伴Ⅲ型肩胛动力障碍肩袖撕裂患者的肩胛骨运动及肩部功能表现  

Scapular motion and shoulder function in patients suffering from rotator cuff tears with type Ⅲscapular dyskinesis

作　　者：李磊 高奉[2,3] 付一峰 孙婧怡 贺忱[2,3] 钱驿 果森 胥皞 郝悦 杨京伦 张霄瀚 巩亚伟 赵盈绮 刘壮 周敬滨[2,3] Li Lei;Gao Feng;Fu Yifeng;Sun Jingyi;He Chen;Qian Yi;Guo Sen;Xu Hao;Hao Yue;Yang Jinglun;Zhang Xiaohan;Gong Yawei;Zhao Yingqi;Liu Zhuang;Zhou Jingbin(Binzhou Medical University,Yantai 264003,China;National Institution of Sports Medicine,Beijing 100061,China;National Institute of Key Laboratory of Sports Trauma and Rehabilitation of General Administration of Sport of China,Beijing 100010,China)

机构地区：[1]滨州医学院,山东烟台264003 [2]国家体育总局运动医学研究所,北京100061 [3]国家体育总局运动创伤与康复重点实验室,北京100010

出　　处：《中国运动医学杂志》2024年第3期167-174,共8页Chinese Journal of Sports Medicine

基　　金：北京医院临床研究“领航”专项(KY2212281300);国家重点研发计划(2018YFF0300604)。

摘　　要：目的:探究伴有Ⅲ型肩胛动力障碍(SD)和不伴有SD的肩袖撕裂患者在肩胛骨运动和肩部功能方面的不同表现。方法:纳入2021年9月至2023年3月在国家体育总局体育医院因肩袖撕裂就诊的16名伴Ⅲ型SD的肩袖撕裂患者(SD组)与17名无SD的肩袖撕裂患者(无SD组),分别拍摄患者患侧于冠状面外展0°、30°、60°、90°时的X线平片,通过测量X线平片中的3个参数来评估肩胛骨的三维运动,3个参数分别为肩胛冈线长度(LSS)、肩胛骨上旋角度(SURA)、喙突上移高度(CUSD),并记录患者的前屈、外展、外旋活动度,疼痛视觉模拟评分(VAS)及美国肩肘外科协会评分(ASES)。结果:(1)在肩关节外展0°及30°位,两组间SURA、CUSD及LSS均无显著差异;在肩关节外展60°及90°位,两组间CUSD及LSS无显著差异,但SD组的SURA显著大于无SD组(P<0.05)。(2)SD组的主动前屈、外展及外旋活动度均显著小于无SD组(P<0.05)。(3)SD组的VAS得分显著高于无SD组(P<0.05)。(4)SD组的ASES评分显著低于无SD组(P<0.05)。结论:伴Ⅲ型SD的肩袖撕裂患者相比于无SD的肩袖撕裂患者在肩外展过程中表现出更大的肩胛骨上旋角度;相比于无SD的肩袖撕裂患者,伴Ⅲ型SD的肩袖撕裂患者的疼痛程度更为剧烈,肩部活动度及肩部功能表现更差。Objective To explore the differences in scapular motion and shoulder function between patients suffering from rotator cuff tears(RCT) with and without type III scapular dyskinesis(SD).Methods Between September 2021 and March 2023,sixteen patients suffering from rotator cuff tears with SD(SD group) and 17 counterparts without SD(non-SD group) were recruited from the Sports Hospital of the General Administration of Sport of China.Their scapular motion was assessed by measuring three parameters in the X-rays,including scapular spine line(LSS),scapular upward rotation angle(SURA),and coracoid upward shift distance(CUSD).Moreover,their shoulder range of motion in flexion,abduction and external rotation were recorded,and further evaluated using the Pain Visual Analog Scale(VAS) and American Shoulder and Elbow Surgeons Score(ASES).Results No significant differences were found between the two groups in the average score of SURA,CUSD and LSS at 0°~30° shoulder abduction,or in that of CUSD and LSS at 60°~90°shoulder abduction.However,the average SURA score of the SD group at 60°~90°shoulder abduction was significantly greater than the other group(P<0.05).The shoulder ranges of motion during active flexion,abduction and external rotation were significantly smaller in the SD group than in the non-SD group(P<0.05).Moreover,the average VAS score in the SD group was significantly higher than the non-SD group(P<0.05),while the average ASES score was significantly lower than the latter group(P<0.05).Conclusions RCT patients type III SD exhibits greater scapular upward rotation during shoulder abduction compared to those without SD.Moreover,the former patients suffer from more severe pain and have worse shoulder range of motion and functional performance than the latter.

关 键 词：肩胛动力障碍 肩袖撕裂 肩胛骨运动 

分 类 号：R68[医药卫生—骨科学]