肩峰肱骨头相对位置与肩峰下撞击综合征关系的研究  

Research on the correlation between subacromial impingement syndrome and the relative position of acromion and humeral head

作　　者：瞿玉兴[1] 郑冲[1] 范文潮[1] 高益[1] 

机构地区：[1]南京中医药大学附属常州中医院骨科,江苏常州213003

出　　处：《中国矫形外科杂志》2008年第5期362-364,共3页Orthopedic Journal of China

摘　　要：[目的]探讨肩峰肱骨头相对位置对肩峰下间隙的影响，为肩峰下撞击综合征的诊断、预防和治疗提供理论依据。[方法]对本科2006年10月-2007年3月就诊的肩峰下撞击综合征患者31肩（平均年龄54．3岁，男13肩，女18肩）的Grashey位片，计算肩峰指数即肩峰最外侧缘至肩关节盂平面的距离与肱骨近端最外侧缘至肩关节盂平面的距离的比值，通过肩峰指数对肩峰肱骨头相对位置进行定量评估，与正常人群40肩（平均年龄52．8岁；男18肩，女22肩）进行比较、分析。[结果]病例组平均肩峰指数及标准差为（0．72±0．05），正常组平均肩峰指数及标准差为（0．61±0．04），2组之间有明显差异（P〈0．0001）。[结论]肩峰指数可准确的反映肩峰与肱骨头在冠状位上的位置关系，肩峰下撞击综合征与较大的肩峰指数有关。在较大的肩峰指数所反映的肩峰肱骨头位置关系中，外展时三角肌对肱骨头向上的分力大，肩峰下间隙内压力高，易引发肩峰下撞击综合征。[ Objective] To evluate the influence of subacromial space caused by the relative position of acromion and humeral head, and to provide theoretical guidance for diagnosis, prevention and treatment of subacromial impingement syndrome. [ Method] From October 2006 to March 2007, 31 shoulders （13 men and 18 women with average age of 54.3） with subacromial impingement syndrome, from our department, were selected to form the patient group, An age and gender-matched of 40 asymptomatic shoulders （ 18 men and 22 women with average age of 52. 8 ） formed the control group. The acromion index was measured on the Grashey view. The distance from the glenoid plane to the lateral border of the acromion was divided by the distance from the glenoid plane to the lateral aspect of the humeral head to calculate the acromion index. [Result] The average acromion index （and standard deviation） was （0. 72±0. 05）, in patient group, （0. 61±0. 04） in the asymptomatic, normal shoulders. The difference between the index in the shoulders with subacromial impingement syndrome and the index in normal shoulder was highly significantly （P 〈 0. 0001 ）. [ Conclusion] Acormion index can be accurately reflected the acromion and the humeral head in the coronal position. The larger the acromion index, the higher the ascending force component during active abduction and the higher of the pressure in the subacromial space. The situation may cause the subacromial impingement syndrome.

关 键 词：肩峰下撞击综合征 肩峰 肩峰指数 

分 类 号：R684[医药卫生—骨科学]