Hakuno A, Sashika H, Ohkawa T, Itoh R
Arch Phys Med Rehabil. 1984 Nov;65(11):706-11.
To discover the influence of hemiplegia on arthrographic changes in hemiplegic shoulders, we compared arthrographic findings from paralyzed and nonparalyzed shoulders in 77 patients with hemiplegia. The correlation between arthrographic changes in paralyzed shoulders and characteristics of the hemiplegic condition was also investigated. Hemiplegic changes were considered to be responsible for adhesive changes in affected shoulders because those changes were found in paralyzed shoulders at a statistically significant higher rate (54.6%) than in the nonparalyzed side (32.5%). The occurrence rate of contrast leakage from capsule tear on the subscapular bursa and the bicipital tendon sleeve was higher on the nonparalyzed side than on the paralyzed side. It is suggested that capsular contracture due to hemiplegia prohibits capsular tear during arthrographic maneuvers. No significant difference was found in the occurrence of rotator cuff tear between the paralyzed and the nonparalyzed shoulder. Those changes on the paralyzed side were not correlated with any characteristics of hemiplegics except for shoulder pain prior to the onset of hemiplegia.
为了探究偏瘫对偏瘫侧肩部关节造影变化的影响，我们比较了77例偏瘫患者瘫痪侧与非瘫痪侧肩部的关节造影结果。我们还研究了瘫痪侧肩部关节造影变化与偏瘫状况特征之间的相关性。偏瘫性改变被认为是导致患侧肩部粘连性改变的原因，因为这些改变在瘫痪侧肩部的发生率（54.6%）在统计学上显著高于非瘫痪侧（32.5%）。肩胛下囊和肱二头肌肌腱袖处因关节囊撕裂导致的造影剂渗漏发生率非瘫痪侧高于瘫痪侧。这表明偏瘫导致的关节囊挛缩在关节造影操作过程中阻止了关节囊撕裂。瘫痪侧与非瘫痪侧肩部肩袖撕裂的发生率没有显著差异。瘫痪侧的这些变化与偏瘫患者的任何特征均无相关性，除了偏瘫发作前的肩部疼痛。
