基于肩关节正位片对退行性肩袖撕裂患者肩胛骨位置的研究

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摘要目的基于肩关节正位DR片，研究退行性肩袖撕裂患者静息位时肩胛骨位置的改变。方法选取2019年1月至2022年2月期间在山东第一医科大学第二附属医院关节外科就诊的79例退行性肩袖撕裂患者作为试验组，男32例，女47例；平均年龄为(58.37±9.09)岁。招募符合条件的健康志愿者80例作为对照组，男39例，女41例；平均年龄(56.21±9.91)岁。所有研究对象均进行了肩关节DR片的拍摄，并对其肩胛骨位置的相关指标［即肩胛骨内缘与脊柱中线的成角(θ角)、肩胛盂最大前后径与上下径的比值(CD/EF)、喙突类型、肩胛骨的内外侧移动距离(OA)、上下移动距离(OB)］进行测量与观察。结果 (1)试验组的θ角、CD/EF值分别为(10.58±3.88)°、(0.51±0.12)，与对照组的(8.77±3.53)°、(0.47±0.09)相比，差异具有统计学意义(P＜0.05)。(2)喙突类型分布：试验组Ⅰ型38例(48.1%)，Ⅱ型28例(35.4%)，Ⅲ型13例(16.5%)；对照组Ⅰ型16例(20.0%)，Ⅱ型47例(58.8%)，Ⅲ型17例(21.3%)。两组研究对象喙突类型分布不同，其中Ⅰ型和Ⅱ型分布差异具有统计学意义(P＜0.05)。(3)试验组的OA值、OB值为(64.00±11.27)mm、(59.09±11.95)mm与对照组(62.73±11.36)mm、(59.63±13.76)mm近似，差异无统计学意义(P＞0.05)。结论与对照组相比，试验组在3种旋转运动中存在肩胛骨位置的改变，且肩胛骨位置改变表现为上旋增加、内旋增加，肩胛骨处于前倾位置；在2种平移运动(即上下移动和内外侧移动)中，试验组与对照组差异无统计学意义。

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	谢露
	张延明
	罗丁元
	王玮宁
	王安然

关键词 ：肩袖撕裂, 肩胛骨位置, 肩胛骨动力障碍

Abstract：Objective To study the changes of scapular position in patients with degenerative rotator cuff tear in resting position based on the anteroposterior X-ray of shoulder joint.Methods 79 patients with degenerative rotator cuff tear treated in the Department of Joint Surgery of The Second Affiliated Hospital of Shandong First Medical University from January 2019 to February 2022 were selected as the experimental group.32 males and 47 females were included.The average age was (58.37±9.09)years.80 eligible healthy volunteers were recruited as the control group，including 39 males and 41 females.The average age was (56.21±9.91) years.All subjects were photographed with DR of shoulder joint，and the relevant indexes of scapular position ［i.e the angle between the inner edge of scapula and the midline of spine (θ angle).The ratio of the maximum anterior-posterior diameter to the upper-lower diameter of the glenoid(CD/EF)，the type of coracoid process，medial and lateral movement distance(OA) and up-down movement distance(OB) of scapula］ were measured and observed.Results (1) In the experimental group，the θ angle and CD/EF were (10.58±3.88)° and (0.51±0.12)，which were statistically significant difference compared with (8.77±3.53)° and (0.47±0.09) in the control group (P＜0.05).(2) According to coracoid process types，in the experimental group，there were 38 cases of typeⅠ(48.1%)，28 cases of typeⅡ(35.4%) and 13 cases of type Ⅲ (16.5%).In the control group，there were 16 cases (20.0%) of typeⅠ，47 cases (58.8%) of typeⅡand 17 cases (21.3%) of type Ⅲ.The distribution of coracoid process types in the two groups was different，and the distribution difference of typeⅠand typeⅡwas statistically significant (P＜0.05).(3) The OA and OB values of the experimental group were (64.00±11.27)mm and (59.09±11.95)mm，which were similar to those of control group (62.73±11.36)mm and (59.63±13.76)mm.There was no significant difference (P＞0.05).Conclusion Compared with the control group，there were changes in the position of the scapula in the degenerative rotator cuff tear group during the three kinds of rotational movements，and the changes in the position of the scapula show the increase of upward rotation and internal rotation，and the scapula is in the anterior tilt position.There is no significant difference between the experimental group and the control group in the two translational movements (upward and downward movement and internal and external movement).

Key words： rotator cuff tear scapular position scapular dyskinesia

通讯作者: 张延明

作者简介: 谢露(1995－ )，女，研究生在读，山东第一医科大学运动医学与康复学院，1245474165@qq.com

引用本文:

谢露，张延明，罗丁元，王玮宁，王安然. 基于肩关节正位片对退行性肩袖撕裂患者肩胛骨位置的研究[J]. 实用骨科杂志, 2022, 28(7): 584-589.
Xie Lu，Zhang Yanming，Luo Dingyuan，Wang Weining，Wang Anran. Study on the Position of Scapula in Patients with Degenerative Rotator Cuff Tear Based on Anteroposterior Radiographs of the Shoulder. sygkzz, 2022, 28(7): 584-589.

链接本文:

http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2022/V28/I7/584

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