肩关节疼痛弧的研究  

Painful arc syndrome of the shoulder

作　　者：禹铭杨[1] 朱东[1] 黄旭[1] 谷贵山 

机构地区：[1]吉林大学白求恩第一医院关节外科,长春130021

出　　处：《中国骨与关节杂志》2012年第3期280-283,共4页Chinese Journal of Bone and Joint

摘　　要：各国学者对于肩关节疾病诊断方法的探索从未停止，随着对肩关节软组织结构和运动的不断深入研究，渐渐明确了肩关节疾病的损伤机制。此类疾病的发生与肩峰的形态变异以及长时期的肩袖组织的慢性磨损密切相关。与肱盂关节的特殊运动方式有关的肩关节疼痛弧综合征（Shoulder Painful Arc Syndrome）是指：肩关节在人体肩胛骨平面上做外展动作时，正常者无疼痛。Painful arc syndrome of the shoulder refers that a painful arc occurs between 60° and 120° when the patient actively abducts the shoulder, and while outside this range the pain will disappear. When the patient moves from a position on the upper arm down along the same route, the pain will appear again between 120° and 60°. But during passive abduction, the pain is relieved significantly. This track is called ＂subacromial painful arc＂. Chronic repetitive microtrauma occurred to the rotator cuff as the greater tuberosity of the humerus moves under the coracoacromial arch when the shoulder is elevated, which is the basic pathophysiological mechanism responsible for the painful arc syndrome of the shoulder. There are many causes for rotator cuff tears, one of which is the morphological variation of the acromion. The acromial morphology is born, so those factors which are likely to damage the tissues are named as ＂the congenital and osteal etiological factors＂ of rotator cuff tears. It means that, if the acromial morphology of the patient is just like that, it can be considered that he or she has those factors by nature. The factors will erode the rotator cuff continuously and the patient will have the disease under external incentive condition. Neer supported that in the central part of the supraspinatus tendon, there is the critical area for degenerative tendonitis and tendon rupture, at times extending to the anterior part of the infraspinatus tendon and the long head of the biceps. The most common cause for the pain is tears appearing in this part. With internal rotation of the shoulder, the functional position in which human upper limbs are often used will be achieved, and then the tissues will be brought more closely to the anterior part of the acromion. Elevation of the arm in both internal rotation and external rotation causes the critical area to pass under the coracoacromial ligament or the 1/3 anterior process of the acromion. However, the existence of so many symptoms at the same time makes the

关 键 词：肩关节疼痛 肩关节疾病 软组织结构 运动方式 诊断方法 损伤机制 形态变异 综合征 

分 类 号：R684[医药卫生—骨科学]