Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Clin Anat. 2012 Nov;25(8):1043-50. doi: 10.1002/ca.22045. Epub 2012 Feb 14.
Shoulder arthroplasty is technically demanding and relies heavily on precise surgical technique and preoperative planning. Proper glenoid component sizing plays a crucial role for successful shoulder arthroplasty. In this study, we measured the glenoid size together with penetration depth using three-dimensional computed tomography (3D-CT). From January 2010 to January 2011, 38 patients, including males and females, without evidence of a pathological glenoid, were enrolled for this study. CT images were taken and subsequently reconstructed in 3D images. The height of the glenoid was measured and the width was measured at five different levels (H1-H5). Axial images were taken at each level, with the anteroposterior (AP) glenoid diameter divided into eight areas (W1-W7). The penetration depth between the near and far cortices (thickness) at points W1-W7 was also measured. The overall mean height of the glenoid was 37.67 ± 4.09 mm. The width of the glenoid was the greatest at the distal 4/5th point and it was the least at the proximal 1/5th point. The penetration depth of the glenoid increased as the reference point progressed in the posterior direction, which was at the 5/7th point from the anterior margin. The measurement was greatest at the W4 point at the H1 level, but the W5 point was greatest at all other levels. On the basis of this study, the posterior and inferior parts of the glenoid are thinner than the anterior and superior parts. Thus, caution must be taken when inserting screws into the posteroinferior parts, where the glenoid is thinner than 15 mm, especially in females, to avoid penetration of the far cortex.
肩关节置换术技术要求高，严重依赖精确的手术技术和术前规划。合适的肩胛盂假体尺寸对于肩关节置换术的成功至关重要。在这项研究中，我们使用三维计算机断层扫描（3D-CT）测量了肩胛盂的大小和穿透深度。从 2010 年 1 月至 2011 年 1 月，我们纳入了 38 名患者（包括男性和女性），这些患者没有病理肩胛盂的证据。拍摄 CT 图像并随后重建为 3D 图像。测量肩胛盂的高度和宽度，并在五个不同水平（H1-H5）处测量宽度。在每个水平处拍摄轴向图像，将前后（AP）肩胛盂直径分为八个区域（W1-W7）。还测量了在 W1-W7 点之间近皮质和远皮质之间的穿透深度（厚度）。肩胛盂的总平均高度为 37.67±4.09mm。肩胛盂的宽度在远侧 4/5 处最大，在近侧 1/5 处最小。随着参考点向后方推进，肩胛盂的穿透深度增加，该点位于前缘的 5/7 处。在 H1 水平的 W4 点处测量值最大，但在所有其他水平处，W5 点最大。基于这项研究，肩胛盂的后下部比前上部更薄。因此，在肩胛盂厚度小于 15mm（尤其是女性）的后下部插入螺钉时必须小心，以避免穿透远皮质。
