Konya City Hospital, Department of Orthopaedics & Traumatology, Konya 42020, Turkey.
Necmettin Erbakan University School of Medicine, Department of Orthopaedics & Traumatology, Konya, Turkey.
Injury. 2023 Jul;54(7):110770. doi: 10.1016/j.injury.2023.05.002. Epub 2023 May 2.
INTRODUCTıON: It is estimated that 5-30% of traumatic anterior shoulder dislocations are accompanied by greater tuberosity fracture (GTF), and the pathomechanism of these fractures is not yet clear. Our hypothesis is to examine the relationship between the scapula morphology and anterior shoulder dislocation (ASD) accompanying GTF. MATERıALS AND METHODS: The patients were divided into two groups according to the accompanying GTF. 40 patients with isolated traumatic ASD and 31 patients with accompanying GTF were included in the study. Critical shoulder angle (CSA), glenoid inclination (GI), acromial index (AI) and greater tuberosity angle (GTA) values were measured in two sessions by two independent observers in the standard antero-posterior radiographs of the patients in both groups. RESULTS: The mean CSA was 40.82°±3.19° and 35.49°±2.19° in accompanying GTF group and the isolated ASD group, respectively. The mean CSA was significantly higher in accompanying GTF group than isolated ASD group(P<0.001). The GI was significantly higher in the isolated ASD than in accompanying GTF group (P = 0.001). The mean GI was 18.7°±6.85° and 10.45°±4.87° in accompanying GTF group and the isolated ASD, respectively. Cut-off value of CSA and GI was 38° (88.2% sensitivity,88.9% specificity) and 14.5° (70.6% sensitivity and 72.2% specificity), respectively. There was no significant difference regarding the mean GTA and AI values between GTF group and the isolated ASD group (P = 0.98, P = 0.63). CONCLUSıONS: Increased CSA and GI values are associated with traumatic anterior shoulder dislocation accompanied by greater tuberosity fracture.
据估计,5-30%的创伤性前肩脱位伴有大结节骨折(GTF),其发病机制尚不清楚。我们的假设是研究肩胛骨形态与伴有 GTF 的前肩脱位(ASD)之间的关系。
根据是否伴有 GTF,将患者分为两组。纳入研究的患者包括 40 例单纯创伤性 ASD 患者和 31 例伴有 GTF 的患者。在两组患者的标准前后位 X 线片上,由两位独立观察者分别在两次测量临界肩角(CSA)、肩胛倾斜角(GI)、肩峰指数(AI)和大结节角(GTA)值。
伴有 GTF 组的平均 CSA 为 40.82°±3.19°,孤立 ASD 组为 35.49°±2.19°。伴有 GTF 组的平均 CSA 明显高于孤立 ASD 组(P<0.001)。孤立 ASD 组的 GI 明显高于伴有 GTF 组(P=0.001)。伴有 GTF 组的平均 GI 为 18.7°±6.85°,孤立 ASD 组为 10.45°±4.87°。CSA 和 GI 的截断值分别为 38°(88.2%的敏感性,88.9%的特异性)和 14.5°(70.6%的敏感性和 72.2%的特异性)。GTF 组和孤立 ASD 组的平均 GTA 和 AI 值无显著差异(P=0.98,P=0.63)。
CSA 和 GI 值增加与创伤性前肩脱位伴大结节骨折有关。