Upadhyay Gunjan, Jain Himanshu, Munde Santosh Laxman Rao, Arya Ashish, Agarwal Sashank
Department of Orthopaedics, MMIMISR, Ambala, Haryana, India.
Department of Orthopaedics, Kalpana Chawla Government Medical College, Karnal, Haryana, India.
J Orthop Case Rep. 2024 Oct;14(10):270-274. doi: 10.13107/jocr.2024.v14.i10.4886.
Glenoid mass issues have been extensively published in the recent literature. The controversy arose from our need to compare and obtain the appropriate implant size for reverse shoulder arthroplasty patients. Some well-known authors and surgeons say that Indian patients have a smaller glenoid than their Western friends and patients. Therefore, we decided to examine the glenoid size obtained on a computed tomography (CT) scan and the size obtained on a cadaver, preferably the same cadaver in tertiary care medical school. Necessary permissions were obtained from the relatives of the cadaver, the ethical board, the anatomy department, and the radiology department.
We evaluated 3D CT scans of 100 patients from our medical college during the global pandemic. Of these, we evaluated only 12 patients whose families agreed to postmortem studies and CT scans. Our research focuses on the shoulder of non-orthopedic diseases conducted at KCGMCH and measured the glenoid height, width, and version using a commercially available computer.
The mean age of the patients was 38.5 (range 19-59). The mean glenoid height was 33.8 ± 3.2 mm, maximum glenoid width was 24.3 ± 2.2 mm. The mean glenoid version is 3.48 ± 4 retrospectively. The glenoid width appears to be 23-25 mm on CT scan film, which is similar to cadaver studies.
The findings from the cadaver study indicate that the average glenoid size is smaller in the Indian demographic when compared to CT scans. Glenoid width is less in one subset of the population, especially female patients than of the average population than Westerners. However, our studies are limited by the small size of the population and a larger study is recommended in our institution in the future. A better understanding of this glenoid size could help us design a smaller glenoid plate plan, especially for patients in the Indian subcontinent.
近期文献中对肩胛盂大小问题已有广泛报道。争议源于我们需要为反肩关节置换术患者比较并获取合适的植入物尺寸。一些知名作者和外科医生表示,印度患者的肩胛盂比西方患者的更小。因此,我们决定研究在计算机断层扫描(CT)上获得的肩胛盂尺寸以及在尸体上获得的尺寸,最好是在三级医疗医学院的同一具尸体上。我们已获得尸体亲属、伦理委员会、解剖学系和放射科的必要许可。
在全球大流行期间,我们评估了我校医学院100例患者的三维CT扫描结果。其中,我们仅评估了12例其家属同意进行尸检研究和CT扫描的患者。我们的研究聚焦于在KCGMCH进行的非骨科疾病患者的肩部情况,并使用商用计算机测量肩胛盂的高度、宽度和版本。
患者的平均年龄为38.5岁(范围19 - 59岁)。肩胛盂平均高度为33.8±3.2毫米,最大肩胛盂宽度为24.3±2.2毫米。回顾性分析,肩胛盂平均版本为3.48±4。在CT扫描胶片上,肩胛盂宽度似乎为23 - 25毫米,这与尸体研究结果相似。
尸体研究结果表明,与CT扫描相比,印度人群的平均肩胛盂尺寸较小。在一部分人群中,尤其是女性患者,肩胛盂宽度小于平均人群,也小于西方人。然而,我们的研究受限于样本量小,建议我校未来开展更大规模的研究。更好地了解这种肩胛盂尺寸有助于我们设计更小的肩胛盂钢板方案,特别是针对印度次大陆的患者。