肩关节运动时肌肉力臂改变的实验研究  

The Experiental Study of the Muscles' Moment Arms Changes during the Movement of the Glenohumeral Joint

作　　者：朱鸣镝[1] 汤锦波[1] 凌树才[2] 曹毅[1] 王友华[1] 

机构地区：[1]南通大学附属医院手外科研究中心骨科手外科,江苏南通226001 [2]浙江大学医学院解剖教研室,浙江杭州310005

出　　处：《中国临床医学》2007年第2期221-225,共5页Chinese Journal of Clinical Medicine

基　　金：国家教育部骨干教师基金(2000-65);江苏省青蓝工程基金;江苏省医学重点学科基金(2001-34)

摘　　要：目的:通过分析肩关节运动时各种肌肉的运动力臂大小及其变化,以揭示该类肌肉对肩关节不同方向运动的影响。方法:选用10侧尸体肩关节标本,分别测量三角肌的三个部分、肩袖诸肌在肩外展、前屈、后伸、内旋及外旋过程中的肌腱位移,并根据位移和关节运动角度计算力臂值。结果:在上臂外展过程中,外展0°～30°时,冈上肌力臂变化最大;外展30°～120°时,力臂变化最大的为中部三角肌。在臂后伸或前屈过程中,力臂变化最大的分别为后部三角肌或前部三角肌。在臂内旋时,肩胛下肌的力臂值最大,而臂外旋时冈下肌／小圆肌的力臂值最大。结论:在上臂外展的起始阶段冈上肌腱功效较大,其次为中部三角肌;前部三角肌和中部三角肌分别在臂的前屈和后伸过程中有较大功效;在臂内外旋过程中,肩胛下肌和冈下肌／小圆肌功效较大。Objective：This study was undertaken to determine the efficiency of the shoulder muscles during the movement of the glenohumeral joint at different directions based on measurements of the moment arms of these muscles. Methods： The study was performed on 10 cadaveric shoulder specimens. The excursions of muscles （including the three portions of the deltoid, the rotator cuff muscles） were made during the humerus abduction, extension, flexion, internal or external rotation. Then the moment arms were calculated. Results：The moment arm of supraspinatus was the largest when the humerus abducted from 0% to 30% But when the humerus abducted from 30% to 120% , the middle deltoid muscle had the largest moment arm. The moment arm of the posterior deltoid was the largest during the humerus extension, and it was the anterior deltoid during flexion. The infraspinatus/teres minor had the largest moment arms in external rotation, and the subscapularis had the largest moment arm in internal rotation. Conclusion;Based on the findings, the supraspinatus is very effective at the initial parts of the abduction of the arm and then the middle deltoid. The posterior or anterior deltoid is the most powerful muscle during extension or flexion, respectively. The infraspinatus/teres minor is potentially the most powerful external rotator, and subscapularis is the most effective internal rotator.

关 键 词：肩关节 三角肌 肩袖肌 力臂 生物力学 

分 类 号：R337[医药卫生—人体生理学]