正常国人盂肱关节在不同手臂抬高平面的运动学研究

目的 探究正常国人盂肱关节在外展、肩胛平面外展和前屈时的相对位移，为盂肱关节不稳及肩峰下撞击等疾病的诊断、治疗和随访提供参考依据。方法 采用双平面系统结合模型-图像配准技术，测量13名健康志愿者在手臂外展、肩胛平面外展和前屈的整个过程中肱骨相对于肩胛骨的上下、前后的平移数据。结果 志愿者在手臂外展、肩胛平面外展和前屈时肱骨在前后方向上的总平移量分别为(4.0±1.3)、(4.1±1.5)、(4.8±1.9) mm,上下方向的总平移量分别为(3.0±1.0)、(3.1±1.1)、(3.3±1.5) mm。在整个运动过程中，不同手臂抬高角度的上下平移量具有显著性差异，但未发现其他显著性差异。结论 正常国人手臂抬高过程中，肱骨头平均位于肩胛盂的后上方，且前屈时的肱骨在上下、前后的运动范围均最大。在临床的诊断、治疗和随访过程中，患者行前屈位可能会获得更好的评估效果。

Kinematics Study of Glenohumeral Joint at Different Arm Elevation Planes in Normal Chinese

Objective To investigate relative translations of the glenohumeral joint during abduction, scaption and forward flexion in normal Chinese, so as to provide references for diagnosis, treatment and follow-up of glenohumeral joint instability and subacromial impingement syndrome.Methods The biplanar fluoroscopy system combined with model-image registration technique were used to measure the humeral translation relative to the scapular in 13 healthy volunteers during abduction, scaption and forward flexion.Results The anterior-inferior glenohumeral translation during abduction, scaption and forward flexion was (4.0±1.3), (4.1±1.5),(4.8±1.9) mm, respectively. The superior-inferior glenohumeral translation was (3.0±1.0), (3.1±1.1), (3.3±1.5) mm, respectively. During the whole motion, there was a significant difference in superior-inferior translation at different arm elevation angles, while other significant differences were not found.Conclusions For normal Chinese, the humeral head was positioned posteriorly and superiorly on the glenoid. During forward flexion, the anterior-inferior and superior-inferior glenohumeral translation was the maxium. Therefore, in the process of clinical diagnosis, treatment and follow-up, patients performing the forward flexion may obtain a better evaluation effect.