Faculty of Medicine, Université de Montréal, 2900 Boulevard Edouard-Montpetit, Montreal, QC, H3T 1J4, Canada.
Department of Orthopaedics and Traumatology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
Surg Radiol Anat. 2020 Aug;42(8):895-901. doi: 10.1007/s00276-020-02492-w. Epub 2020 May 13.
Glenoid bony lesions play a role in approximately half of anterior shoulder instability cases. The purpose of this study is to see if the anatomy of the coracoid affects the location of glenoid rim defects. We hypothesized that a prominent coracoid (lower and lateral) would be more likely to cause an anterior-inferior glenoid lesion, and a less prominent coracoid more prone to cause an anterior lesion. The null hypothesis being the absence of correlation.
Fifty-one shoulder CT-scans from a prospective database, with 3D reconstruction, were analyzed. The position of glenoid lesions was identified using the validated clock method, identifying the beginning and end time. The size of bony glenoid defects was calculated using the validated glenoid ratio method. The position of the coracoid tip was measured in three orthogonal planes.
Analysis included 25 right shoulders and 26 left shoulders in seven females and 41 males. The vertical position of the coracoid tip relative to the top of the glenoid was highly correlated to the location of the glenoid defect on the profile view (r = -0.625; 95% CI 0.423-0.768; p = 0.001). Thus, higher coracoids were associated with anterior lesions, while lower coracoids were associated with anterior-inferior lesions. A more laterally prominent coracoid was also correlated with anterior-inferior lesions (r = 0.433; 95% CI 0.179-0.633; p = 0.002).
This study shows that coracoid anatomy affects the location of bony Bankart defects in anterior shoulder instability. Lower and laterally prominent coracoids are associated with anterior-inferior lesions. This variation in anatomy should be considered during pre-op planning for surgeries involving bone graft.
Level 4 basic science.
肩盂骨病变在大约一半的前肩不稳定病例中起作用。本研究的目的是观察喙突的解剖结构是否会影响肩盂缘缺损的位置。我们假设，突出的喙突（更低和更外侧）更有可能导致前下盂骨损伤，而不那么突出的喙突更倾向于导致前盂骨损伤。零假设是缺乏相关性。
对来自前瞻性数据库的 51 例肩部 CT 扫描进行了分析，这些扫描进行了 3D 重建。使用经过验证的时钟方法确定肩盂病变的位置，确定起始和结束时间。使用经过验证的肩盂比率方法计算骨肩盂缺损的大小。在三个正交平面上测量喙突尖端的位置。
分析包括 7 名女性和 41 名男性的 25 个右侧肩部和 26 个左侧肩部。喙突尖端相对于肩盂顶部的垂直位置与轮廓视图上肩盂缺损的位置高度相关（r= -0.625；95%CI 0.423-0.768；p=0.001）。因此，较高的喙突与前盂骨损伤相关，而较低的喙突与前下盂骨损伤相关。喙突更突出于外侧也与前下盂骨损伤相关（r=0.433；95%CI 0.179-0.633；p=0.002）。
本研究表明，喙突解剖结构影响前肩不稳定中骨 Bankart 缺损的位置。较低和更外侧突出的喙突与前下盂骨损伤相关。在涉及骨移植的手术前规划中，应考虑这种解剖结构的变化。
4 级基础科学。
