Effect of humeral head defect size on glenohumeral stability: a cadaveric study of simulated Hill-Sachs defects.
Effect of humeral head defect size on glenohumeral stability: a cadaveric study of simulated Hill-Sachs defects.
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DOI：
10.1177/0363546509350295
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发表时间：
2010-03
期刊：
影响因子：
--
通讯作者：
Miniaci A
中科院分区：
文献类型：
--
作者：
Kaar SG;Fening SD;Jones MH;Colbrunn RW;Miniaci A
Hill-Sachs 病变常常伴有复发性肩关节不稳定，可能是 Bankart 修复失败的原因。盂肱关节的稳定性随着肱骨头缺损的增大而降低。描述性实验室研究。在 8 个人体尸体肩部中创建了肱骨头半径的 1/8、3/8、5/8 和 7/8 的肱骨头缺损，模拟 Hill-Sachs 缺损。测试位置包括45°和90°外展以及40°内旋、中立和40°外旋。对于所有外展和旋转组合，按从最小到最大的顺序对每个缺陷尺寸进行测试。将肱骨头以 0.5 mm/s 的速度沿水平关节盂轴前下方 45° 平移直至脱位。脱位距离（定义为肱骨头平移直至开始半脱位）是主要结果指标。方差分析的重要因素是旋转 (P < .001) 和缺陷大小 (P < .001)。 2 个外展角没有差异。与中立和 40° 内旋相比，40° 外旋显着缩短了脱位距离 (P < .001)。 5/8 和 7/8 半径截骨术显着缩短了完整状态下的脱位距离（分别为 P = .009 和 P < .001）。事后分析确定了轮换位置的显着差异。 5/8 桡骨截骨术、外旋 40°、外展 90° 时脱位距离缩短 (P = .008)。对于 90° 外展的 7/8 桡骨截骨术，中立和 40° 外旋的脱位距离缩短 (P < .001)；外展 45° 时，外旋 40° 时脱位距离缩短 (P < .001)。当肱骨内旋时，脱位距离没有显着变化。外旋和外展 5/8 半径缺陷处盂肱稳定性降低。在 7/8 半径处，中立和外旋转时的稳定性进一步下降。 5/8 肱骨头半径的缺陷可能需要治疗以降低肩关节不稳定修复的失败率。
Hill-Sachs lesions are often present with recurrent shoulder instability and may be a cause of failed Bankart repair. Glenohumeral joint stability decreases with increasingly larger humeral head defects. Descriptive laboratory study. Humeral head defects, 1/8, 3/8, 5/8, and 7/8 of the humeral head radius, were created in 8 human cadaveric shoulders, simulating Hill-Sachs defects. Testing positions included 45° and 90° of abduction and 40° of internal rotation, neutral, and 40° of external rotation. Testing occurred at each defect size sequentially from smallest to largest for all abduction and rotation combinations. The humeral head was translated at 0.5 mm/s 45° anteroinferiorly to the horizontal glenoid axis until dislocation. Distance to dislocation, defined as humeral head translation until it began to subluxate, was the primary outcome measure. Significant factors by ANOVA were rotation (P < .001) and defect size (P < .001). There was no difference for the 2 abduction angles. External rotation of 40° significantly reduced distance to dislocation compared with neutral and 40° internal rotation (P < .001). Osteotomies of 5/8 and 7/8 radius significantly decreased distance to dislocation over the intact state (P = .009 and P < .001, respectively). Post hoc analysis determined significant differences for the rotational positions. Decreased distance to dislocation occurred at 5/8 radius osteotomy at 40° external rotation with 90° of abduction (P = .008). For the 7/8 radius osteotomy at 90° abduction, there was a decreased distance to dislocation for neutral and 40° external rotation (P < .001); at 45° abduction, there was a decreased distance to dislocation at 40° external rotation (P < .001). With the humerus internally rotated, there was no significant change in distance to dislocation. Glenohumeral stability decreases at a 5/8 radius defect in external rotation and abduction. At 7/8 radius, there was a further decrease in stability at neutral and external rotation. Defects of 5/8 the humeral head radius may require treatment to decrease the failure rate of shoulder instability repair.
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影响因子：
3
作者：
Lippitt, S B;Vanderhooft, J E;Matsen, F A 3rd
通讯作者：
Matsen, F A 3rd
DOI：
10.2106/00004623-198466090-00019
发表时间：
1984-01-01
影响因子：
5.3
作者：
WEBER, BG;SIMPSON, LA;HARDEGGER, F
通讯作者：
HARDEGGER, F
影响因子：
2.8
作者：
Debski, RE;Wong, EK;Warner, JJP
通讯作者：
Warner, JJP
DOI：
10.1016/s0749-8063(03)00684-4
发表时间：
2003-09-01
影响因子：
4.7
作者：
Edwards, TB;Boulahia, A;Walch, G
通讯作者：
Walch, G
影响因子：
2.8
作者：
Malicky, DM;Soslowsky, LJ;Shyr, Y
通讯作者：
Shyr, Y