Park Se-Jin, Kim Eugene, Jeong Hwa Jae, Lee Jinmyung, Park Shinsuk
Department of Orthopaedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Indian J Orthop. 2012 Nov;46(6):675-9. doi: 10.4103/0019-5413.104210.
Accurate reduction of rotational displacement for transverse or comminute fracture of humeral shaft fracture is difficult during operation. The purpose of this study was to evaluate the reliability of the bicipital groove as a point of reference for the prediction of the rotational state of the humerus on two dimensional images of C-arm image intensifier during operation for humeral shaft fractures.
One hundred subjects, 62 male, 38 female, aged 22-53 years were recruited contralateral bicipital groove on the 45 degrees externally rotational standard anterior-posterior view recorded before surgery. Three observers, watched only contour of bicipital groove in monitor of C-arm image intensification with naked eye without looking at the subject and predicted rotational state of the humerus by comparing the contour of the opposite side of bicipital groove. The angle of discrepancy from real rotational position was then assessed.
The mean (SD), angular discrepancy between the neutral point and the predicted angle was 3.4°(±2.7°). A value within 5° was present in 72% of cases. All observations were within 15°. There was no interobserver variation (P = 0.47). The intraclass correlation coefficient (ICC) was 0.847.
Contour of the bicipital groove on simple radiograph was a useful landmark. Comparing the contour of the bicipital groove in the 45 degrees externally rotational standard view bilaterally, was an effective method for reduction of rotational displacement of the humerus.
肱骨干横行或粉碎性骨折手术中，准确复位旋转位移较为困难。本研究旨在评估在肱骨干骨折手术中，二头肌沟作为肱骨头旋转状态预测参考点在C形臂影像增强器二维图像上的可靠性。
招募100名受试者，年龄22 - 53岁，其中男性62名，女性38名，术前记录45度外旋标准前后位片上的对侧二头肌沟。三名观察者仅通过肉眼观察C形臂影像增强器监视器中二头肌沟的轮廓，不看受试者，通过比较二头肌沟对侧的轮廓预测肱骨头的旋转状态。然后评估与实际旋转位置的角度差异。
中性点与预测角度之间的平均（标准差）角度差异为3.4°（±2.7°）。72%的病例差异值在5°以内。所有观察值均在15°以内。观察者间无差异（P = 0.47）。组内相关系数（ICC）为0.847。
单纯X线片上二头肌沟的轮廓是一个有用的标志。双侧比较45度外旋标准位片上二头肌沟的轮廓，是减少肱骨头旋转位移的有效方法。
