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肱骨近端骨折中肱骨头成角与肱骨头内骨缺损之间的关系。

The relationship between humeral head angulation and bone void within the humeral head in proximal humerus fractures.

作者信息

Ju Jiabao, Zhou Yongwen, Chen Liang, Ma Mingtai, Zhang Yichong, Ding Zhentao, Li Renbin, Chen Jianhai

机构信息

Department of Trauma & Orthopedics, Peking University People's Hospital, Beijing, China.

Department of Orthopedics, Affiliated Hospital of Panzhihua University, Sichuan, China.

出版信息

Heliyon. 2024 Aug 10;10(16):e36145. doi: 10.1016/j.heliyon.2024.e36145. eCollection 2024 Aug 30.

DOI:10.1016/j.heliyon.2024.e36145
PMID:39229528
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11369451/
Abstract

BACKGROUND

The variability of humeral head angulation in proximal humerus fractures (PHFs) is a noteworthy observation. The purpose of this study was to investigate the potential association between humeral head angulation and bone void within the humeral head in PHFs.

METHODS

We used the reconstruction function in Mimics software to generate three-dimensional models of fractures. Bony landmarks were employed to accurately define the calcar and humeral head zone. Boolean subtraction was performed to calculate the volume of head bone void.

RESULTS

The cohort consisted of 60 (74.1 %) varus, 21 (25.9 %) valgus, and 23 (22.1 %) neutral angulated PHFs. The mean percentage of humeral head bone void was 38.5 ± 17.8 in varus, 36.3 ± 15.7 in valgus, and 30.1 ± 10.6 in neutral angulated PHFs. A significant difference was observed between the varus and neutral groups (P = 0.035). In addition, an analysis of humeral head bone void was conducted among patients aged over 65 years old, revealing a mean percentage of 42.7 ± 16.4 in varus (27 cases), 34.8 ± 14.5 in valgus (13 cases), and 28.1 ± 11.8 in neutral (8 cases) angulated PHFs. The difference between the varus and neutral groups was also significant (P = 0.023).

CONCLUSION

All types of angulation patterns exhibited humeral head bone void to some extent, with the varus-displaced PHFs demonstrating more obvious defects in comparison to the neutral angulated type.

摘要

背景

肱骨近端骨折（PHFs）中肱骨头成角的变异性是一个值得关注的现象。本研究的目的是探讨PHFs中肱骨头成角与肱骨头内骨缺损之间的潜在关联。

方法

我们使用Mimics软件中的重建功能生成骨折的三维模型。采用骨性标志精确界定肱骨距和肱骨头区域。通过布尔减法计算肱骨头骨缺损的体积。

结果

该队列包括60例（74.1%）内翻、21例（25.9%）外翻和23例（22.1%）中立位成角的PHFs。内翻位PHFs肱骨头骨缺损的平均百分比为38.5±17.8，外翻位为36.3±15.7，中立位成角的PHFs为30.1±10.6。内翻组与中立组之间存在显著差异（P = 0.035）。此外，对65岁以上患者的肱骨头骨缺损进行分析，结果显示内翻位（27例）平均百分比为42.7±16.4，外翻位（13例）为34.8±14.5，中立位（8例）成角的PHFs为28.1±11.8。内翻组与中立组之间的差异也具有显著性（P = 0.023）。

结论

所有类型的成角模式在一定程度上均表现出肱骨头骨缺损，与中立位成角型相比，内翻移位型PHFs的缺损更为明显。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a330/11369451/91170ab12f86/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a330/11369451/cc253f575f92/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a330/11369451/bd9dc19b98c5/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a330/11369451/1afa13bcc4a4/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a330/11369451/3995193e4e49/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a330/11369451/91170ab12f86/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a330/11369451/cc253f575f92/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a330/11369451/bd9dc19b98c5/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a330/11369451/1afa13bcc4a4/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a330/11369451/3995193e4e49/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a330/11369451/91170ab12f86/gr5.jpg

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Fracture Line Morphology of Greater Tuberosity Fragments of Neer Three- and Four-Part Proximal Humerus Fractures.Neer 三部分和四部分肱骨近端骨折中大结节碎片的骨折线形态。
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