Finding consistent strain distributions in the glenohumeral capsule between two subjects: implications for development of physical examinations.
Finding consistent strain distributions in the glenohumeral capsule between two subjects: implications for development of physical examinations.
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DOI：
10.1016/j.jbiomech.2010.11.018
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发表时间：
2011-02-24
影响因子：
2.4
通讯作者：
Debski, Richard E.
中科院分区：
文献类型：
--
作者：
Drury, Nicholas J.;Ellis, Benjamin J.;Weiss, Jeffrey A.;McMahon, Patrick J.;Debski, Richard E.
前下盂肱关节囊是前脱位时盂肱关节的主要被动稳定器。脱位后的体格检查对于正确诊断关节囊病变至关重要;然而，这些检查对于关节位置不标准，可能导致误诊和不良结局。为了建议关节位置用于体格检查，其中关节囊提供的稳定性在患者中可能是一致的，本研究的目的是使用临床相关关节位置的盂肱关节的两个经确认的受试者特定有限元模型评价前下关节囊上的最大主应变分布。在盂肱外展60°和外旋10°、20°、30°和40°时施加25 N前向载荷的关节位置导致肩关节之间的应变分布相似（r2 ≥ 0.7）。此外，外旋20°至40°的位置导致下盂肱韧带前带关节盂侧的关节囊应变显著大于所有其他关节囊区域。这些结果表明，在盂肱关节外展60°和中等范围（20°至40°）外旋的关节位置，前下关节囊提供的前稳定性在受试者中可能是一致的，并且关节盂侧对这些关节位置的稳定性贡献最大。因此，有可能建立标准的关节位置进行体格检查，临床医生可以使用这些位置有效诊断脱位后前下关节囊的病理学，并改善结局。
The anterior-inferior glenohumeral capsule is the primary passive stabilizer to the glenohumeral joint during anterior dislocation. Physical examinations following dislocation are crucial for proper diagnosis of capsule pathology; however, they are not standardized for joint position which may lead to misdiagnoses and poor outcomes. To suggest joint positions for physical examinations where the stability provided by the capsule may be consistent among patients, the objective of this study was to evaluate the distribution of maximum principal strain on the anterior-inferior capsule using two validated subject-specific finite element models of the glenohumeral joint at clinically relevant joint positions. The joint positions with 25 N anterior load applied at 60° of glenohumeral abduction and 10°, 20°, 30° and 40° of external rotation resulted in distributions of strain that were similar between shoulders (r2 ≥ 0.7). Furthermore, those positions with 20° to 40° of external rotation resulted in capsule strains on the glenoid side of the anterior band of the inferior glenohumeral ligament that were significantly greater than in all other capsule regions. These findings suggest that anterior stability provided by the anterior-inferior capsule may be consistent among subjects at joint positions with 60° of glenohumeral abduction and a mid-range (20° to 40°) of external rotation, and that the glenoid side has the greatest contribution to stability at these joint positions. Therefore, it may be possible to establish standard joint positions for physical examinations that clinicians can use to effectively diagnose pathology in the anterior-inferior capsule following dislocation and lead to improved outcomes.
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影响因子：
3
作者：
Debski, RE;Weiss, JA;McMahon, PJ
通讯作者：
McMahon, PJ
影响因子：
3
作者：
Harryman, D T 2nd;Sidles, J A;Matsen, F A 3rd
通讯作者：
Matsen, F A 3rd
影响因子：
1.8
作者：
Boselli, Karen J.;Cody, Elizabeth A.;Bigliani, Louis U.
通讯作者：
Bigliani, Louis U.
影响因子：
2.8
作者：
Debski, RE;Wong, EK;Warner, JJP
通讯作者：
Warner, JJP
影响因子：
9.6
作者：
Bankart, ASB
通讯作者：
Bankart, ASB