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基于三维 CT 测量的肩盂骨长径形态与复发性肩关节前脱位发生的相关性:病例对照研究。

Glenoid bony morphology along long diameter is associated with the occurrence of recurrent anterior shoulder dislocation: a case-control study based on three-dimensional CT measurements.

机构信息

The School of Medicine, Nankai University, Tianjin, China.

Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, China.

出版信息

Int Orthop. 2022 Aug;46(8):1811-1819. doi: 10.1007/s00264-022-05463-5. Epub 2022 Jun 7.

Abstract

PURPOSE

The purpose of our study is to compare the anatomic parameters of proximal humerus, glenoid, and glenohumeral joint between patients with recurrent anterior shoulder dislocation (RASD) and patients without RASD with the assistance of three-dimensional (3D) CT scans.

METHODS

Sixty patients were included in the study and divided into group RASD and group control. 3D-CT models of shoulder joint for each included patient were reconstructed and multiple anatomic parameters were measured.

RESULTS

There were no statistically significant differences between the two groups in morphological parameters of humerus and glenohumeral joints. Long diameter of glenoid was 3.50 ± 0.34 cm for patients in group RASD and 3.31 ± 0.32 cm in group control (p = 0.039). There was a statistically significant difference in the ratio of long to short diameter of glenoid (p < 0.001). Ratio of humeral head height to glenoid long diameter (Hhh/Gld) was 1.02 ± 0.07 in group RASD, significantly lower than 1.09 ± 0.08 in group control (p = 0.001). Longitudinal depth of glenoid was significantly higher in group RASD (p = 0.013).

CONCLUSION

The glenoid morphology along long diameter is closely correlated with the stability of glenohumeral joint, including glenoid long diameter and glenoid longitudinal depth. It is especially noteworthy that the value of Hhh/Gld decreases in patients with RASD. The difference of Hhh/Gld between the two groups reminds us that the correlation of bony structure along long diameter between glenoid and humeral head plays an important role in RASD.

摘要

目的

本研究旨在借助三维(3D)CT 扫描,比较复发性肩关节前脱位(RASD)患者与无 RASD 患者的肱骨近端、肩盂和盂肱关节解剖参数。

方法

共纳入 60 例患者,分为 RASD 组和对照组。对每位纳入患者的肩关节 3D-CT 模型进行重建,并测量多个解剖参数。

结果

两组患者肱骨和盂肱关节形态学参数无统计学差异。RASD 组患者的肩盂长径为 3.50±0.34cm,对照组为 3.31±0.32cm(p=0.039)。肩盂长径与短径比值有统计学差异(p<0.001)。RASD 组肱骨头高度与肩盂长径比值(Hhh/Gld)为 1.02±0.07,显著低于对照组的 1.09±0.08(p=0.001)。RASD 组肩盂纵向深度显著较高(p=0.013)。

结论

肩盂长径方向的形态与盂肱关节稳定性密切相关,包括肩盂长径和肩盂纵向深度。值得注意的是,RASD 患者的 Hhh/Gld 值降低。两组间 Hhh/Gld 的差异提示我们,肩盂和肱骨头长径方向的骨性结构之间的相关性在 RASD 中起着重要作用。

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