Sakurai G, Ozaki J, Tomita Y, Kondo T, Tamai S
Department of Orthopaedic Surgery, Nara Medical University, Kashihara City, Japan.
J Shoulder Elbow Surg. 1998 Sep-Oct;7(5):510-5. doi: 10.1016/s1058-2746(98)90204-x.
This study was undertaken to evaluate incomplete tears of the subscapularis tendon that occur in conjunction with small or medium-sized tears of the supraspinatus tendon. Fifty-two shoulders were examined in 26 embalmed cadavers. The average age at the time of death was 76.3 years. Rotator cuff tears were observed in 32 (61.5%) shoulders. Six (11.5%) shoulders had massive rotator cuff tears and were excluded from the study, leaving 46 shoulders for study. Twenty shoulders had a tear of the supraspinatus tendon, and 17 had a tear of the subscapularis tendon. All tears of the subscapularis tendon were articular-side incomplete tears. On histologic examination most pathologic changes of the subscapularis tendon were observed on the articular side of the upper portion. Lesions of the long head of the biceps brachii were identified in 14 (30.4%) shoulders. A statistically significant correlation was found between tears of the subscapularis tendon and the presence of lesions of the long head of the biceps brachii (P=.0014). In addition, the results of preoperative magnetic resonance imaging of 15 patients (average age, 62.9 years) with a surgically confirmed diagnosis of incomplete tears of the subscapularis tendon in conjunction with tears of the supraspinatus tendon were also evaluated. Incomplete tears of the subscapularis tendon could be identified on magnetic resonance imaging as an area of high signal intensity on axial T2-weighted images in all 15 shoulders studied.
本研究旨在评估与冈上肌腱中小型撕裂同时出现的肩胛下肌腱不完全撕裂。对26具防腐尸体的52个肩部进行了检查。死亡时的平均年龄为76.3岁。在32个（61.5%）肩部观察到肩袖撕裂。6个（11.5%）肩部有巨大肩袖撕裂，被排除在研究之外，剩下46个肩部用于研究。20个肩部有冈上肌腱撕裂，17个肩部有肩胛下肌腱撕裂。所有肩胛下肌腱撕裂均为关节侧不完全撕裂。组织学检查发现，肩胛下肌腱的大多数病理变化出现在上部的关节侧。在14个（30.4%）肩部发现肱二头肌长头病变。肩胛下肌腱撕裂与肱二头肌长头病变的存在之间存在统计学上的显著相关性（P = 0.0014）。此外，还评估了15例（平均年龄62.9岁）经手术确诊为肩胛下肌腱不完全撕裂合并冈上肌腱撕裂患者的术前磁共振成像结果。在所有15个研究的肩部中，肩胛下肌腱不完全撕裂在磁共振成像上可表现为轴向T2加权图像上的高信号强度区域。
