肩盂骨性缺损致肩关节前方不稳定的生物力学研究  

BIOMECHANICAL EVALUATION OF ANTERIOR INSTABILITY OF SHOULDER JOINT AFTER GLENOID OSSEOUS DEFECT

作　　者：檀臻炜[1,2] 黄富国[1] 

机构地区：[1]四川大学华西医院骨科,成都610041 [2]解放军第452医院骨科

出　　处：《中国修复重建外科杂志》2011年第3期296-298,共3页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的评价肩盂前下方骨性结构在肩关节前方稳定性中的生物力学特性和作用,为临床治疗肩盂骨性缺损提供理论依据。方法于自愿捐献的成年男性新鲜尸体取带肩胛骨的肩关节-肱骨标本10具,制备为"骨-韧带"标本;左侧4具,右侧6具。分别于肩关节外展0、90°位时,采用Instron 8874液压伺服生物力学测试系统给予肱骨头50 N的单轴压缩,每个标本按照完整肩关节、盂唇缺损、骨性缺损10%、骨性缺损20%、骨性缺损修复顺序,测量标本位移值。结果肩关节外展0°位时,完整组、盂唇缺损组、骨性缺损10%组、骨性缺损20%组、骨性缺损修复组位移分别为(10.73±2.93)、(11.43±3.98)、(13.58±4.86)、(18.53±3.07)、(12.77±3.13)mm;90°位时,分别为(8.41±2.10)、(8.55±2.28)、(9.06±2.67)、(12.49±2.32)、(8.55±2.15)mm。除骨性缺损20%组与完整组比较差异有统计学意义(P<0.05)外,其余各组与完整组比较差异均无统计学意义(P>0.05)。结论肩盂前下盂唇缺损或骨性缺损<20%时,如关节囊韧带复合体未损伤或已修复,肩关节前方稳定性无明显下降;肩盂骨性缺损≥20%时,即使修复关节囊韧带复合体,肩关节前方稳定性仍明显下降;而同时修复骨性缺损和关节囊韧带复合体可恢复肩关节前方稳定性。Objective To evaluate the role of glenoid osseous structure on anterior stabil ity of shoulder so as to provide the biomechanical basis for cl inical treatment. Methods Ten fresh shoulder joint-bone specimens were collected from 10 adult males cadavers donated voluntarily, including 4 left sides and 6 right sides. The displacements of the specimens were measured at 0° and 90° abduction of shoulder joint by giving 50 N posterior-anterior load under the conditions as follows： intact shoulder joint, glenoid l ip defect, 10% of osseous defect, 20% of osseous defect, and repairing osseous defect. Results For intact shoulder joint, glenoid l i p defect, 10% of osseous defect, 20% of osseous defect, and repairing osseous defect, the displacements were （10.73 ± 2.93）, （11.43 ± 3.98）, （13.58 ± 4.86）, （18.53 ± 3.07）, and （12.77 ± 3.13） mm, respectively at 0° abduction of shoulder joint; the displacements were （8.41 ± 2.10）, （8.55 ± 2.28）, （9.06 ± 2.67）, （12.49 ± 2.32）, and （8.55 ± 2.15） mm, respectively at 90° abduction of shoulder joint. There was no significant difference between intact shoulder joint and others （P 〉 0.05） except between intact shoulder joint and 20% of osseous defect （P 〈 0.05）. Conclusion When shoulder glenoid l ip defects or the glenoid osseous defect is less than 20%, the shoulder stabil ity does not decrease obviously, indicating articular l igament complex is not damaged or is repaired. When glenoid osseous defect is more than 20% , the shoulder stabil ity decreases obviously even if articular l igament complex is not damaged or is repaired. Simultaneous repair of glenoid osseous defect and articular l igament complex can recover the anterior stabil ity of the shoulder.

关 键 词：肩盂 骨性缺损 肩关节前方稳定性 生物力学 

分 类 号：R684[医药卫生—骨科学]