Morisawa Y
Department of Orthopaedic Surgery, Kochi Medical School, Kohasu, Okoh-cho, Nankoku, Kochi 783, Japan.
J Orthop Sci. 1998;3(2):102-10. doi: 10.1007/s007760050029.
We performed gold chloride staining of coracoacromial ligaments removed at operation, observed the peripheral nerve endings in the ligament, and studied their distribution and changes with aging in order to clarify the proprioception of the shoulder joint. The coracoacromial ligament was found to contain four types of typical nerve endings: Pacinian corpuscles, Ruffini receptors, Golgi tendon organ-like receptors, and free nerve endings. In addition, non-typical Pacinian corpuscles and Ruffini receptors with non-typical morphology were present. There were also unclassifiable nerve endings with a morphology which did not fit any of the above categories. These typical, non-typical, and unclassifiable nerve endings were all widely distributed on the surface of the subacromial side at the insertion into the acromion and around the coracoid process in the ligament. Free nerve endings were found sporadically on the surface of the subacromial bursal side in the ligament. The resected coracoacromial ligaments (23 specimens) were divided into two groups based on the disorder that required surgery: a fracture group without subacromial impingement (5 specimens) and a group with subacromial impingement (18 specimens). Age-related changes in the number of nerve endings were compared in each group. The total number of nerve endings decreased with age in both groups. The number of Pacinian corpuscles, Ruffini receptors, Golgi tendon organ-like receptors, and free nerve endings of typical morphology tended to decrease with age. The data from the fracture and subacromial impingement groups were not analyzed statistically because of the difference in the number of specimens in each group. However, the total number of nerve endings was lower in the subacromial impingement group than in the fracture group at all ages. The typical nerve endings of the coracoacromial ligament in both groups tended to decrease in the elderly, suggesting that the proprioception of the shoulder joint may become impaired with aging.
我们对手术切除的喙肩韧带进行了氯化金染色，观察韧带中的周围神经末梢，并研究其分布及随年龄的变化，以阐明肩关节的本体感觉。结果发现喙肩韧带包含四种典型的神经末梢：帕西尼小体、鲁菲尼小体、高尔基腱器官样受体和游离神经末梢。此外，还存在形态不典型的帕西尼小体和鲁菲尼小体。也有形态不符合上述任何一类的无法分类的神经末梢。这些典型、非典型和无法分类的神经末梢均广泛分布于韧带在肩峰附着处的肩峰下侧表面以及喙突周围。在韧带肩峰下滑囊侧表面偶尔可见游离神经末梢。根据手术所需处理的病症，将切除的喙肩韧带（23个标本）分为两组：无肩峰下撞击的骨折组（5个标本）和有肩峰下撞击的组（18个标本）。比较了每组中神经末梢数量的年龄相关变化。两组中神经末梢的总数均随年龄减少。典型形态的帕西尼小体、鲁菲尼小体、高尔基腱器官样受体和游离神经末梢的数量倾向于随年龄减少。由于每组标本数量不同，未对骨折组和肩峰下撞击组的数据进行统计学分析。然而，在所有年龄段，肩峰下撞击组的神经末梢总数均低于骨折组。两组中喙肩韧带的典型神经末梢在老年人中均有减少的趋势，提示肩关节的本体感觉可能会随着年龄增长而受损。
