Orthopaedic Department, Hospital del Mar de Barcelona, Passeig Marítim 25-29, 08003 Barcelona, Spain.
J Orthop Surg Res. 2008 Oct 10;3:49. doi: 10.1186/1749-799X-3-49.
The purpose of this study is to analyze the morphology of the scapula with reference to the glenoid component implantation in reversed shoulder prosthesis, in order to improve primary fixation of the component.
Seventy-three 3-dimensional computed tomography of the scapula and 108 scapular dry specimens were analyzed to determine the anterior and posterior length of the glenoid neck, the angle between the glenoid surface and the upper posterior column of the scapula and the angle between the major craneo-caudal glenoid axis and the base of the coracoid process and the upper posterior column.
The anterior and posterior length of glenoid neck was classified into two groups named "short-neck" and "long-neck" with significant differences between them. The angle between the glenoid surface and the upper posterior column of the scapula was also classified into two different types: type I (mean 50 degrees-52 degrees ) and type II (mean 62.50 degrees-64 degrees ), with significant differences between them (p < 0.001). The angle between the major craneo-caudal glenoid axis and the base of the coracoid process averaged 18,25 degrees while the angle with the upper posterior column of the scapula averaged 8 degrees .
Scapular morphological variability advices for individual adjustments of glenoid component implantation in reversed total shoulder prosthesis. Three-dimensional computed tomography of the scapula constitutes an important tool when planning reversed prostheses implantation.
本研究旨在分析肩胛骨的形态结构，特别是肩盂关节面在反式肩关节假体中的植入位置，以提高假体的初始固定效果。
对 73 例肩胛骨三维 CT 及 108 例肩胛骨干标本进行分析，以确定肩盂颈的前后长度、肩盂关节面与肩胛骨上后柱之间的角度以及主要前后向肩盂轴线与喙突基底部和肩胛骨上后柱之间的角度。
将肩盂颈的前后长度分为“短颈”和“长颈”两组，两者之间有显著差异。肩盂关节面与肩胛骨上后柱之间的角度也分为两种不同类型：I 型（平均 50-52 度）和 II 型（平均 62.5-64 度），两者之间有显著差异（p<0.001）。主要前后向肩盂轴线与喙突基底部的平均角度为 18.25 度，与肩胛骨上后柱的平均角度为 8 度。
肩胛骨形态的可变性提示我们在反式全肩关节置换术中需要对肩盂关节面进行个体化的调整。肩胛骨的三维 CT 是规划反式假体植入的重要工具。
