Glenohumeral translation during active external rotation with the shoulder abducted in cases with glenohumeral instability: a 4-dimensional computed tomography analysis

Research output: Contribution to journalArticle

Abstract

Background: Although glenohumeral instability is common, the mechanism of instability remains unclear. The purpose of this study was to quantitatively evaluate humeral head translation during active external rotation with abduction in patients with glenohumeral instability by use of 4-dimensional computed tomography scans. Methods: Ten patients with unilateral glenohumeral instability with a positive fulcrum test were prospectively included in this study. Sequential computed tomography of bilateral shoulders during active external rotation at 90° of shoulder abduction was performed for 6 seconds at 5 frames per second. The 3-dimensional positions of the humeral head center in the anteroposterior, superoinferior, and mediolateral directions were calculated at 0°, 20°, 40°, 60°, and maximum shoulder abduction–external rotation from the starting position. Translation of the humeral head center from the starting position was evaluated using Dunnett multiple-comparison tests, and the differences between the affected and intact shoulders were assessed using Wilcoxon signed rank tests. Results: The humeral head center translated posteriorly, inferiorly, and medially during glenohumeral external rotation with the shoulder in the abducted position on the intact side. However, the affected humeral head showed significantly less posterior translation (P = .028), greater inferior translation (P = .047), and less medial translation (P = .037) than the contralateral side. Conclusions: This study indicated that dysfunction of the anterior band of the inferior glenohumeral ligament causes decreased posterior, increased inferior, and decreased medial translation of the humeral head during active shoulder abduction–external rotation.

Original languageEnglish
JournalJournal of Shoulder and Elbow Surgery
DOIs
Publication statusPublished - 2019 Jan 1

Fingerprint

Humeral Head
Tomography
Nonparametric Statistics
Ligaments

Keywords

  • anterior dislocation
  • Basic Science Study
  • glenohumeral dislocation
  • Glenohumeral instability
  • glenohumeral translation
  • humeral head translation
  • inferior glenohumeral ligament
  • Kinesiology
  • shoulder dislocation

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

@article{f783dbd4ea2846e1b3310163fe744c3d,
title = "Glenohumeral translation during active external rotation with the shoulder abducted in cases with glenohumeral instability: a 4-dimensional computed tomography analysis",
abstract = "Background: Although glenohumeral instability is common, the mechanism of instability remains unclear. The purpose of this study was to quantitatively evaluate humeral head translation during active external rotation with abduction in patients with glenohumeral instability by use of 4-dimensional computed tomography scans. Methods: Ten patients with unilateral glenohumeral instability with a positive fulcrum test were prospectively included in this study. Sequential computed tomography of bilateral shoulders during active external rotation at 90° of shoulder abduction was performed for 6 seconds at 5 frames per second. The 3-dimensional positions of the humeral head center in the anteroposterior, superoinferior, and mediolateral directions were calculated at 0°, 20°, 40°, 60°, and maximum shoulder abduction–external rotation from the starting position. Translation of the humeral head center from the starting position was evaluated using Dunnett multiple-comparison tests, and the differences between the affected and intact shoulders were assessed using Wilcoxon signed rank tests. Results: The humeral head center translated posteriorly, inferiorly, and medially during glenohumeral external rotation with the shoulder in the abducted position on the intact side. However, the affected humeral head showed significantly less posterior translation (P = .028), greater inferior translation (P = .047), and less medial translation (P = .037) than the contralateral side. Conclusions: This study indicated that dysfunction of the anterior band of the inferior glenohumeral ligament causes decreased posterior, increased inferior, and decreased medial translation of the humeral head during active shoulder abduction–external rotation.",
keywords = "anterior dislocation, Basic Science Study, glenohumeral dislocation, Glenohumeral instability, glenohumeral translation, humeral head translation, inferior glenohumeral ligament, Kinesiology, shoulder dislocation",
author = "Noboru Matsumura and Satoshi Oki and Naoto Fukasawa and Morio Matsumoto and Masaya Nakamura and Takeo Nagura and Yoshitake Yamada and Masahiro Jinzaki",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.jse.2019.03.008",
language = "English",
journal = "Journal of Shoulder and Elbow Surgery",
issn = "1058-2746",
publisher = "Mosby Inc.",

}

TY - JOUR

T1 - Glenohumeral translation during active external rotation with the shoulder abducted in cases with glenohumeral instability

T2 - a 4-dimensional computed tomography analysis

AU - Matsumura, Noboru

AU - Oki, Satoshi

AU - Fukasawa, Naoto

AU - Matsumoto, Morio

AU - Nakamura, Masaya

AU - Nagura, Takeo

AU - Yamada, Yoshitake

AU - Jinzaki, Masahiro

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Although glenohumeral instability is common, the mechanism of instability remains unclear. The purpose of this study was to quantitatively evaluate humeral head translation during active external rotation with abduction in patients with glenohumeral instability by use of 4-dimensional computed tomography scans. Methods: Ten patients with unilateral glenohumeral instability with a positive fulcrum test were prospectively included in this study. Sequential computed tomography of bilateral shoulders during active external rotation at 90° of shoulder abduction was performed for 6 seconds at 5 frames per second. The 3-dimensional positions of the humeral head center in the anteroposterior, superoinferior, and mediolateral directions were calculated at 0°, 20°, 40°, 60°, and maximum shoulder abduction–external rotation from the starting position. Translation of the humeral head center from the starting position was evaluated using Dunnett multiple-comparison tests, and the differences between the affected and intact shoulders were assessed using Wilcoxon signed rank tests. Results: The humeral head center translated posteriorly, inferiorly, and medially during glenohumeral external rotation with the shoulder in the abducted position on the intact side. However, the affected humeral head showed significantly less posterior translation (P = .028), greater inferior translation (P = .047), and less medial translation (P = .037) than the contralateral side. Conclusions: This study indicated that dysfunction of the anterior band of the inferior glenohumeral ligament causes decreased posterior, increased inferior, and decreased medial translation of the humeral head during active shoulder abduction–external rotation.

AB - Background: Although glenohumeral instability is common, the mechanism of instability remains unclear. The purpose of this study was to quantitatively evaluate humeral head translation during active external rotation with abduction in patients with glenohumeral instability by use of 4-dimensional computed tomography scans. Methods: Ten patients with unilateral glenohumeral instability with a positive fulcrum test were prospectively included in this study. Sequential computed tomography of bilateral shoulders during active external rotation at 90° of shoulder abduction was performed for 6 seconds at 5 frames per second. The 3-dimensional positions of the humeral head center in the anteroposterior, superoinferior, and mediolateral directions were calculated at 0°, 20°, 40°, 60°, and maximum shoulder abduction–external rotation from the starting position. Translation of the humeral head center from the starting position was evaluated using Dunnett multiple-comparison tests, and the differences between the affected and intact shoulders were assessed using Wilcoxon signed rank tests. Results: The humeral head center translated posteriorly, inferiorly, and medially during glenohumeral external rotation with the shoulder in the abducted position on the intact side. However, the affected humeral head showed significantly less posterior translation (P = .028), greater inferior translation (P = .047), and less medial translation (P = .037) than the contralateral side. Conclusions: This study indicated that dysfunction of the anterior band of the inferior glenohumeral ligament causes decreased posterior, increased inferior, and decreased medial translation of the humeral head during active shoulder abduction–external rotation.

KW - anterior dislocation

KW - Basic Science Study

KW - glenohumeral dislocation

KW - Glenohumeral instability

KW - glenohumeral translation

KW - humeral head translation

KW - inferior glenohumeral ligament

KW - Kinesiology

KW - shoulder dislocation

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UR - http://www.scopus.com/inward/citedby.url?scp=85067044018&partnerID=8YFLogxK

U2 - 10.1016/j.jse.2019.03.008

DO - 10.1016/j.jse.2019.03.008

M3 - Article

C2 - 31204064

AN - SCOPUS:85067044018

JO - Journal of Shoulder and Elbow Surgery

JF - Journal of Shoulder and Elbow Surgery

SN - 1058-2746

ER -