Analysis of Joint Morphology and Mechanical Characteristics of Scapulohumeral Periarthritis Based on Anteroposterior Radiographs of Shoulder
Objective:To analyze shoulder joint morphology and mechanical distribution characteristics in patients with periarthritis of the shoulder based on shoulder radiographs.Methods:30 patients with frozen shoulder were selected as the research subjects(shoulder periarthritis group),and 20 normal shoulder joints were selected as the control group.The morphology of the acromioclavicular joint and the mor-phology of the greater tuberosity of the humerus were classi-fied into type Ⅰ,type Ⅱ,and type Ⅲ according to classifica-tion criteria.The shoulder-humerus distance,acromion index,distance from the coracoid process articular surface to the ac-romion articular surface,acromioclavicular gap,distance from the conoid tubercle to the clavicular articular surface,dis-tance between the conoid tubercle and the coracoid process finger-like protrusion,distance between the conoid tubercle and the attachment point of the coracoclavicular ligament on the coracoid process,and other indicators were measured in each group.Statistical analysis was performed to compare the differences between each group and analyze the relationship between the characteristics of the shoulder joint and acromioclavicular joint observed on the shoulder radiograph and frozen shoulder.Results:There was no statistically significant difference in the morphology of the acromioclavicular joint and the classification of the greater tuberosity of the humerus between the shoulder periarthritis group and the control group(P＞0.05).The shoulder periarthritis group mainly had type Ⅱ acromioclavicular joint morphology and type Ⅲ greater tuber-osity of the humerus.The difference in shoulder peak index between the shoulder periarthritis group and the control group was not statistically significant(P＞0.05),while the difference in shoulder humeral distance was statistically significant(P＜0.05).The shoulder humeral distance in the shoulder periarthritis group was smaller than that in the control group.There was no statistical significance in the distance b between the acromioclavicular joint space and the distance e between the conical ligament of the superior coracoprocess and the coracoshoulder ligament between the periarthritis group and the control group(P＞0.05).There were statistically significant differences between the periarthritis group and the control group in the distance a from the articular surface of coracoideus to acromialis articularis,the distance c from the conical tubercle to the most lateral end of the clavicle,the distance d from the conical tubercle to the digital process of coracoideus and the area S surrounding them(P＜0.05),and the periarthritis group was significantly smaller than the control group.There was a statistically significant difference in the angle 3 between the subclavian oblique spine to coracoid process line and c between the shoulder periarthritis group and the control group(P＜0.05),while there was no statistically signifi-cant difference in the angle 1 between a and b and the angle 2 between c and d(P＞0.05).The correlation analysis between area S and distances a,c,d showed statistical significance(P＜0.05),while there was no statistically significance in the correlation analysis among distances b,e,angle 1,angle 2,and angle 3(P＞20.05).Conclusion:Patients with periar-thritis of the shoulder have a smaller distance between the shoulder and humerus,shorter coracoacromial ligaments,and increased compression and friction of the soft tissue beneath them.The vertical stability of the shoulder joint is weakened,and the volume of the subacromial space and rotator cuff space is reduced,which increases the likelihood of rotator cuff injury and shoulder periarthritis.The smaller the distance from the cone-shaped nodule to the outermost end of the clavicle in patients with periarthritis of the shoulder,the closer the coracoacromial ligament is to the cone-shaped ligament,which is prone to exceeding the tensile limit and causing damage.The weakened stability caused by damage to the diagonal liga-ment may be one of the causes of shoulder periarthritis.The weakening of shoulder joint stability in patients with shoulder periarthritis is a series of chain changes from a single ligament to the core stable area to the shoulder joint.The smaller the area of the core stable area,the greater the stress.
万方数据
维普
