Necmettin Erbakan University School of Medicine, Department of Orthopaedics & Traumatology, Konya, Turkey.
Ankara Bilkent City Hospital, Department of Orthopaedics & Traumatology, Ankara, Turkey.
Acta Chir Orthop Traumatol Cech. 2024;91(4):239-244. doi: 10.55095/ACHOT2024/032.
This study investigated the relationship between the position of the tip of the coracoid process (CP) relative to the glenoid with subscapularis (Ssc) tears. We hypothesized that the coracoid tip is more inferior, lateral and posterior in patients with Ssc tear.
This research enrolled 34 isolated Ssc tears and 44 controls. We introduced the axial central glenoid-coracoid angle (acGCA) and sagittal central glenoid-coracoid angle (scGCA) to evaluate the position of the tip of the CP relative to the glenoid center on MRI images. In both groups, acGCA, scGCA on MRI and critical shoulder angle (CSA), glenoid inclination (GI) on true anterior-posterior shoulder radiography were evaluated.
When both groups were compared in terms of acGCA, the acGCA values of the Ssc tear group were significantly higher than the control group (p<0.001). The best cut-off value of acGCA for Ssc tears was 28.3°. acGCA values higher than 28.3° showed 93.3% sensitivity and 93.1% specificity for Ssc tears (likelihood ratio:13.53, AUC: 0.979, 95% CI of AUC: 0.950- 0.999). In terms of acGCA, the power analysis between Ssc tears group and control group was 99.9% between Ssc tears and the control group (effect size d=2.63). When both groups were compared in terms of scGCA, the scGCA values of the Ssc tear group were significantly higher than the control group (p<0.001). The best cut-off value of scGCA for Ssc tears was 41.4°. Scores of scGCA greater than 41.8° showed 80% sensitivity and 89.7% specificity for Ssc tears (likelihood ratio: 7.73, AUC: 0.899 95% CI of AUC: 0.837-0.958). In terms of scGCA, the power analysis between Ssc tear and control group was 99.8% (effect size d=1.23). When both groups were compared in terms of CSA and GI; CSA and GI values in the Ssc tear group were significantly higher (p<0.001 and p<0.012, respectively).
AcGCA values higher than 28.3° indicate that the coracoid tip is located more laterally and posteriorly; scGCA values higher than 41.8° indicate that the coracoid tip is located more inferiorly and these two new indexes are showing that more laterally, posteriorly and inferiorly coracoid tip is related to subscapularis tears.
coracoid process, subscapularis tear, coracoid morphology, scapula morphology.
本研究旨在探讨喙突尖端相对于肩胛下肌（SSc）撕裂的位置与肩胛盂的关系。我们假设在 SSc 撕裂患者中，喙突尖端更靠下、更靠外和更靠后。
本研究纳入了 34 例孤立性 SSc 撕裂患者和 44 例对照组。我们引入了轴向中心盂-喙突角（acGCA）和矢状面中心盂-喙突角（scGCA），以评估 MRI 图像上喙突尖端相对于盂中心的位置。在两组中，均评估了 acGCA、MRI 上的 scGCA、临界肩角（CSA）和真前后位肩 X 线片上的肩胛倾斜角（GI）。
当两组在 acGCA 方面进行比较时，SSc 撕裂组的 acGCA 值明显高于对照组（p<0.001）。acGCA 用于 SSc 撕裂的最佳截断值为 28.3°。acGCA 值大于 28.3°时，对 SSc 撕裂的敏感性为 93.3%，特异性为 93.1%（优势比：13.53，AUC：0.979，95%CI 的 AUC：0.950-0.999）。在 acGCA 方面，SSc 撕裂组和对照组之间的功效分析为 99.9%（效应大小 d=2.63）。当两组在 scGCA 方面进行比较时，SSc 撕裂组的 scGCA 值明显高于对照组（p<0.001）。scGCA 用于 SSc 撕裂的最佳截断值为 41.4°。scGCA 评分大于 41.8°时，对 SSc 撕裂的敏感性为 80%，特异性为 89.7%（优势比：7.73，AUC：0.899，95%CI 的 AUC：0.837-0.958）。在 scGCA 方面，SSc 撕裂和对照组之间的功效分析为 99.8%（效应大小 d=1.23）。当两组在 CSA 和 GI 方面进行比较时；SSc 撕裂组的 CSA 和 GI 值均显著升高（p<0.001 和 p<0.012，分别）。
acGCA 值大于 28.3°表明喙突尖端更靠外和更靠后；scGCA 值大于 41.8°表明喙突尖端更靠下；这两个新指标表明喙突尖端更靠外、靠后和靠下与肩胛下肌撕裂有关。
喙突；肩胛下肌撕裂；喙突形态；肩胛形态。
