Médecine

Paramédical

Autres domaines


Suscribirse

Dynamic radiographic evaluation of the antero-inferior gleno-humeral ligament - 06/05/08

Doi : RCOE-05-2003-89-3-0035-1040-101019-ART1 

A. Vuillemin [1],

P. Hardy [1],

P. Guigui [2],

T. Bauer [1],

B. Rousselin [1],

A. Lortat-Jacob [1]

Ver las filiaciones

Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
Artículo gratuito.

Conéctese para beneficiarse!

Abstract

Dynamic radiographic evaluation of the antero-inferior gleno-humeral ligament

Purpose of the study

The purpose of this work was to propose an objective radiographic evaluation of the antero-inferior gleno-humeral ligament for comparison with the clinical assessment proposed by Gagey.

Material and methods

A test radiogram was obtained from 32 healthy volunteers (15 men, 17 women, mean age, 29 years, age range 21-54 years) free of shoulder disease. The dynamic test image consisted in a strictly AP view of the shoulder in forced abduction in neutral rotation. The subjects were awake and in dorsal decubitus. Displacements of the scapulo-thoracic articulation were limited by a counter-force applied to the acromion, in accordance with the method described by Gagey. Bilateral images were obtained for comparison. Several angles were measured between the humeral shaft and the scapula to search for the most reliable and reproducible measurement.

Results

Three series of angles were measured between the axis of the humeral shaft and the scapula. The mean angle between the axis of the humeral shaft and line drawn from the lower rim of the glenoid cavity to the lateral border of the scapular tubercle was 130.3° (range 110-148°) on the dominant side and 131.5° (108-148°) on the non-dominant side; giving 38° variability on the dominant side and 40° variation on the non-dominant side and a standard deviation of 10.4° on the dominant side and 11.5° on the non-dominant side. The mean difference in gleno-humeral abduction was 3.8° (range 0-14°) between the dominant and non-dominant side.

Discussion

Among the different angles measured between the scapula and the humerus, the angle between the axis of the humeral shaft and the line drawn from the lower rim of the glenoid cavity to the lateral border of the scapular tubercle was the most reliable and reproducible. Inter-observer measurements were well correlated. We observed that the variability in the radiographic values of the scapulo-humeral angle was much greater than the clinical values described by Gagey who, finding very constant values during forced abduction, described “invariable” scapulo-humeral abduction of the shoulder. Our study demonstrates that scapulo-humeral abduction is not an invariable parameter. More interestingly, the difference in amplitude between the dominant and non-dominant sides showed very strong interindividual correlation. Interobserver variability was low and reproducibility was good.

Conclusion

This dynamic radiographic test enables a precise quantified assessment of pure gleno-humeral abduction which depends on the antero-inferior gleno-humeral ligament. This test is reliable and reproducible. Variations in the length of the antero-inferior gleno-humeral ligament evaluated radiographically were greater than described clinically. We did not find any difference in pure gleno-humeral abduction greater than 14° between the dominant and non-dominant sides in healthy subjects.

Keywords: Joint instability , shoulder joint , shoulder dislocation , ligament , arthroscopy


Esquema



© 2003 Elsevier Masson SAS. Tous droits réservés.
Añadir a mi biblioteca Eliminar de mi biblioteca Imprimir
Exportación

    Exportación citas

  • Fichero

  • Contenido

Vol 89 - N° 3

P. 201-209 - mai 2003 Regresar al número

Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
El acceso al texto completo de este artículo requiere una suscripción o una compra individual.

¿Ya suscrito a @@106933@@ revista ?

;

Mi cuenta


Declaración CNIL

EM-CONSULTE.COM se declara a la CNIL, la declaración N º 1286925.

En virtud de la Ley N º 78-17 del 6 de enero de 1978, relativa a las computadoras, archivos y libertades, usted tiene el derecho de oposición (art.26 de la ley), el acceso (art.34 a 38 Ley), y correcta (artículo 36 de la ley) los datos que le conciernen. Por lo tanto, usted puede pedir que se corrija, complementado, clarificado, actualizado o suprimido información sobre usted que son inexactos, incompletos, engañosos, obsoletos o cuya recogida o de conservación o uso está prohibido.
La información personal sobre los visitantes de nuestro sitio, incluyendo su identidad, son confidenciales.
El jefe del sitio en el honor se compromete a respetar la confidencialidad de los requisitos legales aplicables en Francia y no de revelar dicha información a terceros.