頁籤選單縮合
題 名 | Stabilizing Function of Coracohumeral Ligament in Relating to Joint Position=啄突肱骨韌帶在不同肩關節角度之穩定功能 |
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作 者 | 許弘昌; 羅宗平; 安介南; | 書刊名 | 中國醫藥學院雜誌 |
卷 期 | 7:3 1998.09[民87.09] |
頁 次 | 頁43-52 |
分類號 | 418.92 |
關鍵詞 | 啄突肱骨韌帶; Coracohumeral ligament; |
語 文 | 英文(English) |
中文摘要 | 在肩關節手術中,有時為了增加活動度,而需切斷啄突肱骨韌帶。啄突肱骨韌帶 就以往所知,可以增加旋轉肌間隙之厚度及穩定肱二頭肌,而對於肩關節之穩定度之貢獻則 常被忽略。本研究的目的即利用六個新鮮冰凍屍肩及利用生物力學的方法,在不同關節角度 來探究啄突肱骨韌帶的穩定功能研究顯示,啄突肱骨韌帶的確具有穩定肩關節之功能;其穩 定功能在向下方位最明顯,在向後方位最不明顯;而且在切斷啄突肱骨韌帶後當肩關節內轉 時最易向下方脫位,而在外轉時向下方脫位又變不明顯。至於前方之穩定性,在切斷啄突肱 骨韌帶祇在外力增大時才會變不穩定,而且會隋外轉角度增加而變大。所以在病理性肩關節 即當肩關節已不穩定之情形下,如果需切斷啄突肱骨韌帶時,要考慮也可能同時會犧牲掉其 部份對肩關節之穩定功能。 |
英文摘要 | Release of coracohumeral ligament (CHL) is sometimes recommended to increase range of motion during shoulder surgery, and the CHL is known to thicken the rotator interval and insert on either side of the bicipital groove to provide stabilization for the biceps tendon. However, the contribution of stabilizing function of CHL to glenohumeral joint has not been studied extensively. The purpose of this study is to investigate the stabilizing function of CHL in glenohumeral (GH) stability relating to different joint positions. Six fresh frozen cadaveric shoulders were used. All soft tissues and muscles were removed except the deltoid, rotator cuff and the long head of biceps, which were loaded through a pulley-cable system along the line of muscle action. The stability tests were performed in eight clinically relevant positions. The displacement measurement using a magnetic tracking device was made under an applied translation load. The displacement ratio (DR) was calculated and normalized by dividing the length and width of the glenoid. The DR was measured and statistically compared before and after CHL resection in each testing position. The stabilizing function of CHL was most significant in the inferior direction and least in the posterior direction, and it was related to arm rotation. The effect of CHL resection was most obvious in internal rotation for inferior stability. After CHL resection, the inferior stability regained significantly in external rotation (ER). For anterior stability, the effect of CHL resection was statistically significant only at greater translation load, and the difference of displacement ceased to exist as the ER angle increased. After CHL resection, internal rotation made no obvious change on GH contact characteristics when the arm in dependent hanging position; however, external rotation made the contact surface of humeral head (HH) shift backward and the contact area of glenoid and HH statistically increased. The results revealed that CHL indeed had stabilizing function in inferior and anterior directions and it was related to arm rotation. Potentially sacrifice of stabilizing function in some positions should be kept in mind during surgical release of CHL in some pathological unstable conditions. |
本系統中英文摘要資訊取自各篇刊載內容。