Tingart Markus J, Apreleva Maria, von Stechow Dietrich, Zurakowski David, Warner Jon J
Orthopaedic Biomechanics Laboratory, Beth Israel Deaconess Medical Centre, Harvard Medical School, Boston, Massachusetts 02215, USA.
J Bone Joint Surg Br. 2003 May;85(4):611-7. doi: 10.1302/0301-620x.85b4.12843.
The operative treatment of fractures of the proximal humerus can be complicated by poor bone quality. Our aim was to evaluate a new method which allows prediction of the bone quality of the proximal humerus from radiographs. Anteroposterior radiographs were taken of 19 human cadaver humeri. The cortical thickness was measured at two levels of the proximal humeral diaphysis. The bone mineral density (BMD) was determined for the humeral head (HH), the surgical neck (SN), the greater tuberosity (GT) and lesser tuberosity (LT) using dual-energy x-ray absorptiometry. The mean cortical thickness was 4.4 +/- 1.0 mm. Specimens aged 70 years or less had a significantly higher cortical thickness than those aged over 70 years. A significant positive correlation was found between cortical thickness and the BMD for each region of interest. The cortical thickness of the proximal diaphysis is a reliable predictor of the bone quality of the proximal humerus.
肱骨近端骨折的手术治疗可能因骨质不佳而变得复杂。我们的目的是评估一种能从X线片预测肱骨近端骨质的新方法。对19具人类尸体的肱骨进行前后位X线摄影。在肱骨近端骨干的两个层面测量皮质厚度。使用双能X线吸收法测定肱骨头（HH）、外科颈（SN）、大结节（GT）和小结节（LT）的骨密度（BMD）。平均皮质厚度为4.4±1.0毫米。70岁及以下的标本皮质厚度明显高于70岁以上的标本。在每个感兴趣区域，皮质厚度与骨密度之间发现显著正相关。近端骨干的皮质厚度是肱骨近端骨质的可靠预测指标。
