在外伤性肩关节前侧不稳定中使用临界肩角能否预测 SLAP-5 病变的存在?

IF 1.9 3区 医学 Q2 ORTHOPEDICS Skeletal Radiology Pub Date : 2026-01-01 Epub Date: 2024-05-17 DOI:10.1007/s00256-024-04708-1
Haluk Yaka, Turgut Emre Erdem, Mustafa Özer, Ulunay Kanatli
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引用次数: 0

摘要

目的:虽然 SLAP-5 病变与复发性脱位有关,但其原因和病理机制尚未完全阐明。本研究旨在探讨外伤性肩关节前不稳定(ASI)中 SLAP-5 病变与肩胛骨形态之间的关系。我们假设外伤性肩关节前不稳定患者的SLAP-5病变与肩胛骨形态之间可能存在关系:研究纳入了74名孤立性Bankart病变患者和69名SLAP-5病变患者,这些患者因ASI接受了关节镜下肩关节唇修复术。临界肩角(CSA)在X光片上测量,而盂倾角(GI)和盂版度(GV)则在磁共振成像(MRI)上测量,由两名观察者在互不知情的情况下分两次进行。对两组患者的 CSA、GI 和 GV 进行比较:结果:Bankart和SLAP-5患者的平均年龄分别为28.4±9.1岁和27.9±7.7岁(P=0.89);他们的平均CSA值分别为33.1°±2.6°和28.2°±2.4°(PC结论:在ASI中,低CSA值似乎与SLAP-5病变有关,SLAP病变形成的CSA临界值为30.5°,敏感性为75.0%,特异性为76.7%。肩胛骨形态可能与SLAP-5病变有关,CSA可作为诱导性诊断测试和医学影像技术的附加参数,用于检测伴随Bankart病变的SLAP病变:III 级回顾性病例对照研究。
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Can the presence of SLAP-5 lesions be predicted by using the critical shoulder angle in traumatic anterior shoulder instability?

Objective: Although SLAP-5 lesions are associated with recurrent dislocations, their causes and pathomechanisms have not been fully elucidated. This study aimed to investigate the association between SLAP-5 lesions and scapular morphology in traumatic anterior shoulder instability (ASI). We hypothesized that there may be a relationship between SLAP-5 lesions and scapular morphology in traumatic ASI patients.

Materials and methods: The study included 74 patients with isolated Bankart lesions and 69 with SLAP-5 lesions who underwent arthroscopic labral repair for ASI. Critical shoulder angle (CSA) was measured on the roentgenograms, while glenoid inclination (GI) and glenoid version (GV) were measured on magnetic resonance imaging (MRI) by two observers in two separate sessions blinded to each other. Both groups were compared in terms of CSA, GI, and GV.

Results: The mean ages of Bankart and SLAP-5 patients were 28.4±9.1 and 27.9±7.7 (P=0.89), respectively; their mean CSA values were 33.1°±2.6° and 28.2°±2.4°, respectively (P<0.001). The ROC analysis's cut-off value was 30.5°, with 75.0% sensitivity and 76.7% specificity (AUC = 0.830). SLAP-5 lesions were more common on the dominant side than isolated Bankart lesions (P=0.021), but no difference was found between the groups in terms of GI and GV (P=0.334, P=0.081, respectively).

Conclusions: In ASI, low CSA values appeared to be related to SLAP-5 lesions, and the cut-off value of CSA for SLAP lesion formation was 30.5° with 75.0% sensitivity and 76.7% specificity. Scapula morphology may be related to the SLAP-5 lesions, and CSA can be used as an additional parameter in provocative diagnostic tests and medical imaging techniques for the detection of SLAP lesions accompanying Bankart lesions.

Level of evidence: III retrospective case-control study.

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来源期刊
Skeletal Radiology
Skeletal Radiology 医学-核医学
CiteScore
4.40
自引率
9.50%
发文量
253
审稿时长
3-8 weeks
期刊介绍: Skeletal Radiology provides a forum for the dissemination of current knowledge and information dealing with disorders of the musculoskeletal system including the spine. While emphasizing the radiological aspects of the many varied skeletal abnormalities, the journal also adopts an interdisciplinary approach, reflecting the membership of the International Skeletal Society. Thus, the anatomical, pathological, physiological, clinical, metabolic and epidemiological aspects of the many entities affecting the skeleton receive appropriate consideration. This is the Journal of the International Skeletal Society and the Official Journal of the Society of Skeletal Radiology and the Australasian Musculoskelelal Imaging Group.
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