Vlachopoulos Lazaros, Dünner Celestine, Gass Tobias, Graf Matthias, Goksel Orcun, Gerber Christian, Székely Gábor, Fürnstahl Philipp
Computer Assisted Research and Development Group, Balgrist University Hospital, University of Zurich, Zürich, Switzerland; Computer Vision Laboratory, ETH Zürich, Switzerland.
Computer Vision Laboratory, ETH Zürich, Switzerland.
J Shoulder Elbow Surg. 2016 Feb;25(2):e38-48. doi: 10.1016/j.jse.2015.07.027. Epub 2015 Oct 4.
In the presence of severe osteoarthritis, osteonecrosis, or proximal humeral fracture, the contralateral humerus may serve as a template for the 3-dimensional (3D) preoperative planning of reconstructive surgery. The purpose of this study was to develop algorithms for performing 3D measurements of the humeral anatomy and further to assess side-to-side (bilateral) differences in humeral head retrotorsion, humeral head inclination, humeral length, and humeral head radius and height.
The 3D models of 140 paired humeri (70 cadavers) were extracted from computed tomographic data. Geometric characteristics quantifying the humeral anatomy in 3D were determined in a semiautomatic fashion using the developed computer algorithms. The results between the sides were compared for evaluating bilateral differences.
The mean bilateral difference of the humeral retrotorsion angle was 6.7° (standard deviation [SD], 5.7°; range, -15.1° to 24.0°; P = .063); the mean side difference of the humeral head inclination angle was 2.3° (SD, 1.8°; range, -5.1° to 8.4°; P = .12). The side difference in humeral length (mean, 2.9 mm; SD, 2.5 mm; range, -8.7 mm to 10.1 mm; P = .04) was significant. The mean side difference in the head sphere radius was 0.5 mm (SD, 0.6 mm; range, -3.2 mm to 2.2 mm; P = .76), and the mean side difference in humeral head height was 0.8 mm (SD, 0.6 mm; range, -2.4 mm to 2.4 mm; P = .44).
The contralateral anatomy may serve as a reliable reconstruction template for humeral length, humeral head radius, and humeral head height if it is analyzed with 3D algorithms. In contrast, determining humeral head retrotorsion and humeral head inclination from the contralateral anatomy may be more prone to error.
在存在严重骨关节炎、骨坏死或肱骨近端骨折的情况下，对侧肱骨可作为重建手术三维（3D）术前规划的模板。本研究的目的是开发用于对肱骨解剖结构进行3D测量的算法，并进一步评估肱骨头后倾、肱骨头倾斜、肱骨长度以及肱骨头半径和高度的左右（双侧）差异。
从计算机断层扫描数据中提取140对配对肱骨（70具尸体）的3D模型。使用开发的计算机算法以半自动方式确定量化肱骨3D解剖结构的几何特征。比较两侧的结果以评估双侧差异。
肱骨头后倾角度的平均双侧差异为6.7°（标准差[SD]，5.7°；范围，-15.1°至24.0°；P = 0.063）；肱骨头倾斜角度的平均侧别差异为2.3°（SD，1.8°；范围，-5.1°至8.4°；P = 0.12）。肱骨长度的侧别差异显著（平均，2.9 mm；SD，2.5 mm；范围，-8.7 mm至10.1 mm；P = 0.04）。头球半径的平均侧别差异为0.5 mm（SD，0.6 mm；范围，-3.2 mm至2.2 mm；P = 0.76），肱骨头高度的平均侧别差异为0.8 mm（SD，0.6 mm；范围，-2.4 mm至2.4 mm；P = 0.44）。
如果使用3D算法进行分析，对侧解剖结构可作为肱骨长度、肱骨头半径和肱骨头高度可靠的重建模板。相比之下，从对侧解剖结构确定肱骨头后倾和肱骨头倾斜可能更容易出错。
