Boileau P, Bicknell R T, Mazzoleni N, Walch G, Urien J P
Department of Orthopaedic Surgery and Sports Traumatology, Hôpital de L'Archet, University of Nice, Nice, France.
Clin Orthop Relat Res. 2008 Mar;466(3):661-9. doi: 10.1007/s11999-007-0089-z. Epub 2008 Feb 10.
Humeral head retroversion is not well described with the literature controversial regarding accuracy of measurement methods and ranges of normal values. We therefore determined normal humeral head retroversion and assessed the measurement methods. We measured retroversion in 65 cadaveric humeri, including 52 paired specimens, using four methods: radiographic, computed tomography (CT) scan, computer-assisted, and direct methods. We also assessed the distance between the humeral head central axis and the bicipital groove. CT scan methods accurately measure humeral head retroversion, while radiographic methods do not. The retroversion with respect to the transepicondylar axis was 17.9 degrees and 21.5 degrees with respect to the trochlear tangent axis. The difference between the right and left humeri was 8.9 degrees. The distance between the central axis of the humeral head and the bicipital groove was 7.0 mm and was consistent between right and left humeri. Humeral head retroversion may be most accurately obtained using the patient's own anatomic landmarks or, if not, identifiable retroversion as measured by those landmarks on contralateral side or the bicipital groove.
肱骨小头后倾在文献中描述较少,关于测量方法的准确性和正常值范围存在争议。因此,我们确定了正常的肱骨小头后倾并评估了测量方法。我们使用四种方法对65具尸体肱骨(包括52对标本)的后倾进行了测量:放射照相法、计算机断层扫描(CT)法、计算机辅助法和直接法。我们还评估了肱骨头中心轴与二头肌沟之间的距离。CT扫描方法能准确测量肱骨小头后倾,而放射照相法不能。相对于经髁轴的后倾为17.9度,相对于滑车切线轴的后倾为21.5度。左右肱骨之间的差异为8.9度。肱骨头中心轴与二头肌沟之间的距离为7.0毫米,左右肱骨一致。使用患者自身的解剖标志或在无法使用自身标志时,使用对侧相应标志或二头肌沟测量的可识别后倾,可能最准确地获得肱骨小头后倾。