Chen Yi, Qin Mengyang, Pang Long, Guo Bin, Zhang Chunsen, Tang Xin
Department of Orthopedics, Sports Medicine Center, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P. R. China.
Department of Orthopedics, the Fifth People's Hospital of Datong City, Datong Shanxi, 037009, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2024 Dec 15;38(12):1433-1438. doi: 10.7507/1002-1892.202408035.
To investigate the effect of glenohumeral bone structure on anterior shoulder instability by three-dimensional CT reconstruction.
The clinical data of 48 patients with unilateral anterior shoulder dislocation (instability group) and 46 patients without shoulder joint disease (control group) admitted between February 2012 and January 2024 were retrospectively analyzed. There was no significant difference in gender and side between the two groups ( >0.05). The patients were significantly younger in the instability group than in the control group ( <0.05). The glenoid joint morphological parameters such as glenoid height, glenoid width, ratio of glenoid height to width, glenoid inclination, the humeral containing angle, and glenoid version were measured on three-dimensional CT reconstruction of the glenoid. The differences of the above indexes between the two groups were compared, and the differences of the above indexes between the two groups were compared respectively in the male and the female. Random forest model was used to analyze the influencing factors of anterior shoulder instability.
The comparison between the two groups and the comparison between the two groups in the male and the female showed that the ratio of of the instability group glenoid height to width was larger than that of the control group, the glenoid width and humeral containing angle were smaller than those of the control group, and the differences were significant ( <0.05); there was no significant difference in glenoid height, glenoid inclination, and glenoid version between the two groups ( >0.05). The accuracy of the random forest model was 0.84. The results showed that the top four influencing factors of anterior shoulder instability were ratio of glenoid height to width, the humeral containing angle, age, and glenoid width.
Ratio of glenoid height to width and the humeral containing angle are important influencing factors of anterior shoulder instability.
通过三维CT重建研究盂肱关节骨结构对肩关节前向不稳的影响。
回顾性分析2012年2月至2024年1月收治的48例单侧肩关节前脱位患者（不稳组）和46例无肩关节疾病患者（对照组）的临床资料。两组患者在性别和患侧方面无显著差异（>0.05）。不稳组患者年龄显著低于对照组（<0.05）。在盂肱关节三维CT重建图像上测量盂肱关节形态学参数，如盂高度、盂宽度、盂高宽比、盂倾斜角、肱骨包容角和盂扭转角。比较两组上述指标的差异，并分别比较两组男性和女性上述指标的差异。采用随机森林模型分析肩关节前向不稳的影响因素。
两组间及两组男性和女性间比较显示，不稳组盂高宽比大于对照组，盂宽度和肱骨包容角小于对照组，差异有统计学意义（<0.05）；两组间盂高度、盂倾斜角和盂扭转角差异无统计学意义（>0.05）。随机森林模型的准确率为0.84。结果显示，肩关节前向不稳的前四位影响因素为盂高宽比、肱骨包容角、年龄和盂宽度。
盂高宽比和肱骨包容角是肩关节前向不稳的重要影响因素。
