Nicholson G P, Goodman D A, Flatow E L, Bigliani L U
Orthopaedics Indianapolis, Inc., Riverdale, GA, USA.
J Shoulder Elbow Surg. 1996 Jan-Feb;5(1):1-11. doi: 10.1016/s1058-2746(96)80024-3.
Two hundred ten specimens (420 scapulas) from the Hamann-Todd Osteological Collection at the Cleveland Museum of Natural History were evaluated to determine the influence of age on acromial morphologic condition. Equal numbers of specimens from female and male and black and white subjects were evaluated. The length, width, and anterior thickness of the acromion and the acromial facet of the acromioclavicular joint were measured with digital calipers, examined visually, and evaluated radiographically. Distribution of acromial morphologic types was type I, (flat) 32%, type II (curved), 42%, and type III (hooked), 26%. Analysis of the data revealed no consistent, statistically significant impact of age on morphologic condition. The incidence of os acromiale was 8% (17 of 210), with 7 (41%) of 17 specimens having bilateral involvement. Mean acromial dimensions in men were length = 48.5 mm, width = 19.5 mm, and anterior thickness = 7.7 mm. Mean dimensions in women were length = 40.6 mm, width = 18.4 mm, and thickness = 6.7 mm. Multiple regression analysis revealed no significant changes in any dimension with increasing age. Observation of the acromial facet of the acromioclavicular joint revealed 49% were medially inclined, 48% were vertically inclined, and only 3% were laterally inclined in relationship to the sagittal plane. A statistically significant age-related increase in degenerative changes was noted. Anterior acromial spur formation as determined by visual inspection of the acromion was observed in 7% of specimens from patients younger than 50 years compared with 30% of specimens from patients older than 50 years (p < 0.05). Spur formation on the anterior acromion is an age-dependent process. Acromial morphologic condition as evaluated by outlet radiographs is independent of age and appears to be a primary anatomic characteristic. The variations seen in acromial morphologic condition are not acquired from age-related changes and spur formation and thus contribute to impingement disease independent of and in addition to age-related processes.
对克利夫兰自然历史博物馆哈曼 - 托德骨骼收藏中的210个标本（420块肩胛骨）进行评估，以确定年龄对肩峰形态状况的影响。对来自女性和男性以及黑人和白人受试者的数量相等的标本进行了评估。使用数字卡尺测量肩峰的长度、宽度和前部厚度以及肩锁关节的肩峰小关节面，进行目视检查并进行影像学评估。肩峰形态类型的分布为：I型（扁平）32%，II型（弯曲）42%，III型（钩状）26%。数据分析显示年龄对形态状况没有一致的、具有统计学意义的影响。肩峰骨的发生率为8%（210个中有17个），17个标本中有7个（41%）为双侧受累。男性肩峰的平均尺寸为：长度 = 48.5毫米，宽度 = 19.5毫米，前部厚度 = 7.7毫米。女性的平均尺寸为：长度 = 40.6毫米，宽度 = 18.4毫米，厚度 = 6.7毫米。多元回归分析显示，随着年龄增长，任何尺寸均无显著变化。对肩锁关节肩峰小关节面的观察显示，相对于矢状面，49%向内倾斜，48%垂直倾斜，只有3%向外倾斜。观察到与年龄相关的退行性变化有统计学意义的增加。通过对肩峰的目视检查确定，50岁以下患者的标本中有7%出现肩峰前骨刺形成，而50岁以上患者的标本中有30%出现（p < 0.05）。肩峰前骨刺形成是一个与年龄相关的过程。通过出口位X线片评估的肩峰形态状况与年龄无关，似乎是一种主要的解剖特征。肩峰形态状况的变化不是由与年龄相关的变化和骨刺形成引起的，因此除了与年龄相关的过程外，还独立地导致撞击症。
