Kumari Neelam, Subhash Abhijeet, Panchal Padamjeet
Anatomy, All India Institute of Medical Sciences, Patna, Patna, IND.
Orthopaedics, Indira Gandhi Institute of Medical Sciences, Patna, Patna, IND.
Cureus. 2024 Jul 23;16(7):e65189. doi: 10.7759/cureus.65189. eCollection 2024 Jul.
The glenopolar angle (GPA), usually ranges from 30° to 45°. GPA measures the tilt of the plane of the glenoid cavity in relation to the axis of the body of the scapula passing from the superior pole of the glenoid cavity to the inferior angle of the scapula. It is essential to assess the results of surgeries for dislocated shoulders. Worse long-term outcomes can arise from glenoid misalignment in scapular neck fractures. When evaluating prognosis and planning therapy for shoulder injuries including scapular fractures, GPA assessment is essential. Still, there is a dearth of data on the normal range of GPA and its contributing elements, which calls for more study. The purpose of this study is to determine typical GPA values by utilizing radiographs and a sizable sample of scapular bone specimens.
In this study, the GPA was assessed in 50 chest radiographs of anteroposterior (AP) view and Neer's view of individuals as well as 100 dried scapulae of any gender. The mean GPA obtained using the various methods was then statistically compared.
All scapulae had an average GPA of 42.6°. Twenty-nine scapulae had GPA observations higher than 45°, with an average of 47.2°. Twenty-seven scapulae had GPA measurements below 40°, averaging 37.3°. Right-sided 62 scapulae with an average GPA of 43.1° were present. Thirty-eight of left-side scapulae had a GPA of 41.7° on average. It was determined that the 1.6° mean difference in GPA between the two groups was not statistically significant. The Kolmogorov-Smirnov test verified that the GPA data had a normal distribution. The homogeneity of variances across various measuring techniques was confirmed using Levene's test. The average GPA measured using the dry scapula approach was 42.6°, the average GPA measured using the AP view was 39.8°, and the average GPA measured using the Neer I view was 42.3°. The GPA means from these three approaches differed considerably (p=0.0014) according to a one-way Analysis of Variance (ANOVA). Fisher's least significant difference post hoc testing showed that the scapular bone specimens and the Neer I view revealed significantly higher GPA values than AP shoulder radiographs. The GPA values obtained from the osteological group and the Neer I perspective had a mean difference of 0.21°, which was practically identical and suggested that there was no statistically significant difference between these approaches.
In order to diagnose and treat a variety of shoulder joint diseases, this study estimates the normal values of scapular GPA. Furthermore, it offers support for improved implant design in the context of Indian shoulder joint replacement and repair. Using every measurement technique, the GPA values on the right and left sides did not differ significantly. GPA results from various measuring methods varied significantly, which emphasizes the significance of methodological consistency in clinical and research settings.
肩胛盂极角（GPA）通常在30°至45°之间。GPA测量肩胛盂平面相对于从肩胛盂上极至肩胛下角的肩胛骨干轴线的倾斜度。评估肩关节脱位手术的结果至关重要。肩胛颈骨折时肩胛盂排列不齐可能导致更差的长期预后。在评估包括肩胛骨折在内的肩部损伤的预后和规划治疗方案时，GPA评估至关重要。然而，关于GPA的正常范围及其影响因素的数据仍然匮乏，这需要更多的研究。本研究的目的是利用X线片和大量肩胛骨骼标本确定典型的GPA值。
在本研究中，对50例个体的前后位（AP）胸片和Neer位片以及100具不同性别的干燥肩胛骨进行了GPA评估。然后对使用不同方法获得的平均GPA进行统计学比较。
所有肩胛骨的平均GPA为42.6°。29具肩胛骨的GPA观察值高于45°，平均为47.2°。27具肩胛骨的GPA测量值低于40°，平均为?37.3°。右侧有62具肩胛骨，平均GPA为43.1°。左侧38具肩胛骨的GPA平均为41.7°。两组之间GPA的平均差异1.6°无统计学意义。Kolmogorov-Smirnov检验证实GPA数据呈正态分布。使用Levene检验确认了不同测量技术之间方差的齐性。使用干燥肩胛骨方法测量的平均GPA为42.6°，使用AP位片测量的平均GPA为39.8°，使用Neer I位片测量的平均GPA为42.3°。根据单因素方差分析（ANOVA），这三种方法的GPA均值差异显著（p = 0.0014）。Fisher最小显著差异事后检验表明，肩胛骨骼标本和Neer I位片显示的GPA值明显高于AP位肩部X线片。从骨骼学组和Neer I位获得的GPA值平均差异为0.21°，几乎相同，表明这些方法之间无统计学显著差异。
为了诊断和治疗各种肩关节疾病，本研究估计了肩胛GPA的正常值。此外，它为印度肩关节置换和修复中改进植入物设计提供了支持。使用每种测量技术，左右两侧的GPA值无显著差异。不同测量方法的GPA结果差异显著，这强调了临床和研究环境中方法一致性的重要性。
