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Shoulder subluxation in hemiplegia: a radiologic correlational study
R Prévost1, A B Arsenault, E Dutil
1Research Centre, Institut de réadaptation de Montréal, Québec, Canada.
Archives of Physical Medicine and Rehabilitation
|November 1, 1987
Summary
A novel 3-D X-ray method accurately quantifies shoulder subluxation in hemiplegic patients. This advanced technique validates traditional clinical and radiological evaluations for shoulder instability.
Area of Science:
- Orthopedics
- Radiology
- Biomedical Engineering
Background:
- Shoulder subluxation is a common complication in hemiplegic patients.
- Accurate evaluation of shoulder subluxation is crucial for effective treatment and management.
- Existing clinical and radiological methods for assessing shoulder subluxation have varying degrees of reliability.
Purpose of the Study:
- To introduce and validate a novel three-dimensional (3-D) X-ray method for evaluating shoulder subluxation.
- To compare the precision and reliability of the 3-D X-ray technique against six established clinical and radiological methods.
- To assess the utility of the 3-D X-ray method in a cohort of hemiplegic subjects.
Main Methods:
- A 3-D X-ray evaluation was developed using mathematical computation of two standard shoulder X-rays (0-degree anteroposterior and 45-degree oblique).
- The 3-D method generates a vector to quantify the separation between the humeral head apex and the glenoid fossa inferior border, using the Y-component for inferior displacement.
- Six other evaluation techniques were employed: palpation, anthropometry, templates, humeral head-glenoid fossa center relation, vertical center distance, and vertical apex-border distance.
Main Results:
- The 3-D X-ray technique demonstrated high correlation coefficients (ranging from .738 to .995) when compared with the six other measurement methods.
- The Y-component of the 3-D vector effectively represented the inferior displacement of the humeral head.
- The study found a high level of precision and reliability in the 3-D measurement method.
Conclusions:
- The developed 3-D X-ray method provides a precise and reliable means for evaluating shoulder subluxation.
- The high accuracy of the 3-D technique indirectly validates the reliability of the compared traditional clinical and radiological assessment methods.
- This 3-D approach offers a valuable tool for the assessment of shoulder instability, particularly in hemiplegic populations.