Romeo A A, Loutzenheiser T, Rhee Y G, Sidles J A, Harryman D T, Matsen F A
Rush-Presbyterian-St. Luke's Medical Center, Department of Orthopaedic Surgery, Chicago, IL 60612, USA.
Clin Orthop Relat Res. 1998 May(350):120-7.
Motion between the humerus and scapula commonly is described as glenohumeral motion. However, humeroscapular motion occurs at two distinct sites. In addition to the motion at the diarthrodial glenohumeral joint, movement occurs between the proximal humerus and related structures and the surrounding sleeve of structures, including the acromion, deltoid, coracoid, coracoacromial ligament, and the muscles attached to the coracoid. This site of nonarticular shoulder motion is defined as the humeroscapular motion interface. Nonarticular humeroscapular motion can be documented and measured using standard magnetic resonance imaging techniques. The maximum average interfacial motion using axial images was 29.1 mm, which occurred at the level of the maximum diameter of the humeral head. Interfacial motion varied depending on the site measured. If pathologic conditions such as adhesions secondary to trauma or surgery interfere with or obliterate this space at sites of significant sliding motion, overall shoulder motion will be limited. Successful treatment of shoulder stiffness related to humeroscapular restraints is likely to require restoration of the normal sliding motion at the humeroscapular motion interface, in addition to resolving restraints affecting the glenohumeral joint motion.
肱骨和肩胛骨之间的运动通常被描述为盂肱关节运动。然而，肱肩胛运动发生在两个不同的部位。除了在滑膜盂肱关节处的运动外，肱骨近端与相关结构以及周围结构袖套（包括肩峰、三角肌、喙突、喙肩韧带以及附着于喙突的肌肉）之间也会发生运动。这个非关节性肩部运动的部位被定义为肱肩胛运动界面。非关节性肱肩胛运动可以使用标准磁共振成像技术进行记录和测量。使用轴向图像测得的最大平均界面运动为29.1毫米，发生在肱骨头最大直径水平处。界面运动因测量部位而异。如果诸如创伤或手术继发的粘连等病理状况在显著滑动运动部位干扰或消除了这个间隙，那么整体肩部运动将会受限。除了解决影响盂肱关节运动的限制因素外，成功治疗与肱肩胛限制相关的肩部僵硬可能需要恢复肱肩胛运动界面的正常滑动运动。
