精英上肢运动员的内上髁形态：使用三维计算机模拟技术的深入观察。
Medial Epicondyle Morphology in Elite Overhead Athletes: A Closer Look Using 3-Dimensional Computer Simulation.
机构信息
Department of Orthopaedic Surgery, Columbia Presbyterian Medical Center, New York, New York, USA.
Kaiser Permanente Medical System, San Diego, California, USA.
出版信息
Orthop J Sports Med. 2014 Jan 7;2(1):2325967113517211. doi: 10.1177/2325967113517211. eCollection 2014 Jan.
BACKGROUND
Prior studies have attempted to determine morphological characteristics of the medial epicondyle in overhead athletes, but no study has reported on precise quantitative differences between elite overhead athletes and control patients.
HYPOTHESIS
The medial epicondyle in overhead athletes is larger in volume than those of control patients.
STUDY DESIGN
Cross-sectional study; Level of evidence, 3.
METHODS
Computer simulation modeling from advanced (computed tomography/magnetic resonance imaging) imaging of the elbow of 37 patients (22 elite overhead athletes, 15 control patients) was performed to provide detailed assessment of the morphological characteristics of the medial epicondyle. Several quantitative metrics regarding the medial epicondyle were measured and compared across both cohorts, including that of epicondyle width (medial-lateral), height (superior-inferior), thickness (anterior-posterior), volume, percentage cortical volume, and morphology of the inferior slope of the epicondyle.
RESULTS
The medial epicondyle in overhead athletes was significantly larger than that found in nonathlete controls (4976 vs 3682 mm(3); P = .001). There was no significance between the 2 cohorts in medial-lateral width (16.8 vs 16.6 mm; P = .68), but there was a difference in anterior-posterior thickness (16.96 vs 14.40 mm; P = .001) and superior-inferior height (39.55 vs 35.86 mm; P = .09) in athletes versus controls. The epicondyle volume was 97.9% cortical bone in athletes compared with 82.3% in control patients (P < .001). There were no differences in the morphology of the inferior epicondyle slope between the 2 groups.
CONCLUSION
The medial epicondyle in overhead athletes is larger in volume and anterior-posterior thickness than those of control patients. Additionally, the medial epicondyle is comprised nearly entirely of cortical bone in overhead athletes.
CLINICAL RELEVANCE
These quantitative findings support the theory of adaptive remodeling in skeletally immature overhead athletes.
背景
先前的研究试图确定投掷运动员的内上髁的形态特征，但尚无研究报告投掷运动员和对照组患者之间的精确定量差异。
假设
投掷运动员的内上髁体积大于对照组患者。
研究设计
横断面研究；证据水平，3 级。
方法
对 37 例患者（22 例优秀投掷运动员，15 例对照组患者）肘部的高级（计算机断层扫描/磁共振成像）成像进行计算机模拟建模，以对内上髁的形态特征进行详细评估。测量并比较了两组患者的内上髁的几个定量指标，包括内上髁宽度（内外侧）、高度（上下）、厚度（前后）、体积、皮质体积百分比以及内上髁下斜面的形态。
结果
投掷运动员的内上髁明显大于非运动员对照组（4976 比 3682mm³；P =.001）。两组患者的内上髁内外侧宽度无差异（16.8 比 16.6mm；P =.68），但前后侧厚度（16.96 比 14.40mm；P =.001）和上下高度（39.55 比 35.86mm；P =.09）存在差异。运动员的内上髁体积中有 97.9%为皮质骨，而对照组患者中为 82.3%（P <.001）。两组患者的内上髁下斜面形态无差异。
结论
投掷运动员的内上髁体积和前后侧厚度大于对照组患者。此外，投掷运动员的内上髁几乎完全由皮质骨组成。
临床相关性
这些定量发现支持了在未成熟投掷运动员中存在适应性重塑的理论。
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