Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
J Shoulder Elbow Surg. 2011 Apr;20(3):440-8. doi: 10.1016/j.jse.2010.11.020.
What is thought of as a classic "cubitus varus" deformity usually consists of varus, extension, and internal rotation. However, its 3-dimensional (3D) pattern with 3D imaging has not been reported. This study aimed to obtain such 3D patterns using 3D bone models created from computed tomography data and evaluate the accuracy of conventional radiographic and clinical methods of assessing the deformity.
Imaging of 25 humeri of 25 patients with cubitus varus deformity caused by previous humeral supracondylar fractures was performed. The deformity was assessed by superimposing the 3D bone model onto a mirror-image model of the contralateral normal humerus. The 3D deformity pattern of cubitus varus was evaluated based on the 3 deformity components. Values obtained from conventional radiographic and physical measurements--that is, humerus-elbow-wrist angle (HEW-A), tilting angle (TA), maximal elbow flexion angle (MEF), and internal rotation angle (IRA)--were compared with those from the 3D technique.
Of the patients, 44% had varus, extension, and rotation deformities of 10° or greater; 20% had varus and extension deformities of 10° or greater; 16% had varus and internal rotation deformities of 10° or greater; and 20% had varus deformity only. When the 3D measurements were considered accurate, an error of 10° or greater was found in 8%, 24%, 8%, and 44% of cases in terms of HEW-A, TA, MEF, and IRA values, respectively.
Of the humeri, 80% had other bony deformities in addition to varus and 20% had isolated varus deformities. HEW-A and MEF showed reasonable accuracy as measures for the degree of deformity, whereas TA and IRA were found to be relatively inaccurate.
被认为是经典的“肘内翻”畸形通常包括内翻、伸直和内旋。然而，其三维（3D）模式及其 3D 成像尚未报道。本研究旨在使用从 CT 数据创建的 3D 骨骼模型获得这种 3D 模式，并评估传统放射学和临床评估畸形的方法的准确性。
对 25 例由肱骨髁上骨折引起的肘内翻畸形患者的 25 侧肱骨进行影像学检查。通过将 3D 骨骼模型叠加到对侧正常肱骨的镜像模型上来评估畸形。根据 3 个畸形成分评估肘内翻的 3D 畸形模式。比较传统放射学和体格测量值（即肱骨-肘-腕角（HEW-A）、倾斜角（TA）、最大肘屈曲角（MEF）和内旋角（IRA））与 3D 技术获得的值。
在患者中，44%有 10°或更大的内翻、伸直和旋转畸形；20%有 10°或更大的内翻和伸直畸形；16%有 10°或更大的内翻和内旋畸形；20%仅有内翻畸形。当考虑 3D 测量值准确时，在 HEW-A、TA、MEF 和 IRA 值方面，分别有 8%、24%、8%和 44%的病例存在 10°或更大的误差。
在这些肱骨中，除了内翻外，80%的肱骨还有其他骨畸形，20%的肱骨仅有孤立的内翻畸形。HEW-A 和 MEF 作为评估畸形程度的指标具有合理的准确性，而 TA 和 IRA 则相对不准确。
