Department of Orthopaedics and Traumatology, Başakşehir Çam ve Sakura City Hospital, İstanbul, Turkey.
Department of Orthopaedics and Traumatology, Faculty of Medicine, Harran University, Şanlıurfa, Turkey.
Turk J Med Sci. 2023 Feb;53(1):273-281. doi: 10.55730/1300-0144.5582. Epub 2023 Feb 22.
BACKGROUND: : The purpose of this study is to investigate whether the etiological factors accepted as causes of idiopathic subscapularis tears are true or not when the comparison is made with the opposite side healthy shoulder of the patients who underwent arthroscopic repair for an isolated subscapularis tear. METHODS: Sixteen patients who underwent shoulder arthroscopy between February 2016 and January 2018 and were diagnosed with isolated subscapularis tear were evaluated. The coracohumeral distance (CHDax), coracoid overlap (CO), and tuberculum minus cysts (TMC) were evaluated on the axial images of the MRI studies while the acromiohumeral distance (AHDsag), CHDsag, and subscapularis tendon slip number (STSN) on the sagittal oblique images and the AHDcor and SLAP lesion on the coronal oblique images. Degeneration of the coracoacromial ligament was evaluated during arthroscopy. RESULTS: The mean CHDsag (11.26-10.08), CHDax (10.63-9.98), CO (14.2-15.43), AHDsag (8-7.66), and AHDcor (7.65-7.68) measurements (operated side-healthy side, respectively) were statistically similar (p > 0.05). No statistically significant difference was found between TMC and STSN in healthy and operated shoulders (p > 0.05). There was mild coracoacromial ligament fraying in 4 (25%) and obvious coracoacromial ligament fraying in 8 (50%) which indicated subacromial impingement in 75% of the patients. DISCUSSION: The parameters of the coracoid process did not reveal any significant difference between the operated (for an isolated subscapularis tear) and opposite-side healthy shoulders of the patients. However, coracoacromial ligament degeneration was present in 75% of the patients.
背景:本研究旨在探讨当比较接受为特发性肩胛下肌撕裂病因的因素与接受关节镜下孤立性肩胛下肌撕裂修复术患者的对侧健康肩部时,这些因素是否为真正的病因。
方法:评估了 2016 年 2 月至 2018 年 1 月期间接受肩关节镜检查并诊断为孤立性肩胛下肌撕裂的 16 名患者。在 MRI 研究的轴位图像上评估喙肱距离(CHDax)、喙突重叠(CO)和结节下囊肿(TMC),在斜矢状位图像上评估肩峰肱骨头距离(AHDsag)、CHDsag 和肩胛下肌腱滑数(STSN),在斜冠状位图像上评估 AHDcor 和 SLAP 病变。关节镜检查时评估肩锁韧带的退变。
结果:CHDax(10.63-9.98)、CO(14.2-15.43)、AHDsag(8-7.66)和 AHDcor(7.65-7.68)的均值(患侧-健侧,分别)的测量值在统计学上无显著差异(p>0.05)。TMC 和 STSN 在健康和患侧肩部之间无统计学差异(p>0.05)。4 例(25%)有轻度肩锁韧带撕裂,8 例(50%)有明显肩锁韧带撕裂,表明 75%的患者有肩峰下撞击。
讨论:喙突参数在接受孤立性肩胛下肌撕裂修复术的患者的患侧与对侧健康肩部之间无明显差异。然而,75%的患者存在肩锁韧带退变。
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