Syed Usman Ali Mohammed, Davis Daniel E, Ko Jia-Wei, Lee Brian K, Huttman Daniel, Seidl Adam, Deirmengian Carl, Abboud Joseph A
Orthopedics. 2017 May 1;40(3):155-160. doi: 10.3928/01477447-20170109-03. Epub 2017 Jan 11.
This study explored the radiographic and anatomical differences in normal shoulders between men and women, as well as factors such as race, height, weight, and age. A total of 205 patients with documented normal anatomical radiographs comprised the study population. Five fellowship-trained orthopedic surgeon reviewers measured head diameter, humeral head size, head to tuberosity distance, greater tuberosity width, neck-shaft angle, surface-arc angle, glenoid neck length, and distance from the lateral acromion process to the greater tuberosity on anteroposterior radiographs with the shoulder in external rotation. After the reviewers identified and marked defined anatomical landmarks, a comprehensive automated calculator was used to compute all parameters. Between men and women, head diameter (P<.001), humeral head size (P<.001), greater tuberosity width (P<.001), distance from the lateral acromion process to the greater tuberosity (P<.001), and glenoid neck length (P<.001) were significantly different, whereas race was not significantly different for any anatomical parameter. Using Spearman's rho, there was a strong correlation between head diameter/humeral head height and height (r=0.77/r=0.68), weight (r =0.62), and greater tuberosity width (r=0.66/r= 0.61); there also was a strong negative correlation between head to tuberosity distance and neck-shaft angle (r=-0.80). This study demonstrated precisely defined proximal humeral anatomical relationships and sizes using an advanced standardized imaging software program. With these data, orthopedic surgeons and implant designers can better understand the anatomy and glenohumeral relationships to re-create when performing total shoulder arthroplasty. [Orthopedics. 2017; 40(3):155-160.].
本研究探讨了男性和女性正常肩部的影像学及解剖学差异，以及种族、身高、体重和年龄等因素。共有205例具有正常解剖学X线片记录的患者纳入研究人群。5名接受过专科培训的骨科医生审阅者在肩关节外旋的前后位X线片上测量了肱骨头直径、肱骨头大小、头至结节距离、大结节宽度、颈干角、表面弧度角、关节盂颈长度以及从肩峰外侧突到大结节的距离。在审阅者识别并标记出明确的解剖标志点后，使用一个综合自动计算器来计算所有参数。男性和女性之间，肱骨头直径（P<0.001）、肱骨头大小（P<0.001）、大结节宽度（P<0.001）、从肩峰外侧突到大结节的距离（P<0.001）和关节盂颈长度（P<0.001）存在显著差异，而种族在任何解剖学参数上均无显著差异。使用Spearman等级相关分析，肱骨头直径/肱骨头高度与身高（r=0.77/r=0.68）、体重（r =0.62）和大结节宽度（r=0.66/r= 0.61）之间存在强相关性；头至结节距离与颈干角之间也存在强负相关性（r=-0.80）。本研究使用先进的标准化成像软件程序精确界定了肱骨近端的解剖关系和尺寸。有了这些数据，骨科医生和植入物设计师在进行全肩关节置换术时能够更好地理解解剖结构和盂肱关系，以便进行重建。[《骨科》。2017年；40(3):155 - 160。]
