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Review
. 2023 Apr;15(2):132-139.
doi: 10.1177/17585732221090226. Epub 2022 Mar 29.

Evaluation of the range of motion of scapulothoracic, acromioclavicular and sternoclavicular joints: State of the art

Affiliations
Review

Evaluation of the range of motion of scapulothoracic, acromioclavicular and sternoclavicular joints: State of the art

Edoardo Giovannetti de Sanctis et al. Shoulder Elbow. 2023 Apr.

Abstract

The scapulothoracic, acromioclavicular and sternoclavicular joints play a fundamental role in the shoulder function. Shoulder complex kinematics have been studied with different methods using: goniometers, 2 static radiographs, 3D motion analyzers (invasive or noninvasive) and digital inclinometers. Goniometers have been used traditionally to assess scapular rotation in relation to the thorax. The intrinsic limit of multiple static two-dimensional shoulder radiographs is the attempt of describing in two what is occurring in three dimensions. Technology innovations have led to the development of the 3D shoulder complex kinematics analysis ETS (Electromagnetic tracking systems) using sensors (invasive bone-pin markers or noninvasive skin surface marker) stitched to the scapula/clavicula, thorax, and humerus. Despite being uncomfortable, invasive 3D motion cortical pins analyzers still represent the current gold standard for tracking shoulder complex kinematics. Therefore, access to three-dimensional biomechanical instrumentations for collecting kinematic data represents an active problem for many physicians. A precise, easy to use and low-cost non-invasive method able to draw and analyze the kinematics of the shoulder complex has not been developed yet. Further researches are necessary to design a new non-invasive method able to draw and analyze the kinematics of the scapula and the whole shoulder complex, precisely.

Keywords: Shoulder complex; acromioclavicular; scapulothoracic; sternoclavicular.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Motions of the scapula are defined as internal-external rotation, upward-downward rotation and anterior-posterior tilting.
Figure 2.
Figure 2.
Motion permitted at the sternoclavicular joint: elevation-depression, protraction-retraction, and anterior-posterior long-axis rotation.
Figure 3.
Figure 3.
A) The scapular assistance test The Examiner stabilizes the superior border of the scapula and assists Serratus anterior and lower trapezius muscles during scapular upward rotation. B) The Scapular Retraction Test (Phase 1). The Examiner performs an Empty can manual muscle test to assess supraspinatus muscle strength. C) The Scapular Retraction Test (Phase 2). The Examiner stabilizes the medial scapular border and reapplies the muscle test D) Clinical Assessment of acromioclavicular joint laxity in a patient with suspected scapular dyskinesis. The clavicle is stabilized, and an anteroposterior force is applied to the distal end of the acromion.
Figure 4.
Figure 4.
Schematic diagram showing a subject with scapula locator (A), scapula tracker (B), and acromial method (C).

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