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From October 2006 to March 2007, 31 shoulders (13 men and 18 women with average age of 54.3) with subacromial impingement syndrome, from our department, were selected to form the patient group, An age and gender-matched of 40 asymptomatic shoulders (18 men and 22 women with average age of 52.8) formed the control group. The acromion index was measured on the Grashey view. The distance from the glenoid plane to the lateral border of the acromion was divided by the distance from the glenoid plane to the lateral aspect of the humeral head to calculate the acromion index.

方法]对本科2006年10月~2007年3月就诊的肩峰下撞击综合征患者31肩(平均年龄54.3岁,男13肩,女18肩)的G rashey位片,计算肩峰指数即肩峰最外侧缘至肩关节盂平面的距离与肱骨近端最外侧缘至肩关节盂平面的距离的比值,通过肩峰指数对肩峰肱骨头相对位置进行定量评估,与正常人群40肩(平均年龄52.8岁;男18肩,女22肩进行比较、分析。

Besides the conventional rotator cuff tear, acromion plasty, labrum repair, and surgeries for ennis elbow, osteoarthritis, ankylosis of elbow and teoid osteoma, new techniques have been developed including the arthroscopic repair of large tear of rotator cuff and labrum, tendon transposition, arthroscopic removal of benign tumor around the shoulder joint.

每年除完成常规肩袖修补、肩峰成形、盂唇修补等手术,以及网球肘、骨关节病、肘关节僵直、骨样骨瘤等等的手术治疗外,在关节镜下肩袖、盂唇巨大撕裂修补、肌腱转位、肩关节周围良性肿瘤镜下切除等手术领域内也有了长足发展,使患者在国内可以享受国际先进水平的治疗。

The CNR of fat and muscle belly on T_1WI was higher than on PDWI(p = 0.000).Conclusions:1、Routine MRI can demonstrate the dependency structure of shoulder clearly.The distance of subcoracoid was 8.84±2.97mm.The distance of sub-acromion was 5.23±1.05mm. 2、The 3D-fiesta imaging with muti-angle reconstruction is better in showing the coracohumeral ligament,coracoacromial ligament,coracoclavicular ligament, capsulolabral complex and the bone of shoulder,combing with oblique coronal and oblique sagittal imaging of the fat-suppression sequence,the diseases of shoulder can be diagnosed.

1、常规MRI能够较清楚显示肩关节相关结构,喙突下距离8.84±2.97mm,肩峰下距离5.23±1.05mm.2、3D-fiesta序列图像,应用重建功能行任意角度重建,可更好地显示喙锁韧带、喙肩韧带、喙肱韧带、盂唇-关节囊复合体及肩关节骨骼,结合斜冠位、斜矢状位的压脂序列,即可达到对肩关节疾病进行诊断的目的。

According to the different pathological changes, clearing synovium, biting off or gouging cataplasis cartilage, trimming asperous articular surface and sclerotin surface, stripping hyperplastic osteophyma, drilling under the cartilage to decompress, biting off and gouging injury glenoid labrum, dislodging corpus liberum, lavaging articular cavity with physiological saline and other therapeutic tools were applied.

根据不同病变情况,镜下采取清理滑膜、咬除或刨削退变的软骨、修整不平的关节面和骨质面、磨除增生的骨赘、软骨下微钻孔减压、咬除并修整损伤盂唇、取出游离体、生理盐水灌洗关节腔等治疗手段。

Additional acute lesions included 4 labral detachments, 2 SLAP I and 1 SLAP II lesions, 2 glenohumeral ligament ruptures, and 4 articular-side partial tears of the subscapularis tendon.

另外的深刻损害包括4唇独立小分队,2掴I和1掴II损害,2关节盂与肱骨韧带破裂,和肩胛下肌腱的4 滴关节边部份泪花。

When assessed with arthrography, the Hill-Sachs lesions were small compared with those in shoulders with an isolated Bankart lesion and, interestingly, they were quite similar in size to those seen with humeral aulsion of the inferior glenohumeral ligament.

关节造影分析时,与单独Bankart损伤所见相比,Hill-Sachs损伤较小,有趣的是,其大小与在肩部盂肱下韧带撕脱所见颇为相似。12例患者的Rowe评分由术前的平均30.4分提高到术后31个月的平均90.4分。

Muscularactivity brough about significam changes in glenohUmeral translation, the humera headbeing in a more inferior position and more centered, particularly at 90" and l20" ofabduction (p.01). In anterior/posterior direction the humeral head was more centeredat 60?and 90?of abduction during muscle activity.

肌肉的参与导致盂-肱关节变换关系的显著改变,肱骨头更加偏向下方和靠近中心,特别在90°和120°外展时表现得最为明显(p<0.01),在前后方向,肌肉的参与下,60°和90°外展时,肱骨头更趋向中心。

Results: The suprascapular nerve not only has its starting point and entering-muscle points, but also has two limit-points, it has turn-angle about 50° at spinoglenoid notch, supraspinatus muscle branch 44, infra-spinatus muscle branch 44, upper articular branch 42, lower articular branch 53, and sensory branch 37. The branches innervate supraspinatus muscle、infraspinatus muscle and the shoulder joint.

结果:肩胛上神经行程迂曲,有起点、入肌点两个固定点,另有肩胛上孔、肩胛下孔两个约束点,在冈盂切迹处形成大约50°左右的转折角,发出冈上肌支44支、冈下肌支44支、上关节支42支、下关节支53支、感觉支37支,分布于冈上肌、冈下肌和肩关节等处。

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