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多层面 2D CT 分析喙突形态及其对 Latarjet 手术移植物大小的影响。

Analysis of the coracoid morphology with multiplanar 2D CT and its effects on the graft size in the Latarjet procedure.

机构信息

Department of Orthopedics and Traumatology, Faculty of Medicine, Namık Kemal University, Tekirdağ, Turkey.

Department of Radiology, Faculty of Medicine, Namık Kemal University, Tekirdağ, Turkey.

出版信息

J Orthop Surg (Hong Kong). 2020 Sep-Dec;28(3):2309499020964602. doi: 10.1177/2309499020964602.

Abstract

PURPOSE

In this study, we aimed to reveal the individual differences regarding the size of the coracoid and their effects on the classical and modified Latarjet procedures.

METHODS

Computed tomography images of 120 patients (mean age: 41.18 ± 12.01 years) without shoulder complaints or shoulder instability were evaluated retrospectively. The glenoid width, the surgical graft length, and the coracoid total length, width, and thickness were measured using the multiplanar reconstruction method on the Sectra Picture Archiving and Communications System (PACS) system. Age, gender, side, the dominant hand, and the height of the patients were recorded and the correlations between them were investigated. On the created hypothetical model, the current size of the coracoid was evaluated to determine what size of glenoid defects it could repair by employing the classical and the modified Latarjet techniques.

RESULTS

There was no significant difference between the right-hand-dominant group and the left-hand-dominant group in terms of coracoid measurement results ( > 0.05). Again, there was no statistically significant difference between the right and the left side regarding the coracoid size ( > 0.05). A positive correlation could be detected only between age and the coracoid width and thickness ( < 0.05). A positive correlation was also found between the glenoid width and the coracoid width and thickness in both shoulders ( < 0.001). Coracoid thickness could fill in the defects that amounted to 40% of the glenoid width, while the coracoid width could fill in for the defects that were 50% of the glenoid width in both genders.

CONCLUSION

Our study showed that hand dominance and side were not effective on the coracoid dimensions. In addition, it has been shown that the coracoid dimensions did not have a significant effect in the choice of Latarjet technique in terms of defect repair and that repair rates of up to 40% could be achieved in glenoid defects with both techniques.

摘要

目的

本研究旨在揭示喙突大小的个体差异及其对经典和改良 Latarjet 手术的影响。

方法

回顾性分析 120 例无肩部不适或肩不稳的患者的计算机断层扫描图像(平均年龄:41.18±12.01 岁)。使用 Sectra Picture Archiving and Communications System(PACS)系统的多平面重建方法测量关节盂宽度、手术移植物长度以及喙突总长度、宽度和厚度。记录患者的年龄、性别、侧别、惯用手和身高,并研究它们之间的相关性。在创建的假设模型上,评估当前喙突的大小,以确定其可以通过经典和改良 Latarjet 技术修复多大的关节盂缺损。

结果

右手优势组和左手优势组的喙突测量结果无显著差异(>0.05)。同样,右侧和左侧喙突大小之间也无统计学差异(>0.05)。仅在年龄与喙突宽度和厚度之间检测到正相关(<0.05)。在双侧肩关节中,还发现关节盂宽度与喙突宽度和厚度之间存在正相关(<0.001)。喙突厚度可以填充相当于关节盂宽度 40%的缺损,而喙突宽度可以填充相当于关节盂宽度 50%的缺损。

结论

本研究表明,手优势和侧别对喙突尺寸没有影响。此外,还表明喙突尺寸在选择 Latarjet 技术时对缺损修复没有显著影响,两种技术都可以修复高达 40%的关节盂缺损。

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