Omuz Anatomisi ve Biyomekaniği
Özet
Omuz bozuklukları, kas-iskelet sistemi ağrılarının en sık nedenlerindendir ve doğru tanı için anatomi ve biyomekani bilgisi şarttır. Omuz kompleksi; klavikula, humerus ve skapula kemiklerinden; üç sinovyal ve iki fizyolojik eklemden oluşur. Glenohumeral eklem kapsülü, glenoid labrum ve ligamanlar pasif stabilizasyonu sağlarken; deltoid ve supraspinatus, infraspinatus, teres minör ile subscapularis’ten oluşan rotator manşet kasları dinamik stabilizatör olarak görev yapar. Eklemin 180 derece fleksiyon ve abdüksiyon gibi geniş hareket açıklığı, kombine çalışan kas grupları ve 2:1 oranındaki skapulohumeral ritim sayesinde gerçekleşir.
Shoulder disorders are among the most common causes of musculoskeletal pain, and comprehensive knowledge of anatomy and biomechanics is essential for accurate diagnosis. The shoulder complex consists of the clavicle, humerus, and scapula bones, along with three synovial and two physiological joints. While the glenohumeral joint capsule, glenoid labrum, and ligaments provide passive stabilization, the deltoid and the rotator cuff muscles—comprising the supraspinatus, infraspinatus, teres minor, and subscapularis—act as dynamic stabilizers. The wide range of motion of the joint, such as 180 degrees of flexion and abduction, is achieved through combined muscle groups and the 2:1 scapulohumeral rhythm.
Referanslar
Goldstein, B. (2004). Shoulder anatomy and biomechanics. Physical Medicine and Rehabilitation Clinics, 15(2), 313-349.
Thompson JC . Netter Ortopedik Anatomi Atlası,1.basım, Palme Yayınevi, Ankara,2003 s:45-63.
Jobe CM. Gross Anatomy of the Shoulder. In : Rockwood and Matsen. Second Edition.W.B. Saunders Company . Volume 1, Chapter 2, 1998: 34-97.
Warner JJP, Boardman ND. Anatomy, Biomechanics and Pathophysiology of Glenohumeral İnstability. In: Warren RF, Craig EV,Altchek DW, eds. The Unstable Shoulder. 1sted. Philadelphia: Lippincott-Raven; 1999.p.51-76.
Randelli M, Gambroli PL. Glenohumeral osteometry by computed tomography in normal and unstable shoulders. Clin Orthop. 1986;208:151-156.
Kronberg M, Brostrom LA, Soderlund V. Retroversion of the humeral head in the normal shoulder and its relationship to the normal range of motion. Clin Orthop. 1990;253:113-117.
Patkar D, Verma M. (2013). Anatomy and biomechanics of shoulder joint. DOI:10.13140/RG.2.1.2766.6325
McCluskey GM III, Todd J. Acromioclavicular joint injuries. J South Orthop Assoc. 1995;4:206-213.
Baltacı G. Omuz Yaralanmalarında Rehabilitasyon. 1.basım,Pelikan Yayıncılık Ltd. Şti., Ankara;2015 s:2-23.
Bencardino JT, Beltran J. MR Imaging of the Glenohumeral Ligaments. Radiol Clin N Am. 2006 Jul; 44(4): 489–502.
Fongemie AE, Buss DD, Rolnick SJ. Management of shoulder impingement syndrome and rotator cuff tears. Am Fam Physician. 1998 Feb; 57(4) : 667–674, 680–682.
Mudge,M.K, Wood,W.E.,Frykman, G.K. Rotator cuff tears associated with os acromiale. J.Bone Joint Surg. 1984: 66-A(3): 427-429.
Lugo, R., Kung, P., & Ma, C. B. (2008). Shoulder biomechanics. European journal of radiology, 68 (1), 16-24.
Boardman ND HI, Debski RE, Warner JJP, et al. Tensile properties of the superior glenohumeral ligament and coracohumeral ligaments. J Shoulder Elbow Surg. 1996;5:249-254.
Turkel SJ, Panio MW, Marshall JL, Girgis FG. Stabilizing mechanisms preventing anterior dislocation of the glenohumeral joint. J Bone Joint Surg Am. 1981;63:1208-1217.
Siwetz M, Hammer N, Ondruschka B, Kieser DC. Variations in Subscapularis Muscle Innervation-A Report on Case Series. Medicina (Kaunas). 2020 Oct 12; 56 (10).
Pencle FJ, Varacallo M. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Jul 1, 2021. Proximal Humerus Fracture.
McClelland D, Paxinos A. The anatomy of the quadrilateral space with reference to quadrilateral space syndrome. J Shoulder Elbow Surg. 2008 Jan-Feb;17(1):162-4.
Williams JM, Sinkler MA, Obremskey W. Anatomy, Shoulder and Upper Limb, Infraspinatus Muscle. [Updated 2021 Aug 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021.
O'Neill, J. M. (2008). Musculoskeletal Ultrasound (p. 1). Springer.
Neer,C.S.II.Shoulder Reconstruction,WB Saunders Comp.Philadelphia, 1990.
Aguirre, K., Mudreac, A., & Kiel, J. (2021). Anatomy, shoulder and upper limb, subscapularis muscle. StatPearls [Internet].
Kadi R, Milants A, Shahabpour M. Shoulder Anatomy and Normal Variants. J Belg Soc Radiol. 2017 Dec 16;101(Suppl 2):3.
Terry, G. C., & Chopp, T. M. (2000). Functional anatomy of the shoulder. Journal of athletic training, 35(3), 248.
Flatow EL. Shoulder anatomy and biomechanics. In: Post M, Flatow EL, Bigliani LU, Pollock RG. The Shoulder: Operative Technique. Baltimore, MD: Williams & Wilkins; 1998:1-42.
Myers JB, Laudner KG. Scapular position and orientation in throwing athletes. Am J Sports Medicine. 2005;33:263-271.
Demirhan M., Göksan M.A. Omuz eklemi biomekaniği ve kas kontrolu. Acta Orthop. Traumatol. Turc. 1993: 27: 212- 217.
Murray, I. R., Goudie, E. B., Petrigliano, F. A., & Robinson, C. M. (2013). Functional anatomy and biomechanics of shoulder stability in the athlete. Clinics in sports medicine, 32(4), 607-624.
Culham, E., & Peat, M. (1993). Functional anatomy of the shoulder complex. Journal of Orthopaedic & Sports Physical Therapy, 18(1), 342-350.
Sharkey NA, Marder RA, Hanson PB. The entire rotator cuffcontributes to elevation of the arm. J Orthop Res 1994;12:699-708.
Shahan K., Sarrafian M.D. Gross and Functional Anatomy of the Shoulder. Clinical Orthopaedics and Related Research, 1983: 173: 11-19.
Peat Malcolm. Functional anatomy of the shoulder complex. Physical Therapy 1986: 66 (12): 1855-1865.
Matsen FA, Arntz CT, Lippitt SB. Rotator cuff. In: RockwoodCA, Matsen FA III, editors. The shoulder. Vol. 2, 2nd ed. Philadelphia: W. B. Saunders; 1998. p. 755- 839.
Soslowsky LJ, Malicky DM, Blasier RB. Active and passive factors in inferior glenohumeral stabilization: a biomechanical model. J Shoulder Elbow Surg 1997;6:371-9.
Kapandjia LA.; Funktionelle anatomie der Gelenk Band 1, Ferdinand Enke Verlag 1984
Magee D.J. Orthopedic Physical Assessment. W.B.Saunders Company-Philadelphia, Fourth Edition. Chap, 2002:5: 207-319.
Elzanie A, Varacallo M. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Aug 22, 2020. Anatomy, Shoulder and Upper Limb, Deltoid Muscle.
