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肌肉补偿策略,以保持在旋转手套撕裂:一个尸体的研究中,保持 Glenohumeral 联合稳定性

Kyosuke Hoshikawa^1,2, Manuela Dominguez¹, Rebekah L Lawrence³

¹Department of Biomedical Engineering and Chemical Engineering, University of Texas at San Antonio, San Antonio, Texas.

The Journal of bone and joint surgery. American volume

|October 29, 2024

概括

从剩余的旋转手套 (RC) 肌肉的补偿力可以减少在后面的RC撕裂中部上部头部翻译. 然而,对于涉及 subscapularis 的大规模撕裂,这种补偿是不够的.

科学领域:

整形外科手术整形外科手术
生物力学生物力学
肌肉骨研究研究

背景情况:

上部部头部翻译常见于大型和巨大的旋转手套 (RC) 撕裂.
剩余的RC肌肉在缓解这种转换方面的补偿能力尚未完全理解.

研究的目的:

为了研究剩余的RC肌肉对部头部翻译的补偿力的影响.
使用渐进式旋转手套撕裂模型来模拟不同的撕裂严重程度.

主要方法:

八个尸体肩部经过了定制系统的测试.
创建了三种渐进式RC撕裂模型:上脊椎 (第1次撕裂),上脊椎/内脊椎 (第二次撕裂) 和上脊椎/内脊椎/上下肩骨 (第三次撕裂).
在不同的骨髓负荷和绑架/旋转角度下,用模拟的补偿肌肉负荷来测量部头部翻译.

主要成果:

在 II 和 III 眼中,在绑架/旋转过程中,在高体负荷下,发生了显著的上部部头部转移.
在Tear II中,Teres minor和subscapularis的补偿负荷有效地减少了上部翻译,与完整状态相匹配.
在Tear III中,尽管有补偿性努力,但仍然存在显著的优质翻译.

结论:

剩余的RC肌肉,特别是小和 subscapularis,可以有效地减少后部RC撕裂的上部头部翻译.
当撕裂涉及 subscapularis 上部三分之一时,这种补偿机制是不够的.
保守地加强剩余的RC肌肉可能有利于 posterosuperior RC撕裂的患者;对于涉及这条肌的大规模撕裂,建议对 subscapularis进行手术修复.

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