Tan Jun, Lee Hyun-Joo, Aminata Iman, Chun Jae-Myeung, Kekatpure Aashay L, Jeon In-Ho
Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China.
Department of Orthopedic Surgery, Kyungpook National University Hospital, Daegu, Republic of Korea.
Injury. 2015 Apr;46(4):666-70. doi: 10.1016/j.injury.2014.10.059. Epub 2014 Nov 1.
There is no definite radiographic landmark in plain radiographs for proximal humeral rotation, which is an important parameter for avoiding rotational malalignment during fracture fixation. Here, we used radiographic images of cadaveric humeri to determine whether the landmark of the crest of lesser tuberosity (CoLT) in plain radiographs could be used to determine humeral rotation.
Twenty adult cadaveric humeri were collected and seven consecutive radiographic anteroposterior views (45°, 30°, 15° internal rotation; neutral rotation; and 15°, 30°, 45° external rotation) were obtained for each specimen.
The proportional distance (PD) of the CoLT landmark relative to the humeral head was measured and analysed. The mean PDs of the CoLT landmark were 10.2%, 17.9%, 25.6%, 35.9%, 53.4%, and 62.9% of the diameter of the humeral head, corresponding to 45°, 30°, and 15° external rotation, neutral rotation, and 15° and 30° internal rotation, respectively. We found significant differences in the mean PDs with humeral rotation.
The projection of the CoLT in plain radiographs can be used as an important landmark to assess humeral head rotation and will be a useful landmark for rotational control of fracture fixation.
在普通X线片中，对于肱骨近端旋转没有明确的影像学标志，而肱骨近端旋转是骨折固定过程中避免旋转畸形的一个重要参数。在此，我们使用尸体肱骨的影像学图像来确定普通X线片中较小结节嵴（CoLT）的标志是否可用于确定肱骨旋转。
收集20具成年尸体肱骨，对每个标本获取连续7个前后位X线片视图（内旋45°、30°、15°；中立旋转；外旋15°、30°、45°）。
测量并分析CoLT标志相对于肱骨头的比例距离（PD）。CoLT标志的平均PD分别为肱骨头直径的10.2%、17.9%、25.6%、35.9%、53.4%和62.9%，分别对应外旋45°、30°和15°、中立旋转以及内旋15°和30°。我们发现平均PD随肱骨旋转存在显著差异。
普通X线片中CoLT的投影可作为评估肱骨头旋转的重要标志，并且将是骨折固定旋转控制的有用标志。
