肩胛盂扭转角与肩关节前下不稳的相关性研究

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1、肩胛盂扭转角与肩关节前下不稳的相关性研究金涛1，唐康来2　（1第三军医大学西南医院骨科，重庆400038）摘　要：目的探讨肩胛盂扭转角与肩关节前下不稳之间的关系。方法用16排螺旋CT对比扫描24例单侧肩关节前下不稳患者的双侧肩关节。通过三维CT多平面重组、容积重建等技术获取肩胛盂重建平面，于肩胛盂上结节和盂下结节连线的4等分垂直横截面上分别测量患侧和健侧肩胛盂扭转角，并进行统计学分析。结果24例肩关节前下不稳组的患侧盂扭转角自上而下分别为：-15.24+10.18°，-8.22+8.47°，-2.88+4.56°，-2.49+6.43°，而健侧盂扭转角自上而下分别为：-15.

2、07+12.11°，-10.63+7.25°，-6.04+3.61°，-5.26+3.02°。第1、2、3平面双侧扭转角无统计学差异，而第4平面双侧扭转角统计学有显著性差异(P﹤0.05)，患侧比健侧要大。结论肩胛盂扭转角可能与肩关节前下不稳直接相关，是肩关节前下不稳的原因之一。肩胛盂扭转角的测量对肩关节稳定性的评估、手术方式的选择及手术预后具有重要的参考价值。关键词：肩关节；不稳；肩胛盂扭转角TheRelationshipbetweenAnteroinferiorGlenohumeralInstabilityandGlenoidVersionJINTao,TangKang-

3、lai(DepartmentofOrthopaedics,SouthwestHospital,ThirdMilitaryMedicalUniversity,Chongqing400038,P.R.ChinaCorrespondingauthor:TangKang-lai,Email:tangkanglai@hotmail.com)Abstract:ObjectiveToassesstherelationshipbetweenanteroinferiorglenohumeralinstabilityandglenoidversion.MethodsBothshouldersin

4、24patientswithanteroinferiorglenohumeralinstabilityonlyintheironesidewerescannedwith16-slicesspiralCTscanner(MSCT).TheglenoidwasreconstructedbytheVolumeRenderingtechniqueandMultiplanarReformationin4slicesonaxialplanefromglenoidtoptoitsbottom.Thescapularglenoidversionanglesweremeasuredin4lev

5、elsofbothsidesin24patientsandcomparedbetweenbothsidesbystatistics　analysis.ResultsFromthetoptothebottom,thescapularglenoidversionanglesinthesidewithanteroinferiorglenohumeralinstabilitywererespectively-15.24+10.18°,-8.22+8.47°,-2.88+4.56°,-2.49+6.43°.Theanglesintheothersiderespectively:-15.

6、07+12.11°,-10.63+7.25°,-6.04+3.61°,-5.26+3.02°.Therewasobviousdifferenceatthe4thplanebetweenthenormalandtheinstabilitysides(P﹤0.05),noobviousdifferenceatthe1st,2nd,3rdplane.ConclusionTheglenoidversionanglemaybedirectrelatedwiththeanteroinferiorglenohumeralinstabilityThemessurementofglenoidv

7、ersionanglewouldbehelpfultostabilityevaluation,surgerychoiceandexpectation.Keywords:Glenohummeraljoint;Instability;Scapularglenoidversionangle4肩关节前下不稳是肩关节不稳最为常见的类型，受多因素影响。目前，国内外的研究主要集中在软组织的平衡上，特别是盂唇－韧带复合体损伤修复对盂肱关节前下不稳的诊断与治疗具有重要的指导意义，例如：Bankart损伤、SLAP损伤的关