Tingart M J, Bouxsein M L, Zurakowski D, Warner J P, Apreleva M
Orthopaedic Biomechanics Laboratory, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Calcif Tissue Int. 2003 Dec;73(6):531-6. doi: 10.1007/s00223-002-0013-9.
Bone quality of the proximal humerus is important for the surgical treatment of proximal humeral fractures and rotator cuff tears. However, very few studies have evaluated the areal bone mineral density (BMD) of the proximal humerus. The aim of this study was to analyze the volumetric BMD (vBMD) using peripheral-quantitative-computed-tomography. Total, trabecular and cortical vBMD were determined separately for the proximal and distal half of the humeral head, the surgical neck and seven specific regions of interest. The greater tuberosity (GT) was divided into three regions, and the lesser tuberosity (LT) and articular surface (AS) were each divided into two regions. The proximal head showed a significantly higher trabecular (+ 46%) and cortical vBMD (+ 15%) than the distal one. The mean trabecular vBMD of AS was significantly higher (+ 80%), and the cortical vBMD was significantly lower (- 11%) than that of the tuberosities. In the proximal half of GT, trabecular vBMD was higher in the posterior than in the middle and anterior regions. Cortical vBMD was higher in middle region than in the anterior and posterior ones. In the distal half of GT, trabecular vBMD was significantly higher in the posterior than in the middle region, and cortical vBMD was significantly higher in the anterior than in the middle region. In one. These results point to bone sites that may provide stronger fixation for implants, reduce the risk of implant loosening, and therefore improve patient outcome.
肱骨近端的骨质对于肱骨近端骨折和肩袖撕裂的手术治疗至关重要。然而，很少有研究评估肱骨近端的面积骨密度（BMD）。本研究的目的是使用外周定量计算机断层扫描分析体积骨密度（vBMD）。分别测定肱骨头近端和远端、外科颈以及七个特定感兴趣区域的总体、小梁和皮质vBMD。大结节（GT）分为三个区域，小结节（LT）和关节面（AS）各分为两个区域。近端肱骨头的小梁vBMD（+46%）和皮质vBMD（+15%）显著高于远端。AS的平均小梁vBMD显著更高（+80%），而皮质vBMD显著低于结节（-11%）。在GT的近端半部，小梁vBMD在后部高于中部和前部区域。皮质vBMD在中部区域高于前部和后部区域。在GT的远端半部，小梁vBMD在后部显著高于中部区域，皮质vBMD在前部显著高于中部区域。在一个。这些结果指出了可能为植入物提供更强固定、降低植入物松动风险并因此改善患者预后的骨部位。
