Lind Paige M, Pearl Michael L, Alter Katharine E, Forrest Euan A, Sheehan Frances T
The Department of Rehabilitation Medicine, NIH, Bethesda, Maryland, USA.
Cedars-Sinai Medical Center, Los Angeles, California, USA.
J Orthop Res. 2025 Jul;43(7):1230-1238. doi: 10.1002/jor.26081. Epub 2025 Apr 4.
A quantitative understanding of humeral morphology through the arc of pediatric development is crucial in optimizing the treatment of pediatric shoulder-related orthopedic disorders and athletic overuse injuries. However, data regarding modern normative humeral development are not available. Thus, the aim of this study is to derive biomechanically relevant humeral size and shape measures from a pediatric cohort spanning infancy to adulthood (age 0.6-18.8 years, n = 52). Three-dimensional models were generated by segmenting axial MR images from typically developing, dominant-side humeri. Quadratic regression defined the relationship between each parameter and age. In a sub-cohort, we compared humeral morphological parameters between dominant and nondominant humeri from the same child. Children exhibited a pattern of steady growth, anteversion, and declination throughout development that gradually tapered off toward adulthood. Size measurements had the strongest regressions with age (head diameter: R = 0.908; humeral length: R = 0.960; epicondylar width: R = 0.889, p < 0.001). Version was more variable and less strongly related to age (R = 0.238, p < 0.001), whereas inclination demonstrated the weakest relationship with age (R = 0.128, p < 0.05). The shallow curve fits indicated that there is not a single age where adult values were attained. In the sub-cohort analysis, the data from the right and left limbs were no different and correlated, supporting the use of the contralateral limb as a comparator when unilateral pathology is present, if the contralateral parameters fall within the normative range. Our data set provides a unique asset for pediatric clinical interventional planning as it provides the only current in vivo humeral development measures throughout the arc of childhood.
通过小儿发育阶段全面了解肱骨形态，对于优化小儿肩部相关骨科疾病和运动过度使用损伤的治疗至关重要。然而，目前尚无关于现代肱骨正常发育的数据。因此，本研究的目的是从一个涵盖婴儿期至成年期（年龄0.6 - 18.8岁，n = 52）的小儿队列中得出与生物力学相关的肱骨大小和形状测量值。通过分割典型发育的优势侧肱骨的轴向磁共振图像生成三维模型。二次回归确定了每个参数与年龄之间的关系。在一个亚队列中，我们比较了同一儿童优势侧和非优势侧肱骨的形态学参数。儿童在整个发育过程中呈现出稳定生长、前倾和倾斜的模式，成年后逐渐趋于平稳。尺寸测量与年龄的回归关系最强（头直径：R = 0.908；肱骨长度：R = 0.960；髁上宽度：R = 0.889，p < 0.001）。前倾角度变化更大，与年龄的相关性较弱（R = 0.238，p < 0.001），而倾斜度与年龄的关系最弱（R = 0.128，p < 0.05）。浅曲线拟合表明，不存在一个能达到成人值的单一年龄。在亚队列分析中，左右肢体的数据没有差异且具有相关性，这支持在存在单侧病变且对侧参数在正常范围内时，将对侧肢体用作比较对象。我们的数据集为小儿临床干预计划提供了独特的资源，因为它提供了目前唯一的整个儿童期肱骨发育的体内测量数据。
