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目的:探讨上肢过顶运动中发生继发性喙突下撞击症的机制和特点,为临床诊疗提供依据。方法:16具成人尸体32例肩关节标本上,在肩胛下肌离断前后,观察上肢过顶运动中肩袖间隙与喙突之间的动态关系;自制生物力学测定仪检测肩外展90°位外旋活动度的变化;以压敏片检测肩外展90°位最大程度外旋时肩袖间隙与喙突间接触面积和压力的改变。结果:(1)肩外展位外旋时,肱骨头有向前方移位的趋势,肩胛下肌离断后肱骨头前移更加明显;(2)肩外展90°位的最大外旋活动度,在肩胛下肌离断后明显增大;(3)肩外展90°位最大程度外旋时肩袖间隙与喙突接触面积和压力,在肩胛下肌离断后明显增大。结论:(1)肩胛下肌损伤后导致肩关节前方不稳定,肩外展外旋时肱骨头前移;(2)肩胛下肌损伤可能导致肩外展外旋时肱骨头与喙突的继发性撞击。
Objective: To investigate the mechanism and characteristics of secondary beak bursitis in the process of upper extremity movement, and to provide the basis for clinical diagnosis and treatment. Methods: The dynamic relationship between the rotator cuff space and the coracoid process was observed before and after the subscapularis muscle was dissected in 32 adult shoulder specimens. The spontaneous biomechanical measurement The changes of the contact area and pressure between the rotator cuff space and the coracoid process were detected by the pressure-sensitive strips when the maximum degree of external rotation of the 90 ° shoulder was detected. Results: (1) When the shoulder was abducted, the humeral head had the tendency to shift forward and the humeral head was more obvious after the break of the subscapularis muscle. (2) The maximal degree of external rotation of the shoulder was 90 °, In the subscapularis muscle increased significantly after the break; (3) the maximum degree of external rotation of the shoulder abduction 90 ° rotator cuff clearance and coracoid contact area and pressure in the subscapularis muscle increased significantly after the break. Conclusions: (1) Scapularis muscle injury leads to instability in the anterior shoulder joint and humeral head anterior shift when external shoulder abduction is performed; (2) Scapular lower extremity injury may lead to humeral head and coracoid process Strike.