在上层囊重建后,哪个肌肉是外部旋转补偿器?
Nattakorn Mahasupachai1,2, Nobuyuki Yamamoto1, Atsushi Arino1
1Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan.
JSES international
|February 3, 2025
概括
上层囊重建 (SCR) 可能在巨大的旋转撕裂后恢复外部旋转 (ER). 第三小肌肉体积在手术后增加,这表明它补偿了失去的ER功能.
科学领域:
- 整形外科手术 整形外科手术
- 肌肉骨研究 研究
- 生物医学工程 生物医学工程
背景情况:
- 上层囊重建 (SCR) 是对巨大的不可修复的旋转部撕裂的手术选择,特别是涉及上和下肌.
- 虽然SCR提高了外部旋转 (ER) 角度和强度,但ER恢复的机制仍然不清楚.
- 本研究研究了特定肌肉在SCR后恢复ER中的补偿作用.
研究的目的:
- 在上层囊重建 (SCR) 后,确定负责补偿外部旋转 (ER) 的肌肉.
- 为了评估SCR后后背骨和小骨肌肉体积的变化.
- 为了将肌肉体积变化与术后ER强度和运动范围相关联.
主要方法:
- 对28名因巨大的旋转手套撕裂而接受SCR患者的回顾性审查 (2016-2021年).
- 使用医疗图像处理软件,在手术前和手术后1年测量后部乳头肌肉和小肌肉体积.
- 对手术后ER强度不同水平的患者之间的肌肉体积变化进行比较 (MMT 5级与<5),并与ER强度和脂肪退化进行相关性分析.
主要成果:
- 在SCR后,小肌体体积显著增加 (24.6 ± 10.3厘米3对比20.9 ± 8.3厘米3),而后部角肌体积保持不变.
- 患有ER MMT 5级的患者表现出更大或较小的体积变化趋势 (22.3%与9.4%,P=0.074).
- 在微小的体积变化和ER强度之间存在微弱的正相关 (r=0.308,P=0.055);在ER强度和微小的脂肪变化之间存在显著的负相关.
结论:
- 三小肌肉在SCR后体积增加,这表明它在恢复外部旋转方面发挥了补偿作用.
- 在Teres Minor中减少脂肪退化与手术后更好的ER强度有关.
- 小Teres可能是ER缺陷的关键补偿器在接受SCR的大规模旋转手套撕裂的患者中.
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