A Comparison of Biceps Labrum Complex Findings in Patients With and Without Superior Migration of the Humeral Head in Large or Massive Rotator Cuff Tears: 比較在患有旋轉袖肌巨大破裂的病人中有和沒有肱骨頭向上遷移對於肱二頭肌盂唇複合體的影響

BackgroundThe purpose of this study was to clarify the relationship between superior migration of the humeral head and findings of biceps labrum complex (BLC) in large or massive rotator cuff tears.MethodsForty-nine shoulders that underwent surgery for torn supraspinatus and infraspinatus tendons were included. Patients were divided into two groups according to the acromio–humeral interval (AHI). Arthroscopic findings of BLC were classified into five types; Type 0; normal shape, Type 1: fraying; Type 2: detachment; Type 3: attrition of BLC and superior glenoid; and Type 4: defect.ResultsThe group without migration (AHI ≥ 7 mm) consisted of 21 shoulders and that with migration (AHI < 7 mm) was 28 shoulders. There were significantly more patients with Types 2, 3, and 4 in the group with migration than without migration.ConclusionThis study indicates a potential relationship between BLC injury and superior humeral head migration accompanied by a rotator cuff tear.

中 文 摘 要背景一個大的肩袖撕裂的患者往往被確定有肱骨頭的向上遷移。這項研究的目的是澄清在大型或巨型肩袖撕裂的患者中，肱骨頭向上遷移和關節鏡下的肱二頭肌盂唇複合體（biceps labrum complex; BLC）之間的關係。方法研究包括49個因撕裂岡上肌和岡下肌腱而接受關節鏡手術的病人。患者根據肩峰間隔（acromiohumeral interval; AHI）分成兩組。沒有向上的遷移的一組定義為患者的AHI是或多於7毫米。有向上遷移的一組定義為患者的AHI少於7毫米。研究調查患者的臨床特徵，關節鏡下的肱二頭肌長頭（long head of biceps; LHB）特徵，肩胛下肌腱和BLC。 BLC損傷分為5種類型，類型0:正常形狀，類型1:磨損，2型:分離，3型: BLC和上盂唇的磨損，類型4:缺陷。結果肱骨頭沒有向上遷移的組別包括了21個肩膀，癥狀發作期為7.5個月。肱骨頭向上遷移的組別包括了28的肩膀，癥狀發作期為23.0個月。LHB和肩胛下肌腱狀態兩組沒有顯著差異。兩組中BLC受傷的發現分別是[類型:有遷移;沒有遷移] -- 0型: 4個;1個，1型: 7個;1個，2型: 4個;12個，3型: 6個;13個，和4型: 0個;1個。在肱骨頭向上遷移的組別中，BLC受傷類型為2，3，4型的患者顯著高於沒有遷移的組別。結論這項研究表明在肩袖撕裂的患者中，BLC傷害和肱骨頭向上遷移有潛在的關係。