肩甲骨三次元運動に対する鎖骨の働き　−屍体肩を用いた研究−

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The clavicle serves as a strut between the thorax and shoulder girdle, and lack of it working could possibly affect the shoulder mobility. The purpose of this study was to examine the scapular kinematics in clavicular discontinuity models and to clarify a function of a clavicle that works on scapulothoracic motion.Fourteen shoulders from 7 fresh whole cadavers were used in this study. We stabilized the cadavers in the sitting position, and 3 repetitions of manual elevation were performed in the sagittal, scapular, and coronal planes with the elbow extended and thumb pointing up. The three-dimensional position and orientation of the thorax, scapula, and humerus were tracked by an electromagnetic tracking device (3Space Fastrak, Polhemus) following International Society of Biomechanics standardization proposal. After the experiment of the intact state (intact group), a 4-cm section of the clavicular midshaft was removed to simulate nonunion and another investigation was performed (nonunion group). We assessed the scapular rotations at the resting position and the humerothoracic elevated positions from 30° to 130° in both groups. The differences between the intact group and nonunion group were analyzed using Wilcoxon signed-rank tests at each position.At the resting position, the scapula inclined internally, downwardly, and anteriorly with clavicular discontinuity. During arm elevation, scapular external rotation, upward rotation, and posterior tilting in the nonunion group significantly decreased at the elevated arm positions. All three elevation planes showed the kinematic change and it became obvious during sagittal plane elevation. The findings of this study indicated that clavicular discontinuity could cause shoulder dyskinesis and it might produce clinical symptoms. We speculated that the clavicle keeps the scapula rotating externally, upwardly, and posteriorly during arm movement to prevent subacromial impingement and to decrease mechanical load on the glenohumeral joint, and it stabilizes the shoulder mobility.

肩甲骨三次元運動に対する鎖骨の働き　−屍体肩を用いた研究−

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肩甲骨三次元運動に対する鎖骨の働き −屍体肩を用いた研究−

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肩甲骨三次元運動に対する鎖骨の働き　−屍体肩を用いた研究−