Correlation of acromial morphology with impingement syndrome and rotator cuff tears.
Correlation of acromial morphology with impingement syndrome and rotator cuff tears.
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DOI：
10.3109/17453674.2013.773413
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发表时间：
2013-04
影响因子：
3.7
通讯作者：
Liem D
中科院分区：
文献类型：
--
作者：
Balke M;Schmidt C;Dedy N;Banerjee M;Bouillon B;Liem D
肩峰成形术的适应症基于临床症状，通常由标准X线片上肩峰形态的典型变化支持。我们评价了肩峰形态的5个常用影像学参数，并评估了不同影像学特征与肩峰下撞击或肩袖撕裂之间的关系。 我们在标准X线片上测量了50例冈上肌腱全层撕裂患者、50例肩峰下撞击患者和50例无肩峰下病变的对照组的肩峰类型（Bigliani）、肩峰斜率（AS）、肩峰倾斜度（AT）、肩峰外侧角（LAA）和肩峰指数（AI）。 根据Bigliani的肩峰类型与任何特定的袖带病变无关。对照组和撞击患者之间的AS有统计学显著差异。对照组AT明显小于撞击伤组和袖带撕裂组。袖带撕裂患者的LAA与对照组和撞击患者的LAA有显著差异，但对照组的LAA与撞击患者的LAA无显著差异。撞击患者和袖带撕裂患者之间的差异也很显著。对照组的AI显著低于撞击患者和袖带撕裂患者。肩峰类型与AS之间有很好的相关性。 肩峰外侧角小和肩峰外侧伸展大与撞击和肩袖撕裂的发生率较高相关。前肩峰极度钩状，倾斜度超过43°，LAA小于70°，仅发生在肩袖撕裂患者中。
Indications for acromioplasty are based on clinical symptoms and are generally supported by typical changes in acromial morphology on standard radiographs. We evaluated 5 commonly used radiographic parameters of acromial morphology and assessed the association between different radiographic characteristics on the one hand and subacromial impingement or rotator cuff tears on the other. We measured acromial type (Bigliani), acromial slope (AS), acromial tilt (AT), lateral acromial angle (LAA), and acromion index (AI) on standard radiographs from 50 patients with full-thickness supraspinatus tendon tears, 50 patients with subacromial impingement, and 50 controls without subacromial pathology. The acromial type according to Bigliani was not associated with any particular cuff lesion. A statistically significant difference between controls and impingement patients was found for AS. AT of controls was significantly smaller than that of impingement patients and cuff-tear patients. LAA of cuff-tear patients differed significantly from that of controls and impingement patients, but LAA of controls was not significantly different from that of impingement patients. Differences between impingement patients and cuff-tear patients were also significant. AI of controls was significantly lower than of impingement patients and of cuff-tear patients. A good correlation was found between acromial type and AS. A low lateral acromial angle and a large lateral extension of the acromion were associated with a higher prevalence of impingement and rotator cuff tears. An extremely hooked anterior acromion with a slope of more than 43° and an LAA of less than 70° only occurred in patients with rotator cuff tears.