肩胛盂扭转角与退变性肩袖全层撕裂的关系:配对病例对照试验  

Relationship between glenoid version angle and degenerative rotator cuff full-thickness tear:matched case control trial

作　　者：武亚飞 朱梁 任秋健 李大恩 李大地 高绪仁 郭开今 Wu Yafei;Zhu Liang;Ren Qiujian;Li Daen;Li Dadi;Gao Xuren;Guo Kaijin(Department of Orthopedics,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,Jiangsu Province,China;Xuzhou Medical University,Xuzhou 221000,Jiangsu Province,China)

机构地区：[1]徐州医科大学附属医院骨科,江苏省徐州市221000 [2]徐州医科大学,江苏省徐州市221000

出　　处：《中国组织工程研究》2022年第3期435-439,共5页Chinese Journal of Tissue Engineering Research

基　　金：江苏省省级重点研发专项资金(BE2015627),项目负责人:郭开今。

摘　　要：背景:肩袖撕裂是引起肩关节疼痛和功能障碍的常见原因,肩胛盂的形态学一直是退变性肩袖撕裂的重要研究课题。目的:探究肩胛盂扭转角、肩胛盂前后径与退变性肩袖全层撕裂之间的关系。方法:应用配对病例对照研究,选取2020年2月至2021年2月徐州医科大学附属医院收治经MRI及肩关节镜检测确诊为全层肩袖撕裂的患者36例为试验组,以受试对象的年龄、性别、数量为配对条件,选取同期住院的非肩关节疾病的患者36例为对照组。两组患者都在入院时做了胸部CT,并由同一名骨科医师在胸部CT上测得肩胛盂扭转角以及肩胛盂前后径,对两组之间肩胛盂扭转角度的差异性进行统计学分析。结果与结论:(1)试验组肩胛盂扭转角为(-3.5±4.6)°,与对照组(-1.9±3.9)°相比,有着更加明显的后倾(P<0.05);(2)试验组肩胛盂前后径为(26.8±3.3)mm,对照组肩胛盂前后径为(27.2±3.6)mm,两组间差异无显著性意义(P>0.05);(3)将对照组肩关节进行左右分组,结果显示左侧肩胛盂扭转角为(-1.85±5.42)°,右侧肩胛盂扭转角为(-2.01±6.18)°,差异无显著性意义(P>0.05);(4)患者根据性别进行分组时,发现肩胛盂前后径在男性和女性之间差异有显著性意义(P<0.05);(5)提示肩胛盂大小(前后径)与肩袖的全层撕裂不存在显著相关性,但此次研究所发现的肩胛盂大小的特征性、左右肩的一致性以及男女性别之间的差异性,可以为国人肩关节假体的设计提供指导意见。肩胛盂扭转角与肩袖全层撕裂有显著相关性,肩胛盂过度后倾可能是退行性全层肩袖撕裂的危险因素,测定肩胛盂的扭转角度有助于诊断性评估肩袖全层撕裂。BACKGROUND:Rotator cuff tear is a common cause for shoulder pain and dysfunction.The morphology of scapular glenoid has always been an important research topic of degenerative rotator cuff tear.OBJECTIVE:To explore the relationship between glenoid version angle,scapular glenoid size and degenerative rotator cuff full-thickness tear.METHODS:In a matched case-control study,36 patients with full-thickness rotator cuff tears diagnosed by MRI and shoulder arthroscopy in the Affiliated Hospital of Xuzhou Medical University from February 2020 to February 2021 were selected as the trial group.The 36 patients with non-shoulder diseases in the same period were selected as the control group according to the age,sex and number of the subjects.Chest CT was performed on admission in both groups.The glenoid version angle and anteroposterior diameter of scapular glenoid were measured by the same orthopedic surgeon on the chest CT,and the difference of the glenoid version angle between the two groups was statistically analyzed.RESULTS AND CONCLUSION:(1)The glenoid version angle:in the trial group(-3.5±4.6)°,compared with the control group(-1.9±3.9)°,there was a more obvious posterior inclination(P<0.05).(2)In the trial group,the anteroposterior diameter of the scapular glenoid was(26.8±3.3)mm.In the control group,the anteroposterior diameter of the scapular glenoid was(27.2±3.6)mm(P>0.05).(3)The shoulder joints of the control group were divided into left and right groups,and the results showed that the left scapular glenoid version angle was(-1.85±5.42)°,and the right scapular glenoid version angle was(-2.01±6.18)°.There was no significant difference between the two groups(P>0.05).(4)When the patients were divided into groups according to sex,the results showed that there was a significant difference in the anteroposterior diameter of the scapular glenoid between males and females(P<0.05).(5)It is concluded that there is no significant correlation between the size of the scapular glenoid(anteroposterior diameter)and the

关 键 词：肩袖撕裂 肩胛盂扭转角 肩胛盂前后径 胸部CT 肩关节镜 肩关节假体 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]