssc 撕裂的敏感性为 82.8%，特异性为 80.1%。
LTGI 可能是一种新的预测因子，对 Ssc 撕裂的敏感性为 93.1%，特异性为 93.3%，对 ASI 的敏感性为 86.7%，特异性为 86.2%。此外，LTHHI 可能是一种新的预测因子，对 Ssc 撕裂的敏感性为 82.8%，特异性为 80.1%。
III 级回顾性比较研究。
