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在肩关节置换术中,能否使用对侧肩胛骨作为可靠的模板来重建被侵蚀的肩胛骨?

Can the contralateral scapula be used as a reliable template to reconstruct the eroded scapula during shoulder arthroplasty?

机构信息

Department of Development and Regeneration, KU Leuven, Division of Orthopaedics, Institute for Orthopaedic Research and Training (IORT), Pellenberg, Belgium.

Department of Biomechanics, KU Leuven, Leuven, Belgium; Materialise NV, Leuven, Belgium.

出版信息

J Shoulder Elbow Surg. 2018 Jun;27(6):1133-1138. doi: 10.1016/j.jse.2017.12.024. Epub 2018 Feb 23.

Abstract

HYPOTHESIS

The contralateral scapula can be used as a reliable template to determine scapular offset, glenoid inclination, and version of the native scapula in view of reconstructing pathologic scapulae.

METHODS

Three-dimensional measurements of scapular offset, inclination, and version were performed using data from a set of 50 bilateral computed tomography scans of full scapulae to determine direct side-to-side differences.

RESULTS

The scapula pairs had a mean bilateral difference of 2 mm in offset, 2° in inclination, and 2° in version. Ninety percent of the scapula pairs showed an offset difference smaller than 3 mm. In 96% and 94% of the scapula pairs, the inclination difference and version difference, respectively, were smaller than 5°. The maximum bilateral difference for offset, inclination, and version was 6 mm, 6°, and 8°, respectively.

DISCUSSION AND CONCLUSION

The anatomic parameters of scapular offset, glenoid inclination, and version are quite symmetrical and fall into the currently technically feasible accuracy of shoulder arthroplasty implantation. The healthy scapula can be used as a template to guide the reconstruction of the glenoid during shoulder arthroplasty planning in the case of unilateral advanced arthropathy.

摘要

假设

鉴于病理性肩胛骨的重建,对肩胛骨进行重建时,可将对侧肩胛骨用作确定肩胛骨偏移量、肩胛盂倾斜度和肩胛骨版本的可靠模板。

方法

使用 50 对双侧全肩胛骨计算机断层扫描数据进行三维测量,以确定肩胛骨的直接侧间差异,从而得出肩胛骨偏移量、倾斜度和版本的测量值。

结果

肩胛骨对的平均双侧差异为偏移量 2mm、倾斜度 2°和版本 2°。90%的肩胛骨对的偏移量差异小于 3mm。96%和 94%的肩胛骨对的倾斜度和版本差异分别小于 5°。偏移量、倾斜度和版本的最大双侧差异分别为 6mm、6°和 8°。

讨论与结论

肩胛骨偏移量、肩胛盂倾斜度和版本的解剖参数非常对称,并且落入目前肩部关节置换术植入术的技术可行精度范围内。在单侧晚期关节炎的情况下,在进行肩部关节置换术规划时,健康的肩胛骨可作为模板来指导肩胛盂的重建。

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