Leroux J L, Thomas E, Bonnel F, Blotman F
Functional Rehabilitation Unit, Lapeyronie Hospital, Montpellier, France.
Rev Rhum Engl Ed. 1995 Jun;62(6):423-8.
Results of three clinical tests for detecting shoulder impingement syndrome (Neer's, Hawkins', and Yocum's tests) and four tests for determining the location of the rotator cuff lesion (Jobe's test [supraspinatus], Patte's test [infraspinatus], lift-off test [subscapularis], and palm-up test [long head of the biceps brachii]) were compared to intraoperatively observed anatomic lesions in 55 consecutive patients who had surgery for Neer's syndrome. For Jobe's and Patte's tests, both pain (denoting tendinitis) and functional impairment (denoting tendon rupture) were evaluated. All clinical tests were done by the same examiner and all surgical procedures (acromioplasty with or without rotator cuff repair) by the same surgeon. The location and extent of the lesions (size of the tear in the 34 patients with rotator cuff defects) were determined intraoperatively. The sensitivity, specificity, and positive and negative predictive values of each test were calculated. Sensitivity was satisfactory but specificity was poor, in particular for determining the location and type of rotator cuff lesions. The severity of functional impairment during Jobe's and Patte's maneuvers was not correlated with the size of the tear.
对55例因尼尔氏综合征接受手术的连续患者，将用于检测肩部撞击综合征的三项临床检查（尼尔氏、霍金斯氏和约库姆氏检查）以及用于确定肩袖损伤位置的四项检查（乔布氏检查[冈上肌]、帕特氏检查[冈下肌]、抬离试验[肩胛下肌]和掌心向上试验[肱二头肌长头]）的结果与术中观察到的解剖学损伤进行了比较。对于乔布氏和帕特氏检查，对疼痛（表示肌腱炎）和功能障碍（表示肌腱断裂）均进行了评估。所有临床检查均由同一名检查者完成，所有外科手术（有或无肩袖修复的肩峰成形术）均由同一名外科医生进行。术中确定了病变的位置和范围（34例有肩袖缺损患者的撕裂大小）。计算了每项检查的敏感性、特异性以及阳性和阴性预测值。敏感性令人满意，但特异性较差，尤其是在确定肩袖损伤的位置和类型方面。乔布氏和帕特氏动作期间功能障碍的严重程度与撕裂大小无关。
