肩袖损伤英文版

1、Rotator Cuff InjuryRotator CuffLong Head of BicepsSubscapularisSupraspinatus, up facet of the humeral greater tuberosityInfraspinatus, middle facet of the humeral greater tuberosity Teres minor down facet of the humeral greater tuberosityInfraspinatus Humeral tuberosityMRIInfraspinatusTeres minorSup

2、raspinatusInfraspinatusPathophysiology Intrinsic Factors Vascular supply (? significance) Distal 1cm of supraspinatus tendon (early studies) Degenerative changes Age related Change in proteoglycan and collagen content in symptomatic tendonsPathophysiology Extrinsic factors Impingement Acromial spurs

3、 Type III acromion and decreased geometric area of the supraspinatus outlet Coracoacromial ligament AC joint osteophytes Coracoid process Glenohumeral instability Accentuates abnormal loadingCan lead to internal impingement Repetitive use Tensile overload Muscle fatigue MicrotraumaMechanismTraumatic

4、 PitchingChronicPain and/or fatigue of cuffRotator Cuff dysfunctionImpingement with motionDiagnose1、History Pain on the lateral aspect of the shoulder Stiffness, esp IR Cannot lie on that side Weakness, instability, crepitus Partial tears more sore and stiffer Acute tear may have inciting eventDiagn

5、ose2、Physical Exam Impingement testingNEER SIGNHawkins testDiagnose2、Physical ExamSUBSCAPLULARIS 肩胛下肌SUPRASPINATUS 冈上肌冈上肌 Jobes TestDiagnose2、Physical ExamINFRASPINATUS 冈下肌TERES MINOR 小圆肌Hornblowers sign:Diagnose3、ImagingPlain radiographsUltrasoundMRI small (1 cm), medium (13 cm), large(35 cm), or massive (5 cm）Treatment-surgery三角肌三角肌肱三头肌外侧头肱二头肌