正常国人盂肱关节在不同手臂抬高平面的运动学研究

Kinematics Study of Glenohumeral Joint at Different Arm Elevation Planes in Normal Chinese

目的探究正常国人盂肱关节在外展、肩胛平面外展和前屈时的相对位移,为盂肱关节不稳及肩峰下撞击等疾病的诊断、治疗和随访提供参考依据。方法采用双平面系统结合模型-图像配准技术,测量13名健康志愿者在手臂外展、肩胛平面外展和前屈的整个过程中肱骨相对于肩胛骨的上下、前后的平移数据。结果志愿者在手臂外展、肩胛平面外展和前屈时肱骨在前后方向上的总平移量分别为(4.0±1.3)、(4.1±1.5)、(4.8±1.9)mm,上下方向的总平移量分别为(3.0±1.0)、(3.1±1.1)、(3.3±1.5)mm。在整个运动过程中,不同手臂抬高角度的上下平移量具有显著性差异,但未发现其他显著性差异。结论正常国人手臂抬高过程中,肱骨头平均位于肩胛盂的后上方,且前屈时的肱骨在上下、前后的运动范围均最大。在临床的诊断、治疗和随访过程中,患者行前屈位可能会获得更好的评估效果。

Objective To investigate relative translations of the glenohumeral joint during abduction,scaption and forward flexion in normal Chinese,so as to provide references for diagnosis,treatment and follow-up of glenohumeral joint instability and subacromial impingement syndrome.Methods The biplanar fluoroscopy system combined with model-image registration technique were used to measure the humeral translation relative to the scapular in 13 healthy volunteers during abduction,scaption and forward flexion.Results The anterior-inferior glenohumeral translation during abduction,scaption and forward flexion was(4.0±1.3),(4.1±1.5),(4.8±1.9)mm,respectively.The superior-inferior glenohumeral translation was(3.0±1.0),(3.1±1.1),(3.3±1.5)mm,respectively.During the whole motion,there was a significant difference in superior-inferior translation at different arm elevation angles,while other significant differences were not found.Conclusions For normal Chinese,the humeral head was positioned posteriorly and superiorly on the glenoid.During forward flexion,the anterior-inferior and superior-inferior glenohumeral translation was the maxium.Therefore,in the process of clinical diagnosis,treatment and follow-up,patients performing the forward flexion may obtain a better evaluation effect.