肱骨头缺损程度与肩关节稳定性影响的研究

李文翠, 彭亮权, 陆 伟, 王大平, 欧阳侃, 朱伟民, 柳海峰, 冯文??

中国临床解剖学杂志 ›› 2011, Vol. 29 ›› Issue (6) : 651-652.

中国临床解剖学杂志 ›› 2011, Vol. 29 ›› Issue (6) : 651-652.
应用解剖

肱骨头缺损程度与肩关节稳定性影响的研究

  • 李文翠, 彭亮权, 陆 伟, 王大平, 欧阳侃, 朱伟民, 柳海峰, 冯文哲
作者信息 +

The relationship between humeral head defect and glenohumeral stability

  • LI Wen-cui, PENG Liang-quan, LU Wei, WANG Da-ping, OUYANG Kan, ZHU Wei-men, LIU Hai-feng, FENG Wen-zhe
Author information +
文章历史 +

摘要

目的 探讨肱骨头缺损对肩关节稳定性影响的程度。  方法 8例16侧肩关节的肱骨头后方缺损程度分别设成全部肱骨头的1/8、2/8、3/8、4/8,各4侧标本。检测指标分别为45°和90°外展、40°内旋、中立位、40°外旋等5个指标。检测个缺损的肱骨头由小到大各个角度的外展、内外旋同时作用的结果。肱骨头在各个合力作用下缓慢向前外侧推动,直到脱位。记录肱骨头所移动的距离(distance of  dislocation,DD),并作为基本分析数据。  结果    外展角度比较,DD无显著性差异。但外旋40°与中立为和40°内旋比较,有显著性差异。在3/8缺损组,外旋40°外展90°时,DD明显减小。4/8组,外展90°与中立位时,DD均明显减小。而内旋40°者,各组DD未见明显减小。  结论    肱骨头缺损3/8时,当肩关节外展外旋时,肩关节稳定性下降;而当肱骨头缺损4/8时,肩关节中立位和外旋位均会发生关节不稳。

Abstract

Objective To explore anatomic relationship between the degree of humeral head defect and glenohumeral stability. Methods 12 cadaveric shoulder specimens were applied in this study. The defect scopes of humeral head were prepared as 1/8, 2/8, 3/8, and 4/8. Testing positions included 45° and 90° of abduction, 40° of internal rotation, neutral position, and 40° of external rotation. The humeral head was translated anteroinferiorly to the horizontal glenoid axis until its dislocation. The distance of dislocation (DD) was defined as humeral head translation. Results At the abduction position, there was no difference of the DD for different defects. However, external rotation of 40° significantly reduced the DD compared to that of neutral and 40° internal rotation. The defect of 3/8 and 4/8 significantly decreased the DD compared to that of intact ones. Post hoc analysis determined significant difference for the rotational positions. Decreased distance to dislocation occurred at 2/8 defect group at 40° external rotation with 90° of abduction. For the 4/8 defect at 90°abduction, the DD decreased compared to that of neutral and 40°external rotation; At the position of 45° abduction and 40° external rotation, the DD significantly decreased. At the 40° internal rotation, no significant difference appeared among different defect groups. Conclusions Glenohumeral stability decreases at the 3/8 defect and at external rotation and abduction, however, at the 4/8 defect and at neutral and external rotation, the stability further decreases.

关键词

  / 肩关节 / 稳定性 / 肱骨头 / 缺损

Key words

Shoulder / Stability / Humeral head / Defect

引用本文

导出引用
李文翠, 彭亮权, 陆 伟, 王大平, 欧阳侃, 朱伟民, 柳海峰, 冯文??. 肱骨头缺损程度与肩关节稳定性影响的研究[J]. 中国临床解剖学杂志. 2011, 29(6): 651-652
LI Wen-Cui, BANG Liang-Quan, LIU  Wei, WANG Da-Beng, OU Yang-Kan, SHU Wei-Min, LIU Hai-Feng, FENG Wen-Zhe-. The relationship between humeral head defect and glenohumeral stability[J]. Chinese Journal of Clinical Anatomy. 2011, 29(6): 651-652
中图分类号: R322   

参考文献


[1] Edwards TB, Boulahia A, Walch G. Radiographic analysis of bone defects in chronic anterior shoulder instability
[J].Arthroscopy,2003, 19(7):732-739.

[2] Calandra JJ, Baker CL, Uribe J. The incidence of Hill-Sachs lesions in initial anterior shoulder dislocations
[J]. Arthroscopy, 1989, 5(4):254-257.

[3] Hill HA, Sachs MD. The grooved defect of the humeral head
[J]. Radiology,1940,35:690-700.

[4]  Itoi E, Lee SB, Berglund LJ, et al. The effect of a glenoid defect on anteroinferior stability of the shoulder after B ankart repair: a cadaveric study
[J]. J Bone Joint Surg Am, 2000, 82(1):35-46.

[5]  Sekiya JK, Wickwire AC, Stehle JH, et al. Hill-Sachs defects and repair using osteoarticular allograft transplantation: biomechanicalanalysis using a joint compression model
[J].Am J Sports Med, 2009, 37(12):2459-2466.

[6]  Burkhart SS, Danaceau SM. Articular arc length mismatch as a causeof failed Bankart repair
[J]. Arthroscopy, 2000, 16(7):740-744.

[7]  Burkhart SS, De Beer JF. Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: significance  of the inverted-pear glenoid and the humeral engaging Hill- Sachs lesion
[J].Arthroscopy, 2000, 16(7):677-694.

[8] Miniaci A, Gish M. Management of anterior glenohumeral instability associated with large Hill-Sachs defects
[J]. Tech Shoulder Elbow Surg, 2004,5(3):170-175.

基金

深圳市科技计划立项资助项目(200902046)


Accesses

Citation

Detail

段落导航
相关文章

/