三维立体可视化测量国人肱骨近端解剖学参数

doi:10.13418/j.issn.1001-165x.2022.1.03

中国临床解剖学杂志 ›› 2022, Vol. 40 ›› Issue (1): 10-16.doi: 10.13418/j.issn.1001-165x.2022.1.03

三维立体可视化测量国人肱骨近端解剖学参数

刘蓬然^1,2，申澳¹，吕静¹，陈宇飞¹，袁剑³，廖胜辉⁴，刘立宏¹*

1.中南大学湘雅二医院骨科，长沙 410010； 2.华中科技大学同济医学院附属协和医院骨科，武汉 430022；
3.中南大学湘雅二医院放射科，长沙 410010; 4.中南大学计算机学院，长沙 410083

收稿日期:2021-01-18 出版日期:2022-01-25 发布日期:2022-01-18
通讯作者: 刘立宏，副主任医师，E-mail: drliulh@csu.edu.cn
作者简介:刘蓬然（1994-），男，山东淄博人，在读博士，研究方向:创伤骨科，手显微外科，E-mail：lprlprlprwd@163.com
基金资助:
湖南省自然科学基金(2019JJ40432)；中国科学院上海光源普通课题(2019-SSRF-PT-011011)；中国科学院合肥光源同步辐射装置普通课题（2019-HLS-PT-002299）

The anatomical parameters of proximal humerus in Chinese measured by three-dimensional visualization

Liu Pengran ^1,2, Shen Ao ¹, Lv Jing¹, Chen Yufei¹, Yuan Jian³, Liao Shenghui⁴, Liu Lihong¹*

1.Department of Orthopedics, Second Xiangya Hospital, Central South University, Changsha 410010, China; 2.Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; 3.Department of Radiology, Second Xiangya Hospital, Central South University, Changsha 410010, China; 4. School of Computer Science, Central South University, Changsha 410083, China

Received:2021-01-18 Online:2022-01-25 Published:2022-01-18

摘要/Abstract

摘要： 目的　通过三维立体可视化测量国人肱骨近端骨解剖参数，为手术中骨折端复位、内植物放置及设计匹配我国患者的内植物提供参考。方法　选取2013-2019年肩部外伤患者90例，根据有无肱骨近端骨折诊断设置为骨折组和正常组。使用E-3D数字医疗软件对60例骨折组模拟复位后，测量90例患者肱骨近端骨骼的肱骨头参数、肱骨干髓腔参数、肱骨头干间参数和肱骨头及大、小结节垂直距离参数：肱骨头高度（HH）、肱骨头关节面直径（ASD）、肱骨头关节面曲率半径（ROC）、颈干角（NSA）、向内偏心距（MO）、向后偏心距（PO）、多层面肱骨干髓腔直径（L0、L20、L40）。结果　在冠状面和轴位面上，正常组HH为（15.5±2.0）mm和（15.7±2.3）mm；ASD为（42.0±3.5）mm和（40.0±3.5）mm；ROC为（22.3±2.0）mm和（20.8±1.9）mm；L0为（26.0±3.1）mm和（23.3±2.9）mm；L20为（15.2±2.5）mm和（13.3±2.0）mm；L40为（12.0±2.4）mm和（10.6±2.1）mm；NSA在冠状面角度为（132.1±4.9）°；MO在冠状面距离为（4.2±1.2）mm；PO在矢状面距离为（3.4±1.4）mm。骨折组与正常组测量结果无统计学差异。结论　通过三维立体可视化测量肱骨近端解剖参数的方法精准、可靠；E-3D数字医疗建模软件在骨骼三维重建、骨折块模拟复位、骨骼参数测量功能方面具备较高的准确性和可信度。

关键词: , 肱骨, 　三维重建, 　解剖参数, 　测量

Abstract: Objective　To measure anatomical parameters of Chinese proximal humerus by 3D visualization, which providing guidance for fracture reduction, internal plants placement, and internal plants design matching for Chinese patients.　Methods　A total of 90 patients with shoulder trauma from 2013 to 2019 were selected, they were divided into a fracture group and a normal group according to the diagnosis of proximal humeral fractures. After simulated reduction of 60 patients in the fracture group by using E-3D digital medical software, the following parameters, including the humeral head parameters of the proximal humeral bones, humeral shaft medullary cavity parameters, humeral head-stem relationship parameters, humeral heads, large or small humeral head parameters and nodules related vertical distance parameters, were measured. The parameters including head height of humeru (HH), diameter of the articular surface diameter of humeral head (ASD), radius of curvature of humeral head (ROC), neck shaft angle (NSA), medial offset (MO), posterior offset (PO), multiple level of diameter of medullary cavity of humeral shaft (L0, L20, L40) were measured together with other 30 patients in the normal group.　Results　HH on coronal plane and axial plane in the normal group were (15.5±2.0) mm and (15.7±2.3) mm, ASD were (42.0±3.5) mm and (40.0±3.5) mm, ROC were (22.3±2.0) mm and (20.8±1.9) mm, L0 were (26.0±3.1) mm and (23.3±2.9) mm, L20 were (15.2±2.5) mm and (13.3±2.0) mm, L40 were (12.0±2.4) mm and (10.6±2.1) mm. NSA was (132.1±4.9)° on coronal plane, MO was (4.2±1.2) mm on coronal plane, and PO was (3.4±1.4) mm on sagittal plane. There was no statistical difference in the measuring result between the fracture group and the normal group.　Conclusions　The method of measuring anatomical parameters of proximal humerus by 3D visualization is accurate and reliable. E-3D software has high accuracy and reliability in bone 3D reconstruction of bone, fracture simulation reduction, and parameter measurement.

Key words: , Humerus, 　3D reconstruction, 　Anatomical parameters, 　Measurement

中图分类号:

R322

刘蓬然, 申澳, 吕静, 陈宇飞, 袁剑, 廖胜辉, 刘立宏. 三维立体可视化测量国人肱骨近端解剖学参数[J]. 中国临床解剖学杂志, 2022, 40(1): 10-16.

Liu Pengran, Shen Ao, Lv Jing, Chen Yufei , Yuan Jian, Liao Shenghui, Liu Lihong. The anatomical parameters of proximal humerus in Chinese measured by three-dimensional visualization[J]. Chinese Journal of Clinical Anatomy, 2022, 40(1): 10-16.

参考文献 17

[1]	谢麟臻, 陈春慧, 陈华. 肱骨近端骨折的治疗进展[J]. 中华肩肘外科电子杂志,2020, 8(2):186-190. DOI:10.3877/cma.j.issn.2095-5790.2020. 02.017.
[2]	Zhou J, Zhang L, Shen L, et al. Analyzing on the location of the bicipital groove for alignment in shoulder arthroplasty of Chinese[J]. J Orthop Sci, 2017, 22(3): 425-429. DOI: 10.1016/j.jos.2016.02.015.
[3]	Robinson CM, Stirling P, Goudie EB, et al. Complications and long-term outcomes of open reduction and plate fixation of proximal humeral fractures[J]. J Bone Joint Surg Am, 2019, 101(23):2129-2139. DOI: 10.2106/JBJS.19.00595.
[4]	仇一然, 元熙哲, 周建英. 中国人肱骨近端形态在MSCT多平面重组下的测量及差异研究[J]. 吉林医学, 2020,41(2):407-411.
[5]	赵猛, 江勇, 徐圣康. 数字骨科技术在创伤骨科的应用及前景[J]. 临床外科杂志, 2020, 28(4):307-309. DOI: 10.3969/j. issn. 1005-6483. 2020. 04. 003.
[6]	Hu HZ, Feng XB, Shao ZW, et al. Application and prospect of mixed reality technology in medical field[J]. Curr Med Sci, 2019, 39(1):1-6. DOI: 10.1007/s11596-019-1992-8.
[7]	Valenti P, Aliani D, Maroun C, et al. Shoulder hemiarthroplasty for proximal humeral fractures: analysis of clinical and radiographic outcomes at midterm follow-up: a series of 51 patients[J]. Eur J Orthop Surg Traumatol, 2017, 27(3):309-315. DOI: 10.1007/s00590-017-1927-7.
[8]	Grubhofer F, Wieser K, Meyer D C, et al. Reverse total shoulder arthroplasty for failed open reduction and internal fixation of fractures of the proximal humerus[J]. J Shoulder Elbow Surg, 2017, 26(1):92-100. DOI: 10.1016/j.jse.2016.05.020.
[9]	刘辉均, 丁茂乾, 安玉章. 经皮锁定加压接骨板内固定治疗肱骨近端骨折的临床效果[J]. 中国医刊, 2020,55(08):861-864. DOI:10.3969/j.issn.1008-1070.2020.08.014.
[10]	陈德健, 邱福平, 卞健, 等. 锁定接骨板联合内侧普通钢板治疗肱骨近端NeerⅢ、Ⅳ型骨折[J]. 中国矫形外科杂志, 2019, 27(24):2233-2237. DOI:10.3977/j.issn.1005-8478.2019.24.06.
[11]	Chen CY, Chang HW, Hsieh SL, et al. Preliminary clinical and radiographic outcomes of proximal humeral fractures: comparison of ALPS and PHILOS plating in Asian patients in Taiwan[J]. J Orthop Surg Res, 2020, 15(1):364. DOI: 10.1186/s13018-020-01846-9.
[12]	Iannotti JP, Gabriel JP, Schneck SL, et al. The normal glenohumeral relationships. An anatomical study of one hundred and forty shoulders[J]. J Bone Joint Surg Am, 1992,74(4):491-500.
[13]	Robertson DD, Yuan J, Bigliani LU, et al. Three-dimensional analysis of the proximal part of the humerus: relevance to arthroplasty[J]. J Bone Joint Surg Am, 2000, 82(11):1594-1602.
[14]	Hertel R, Knothe U, Ballmer F T. Geometry of the proximal humerus and implications for prosthetic design[J]. J Shoulder Elbow Surg, 2002,11(4):331-338. DOI: 10.2106/00004623-200011000-00013.
[15]	Walch G, Boileau P. Prosthetic adaptability: a new concept for shoulder arthroplasty[J]. J Shoulder Elbow Surg, 1999, 8(5):443-451. DOI: 10.1016/s1058-2746(99)90074-5.
[16]	袁本祥, 刘祖德, 张琳琳, 等. 国人肱骨近端三维解剖研究及其对假体设计与植入的影响[J]. 中华骨科杂志, 2007, 27(2):120-124. DOI:10.3760/j.issn:0253-2352.2007.02.009.
[17]	Zhang Q, Shi LL, Ravella KC, et al. Distinct proximal humeral geometry in Chinese population and clinical relevance[J]. J Bone Joint Surg Am, 2016, 98(24): 2071-2081. DOI: 10.2106/JBJS.15.01232

三维立体可视化测量国人肱骨近端解剖学参数

The anatomical parameters of proximal humerus in Chinese measured by three-dimensional visualization

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献 17

相关文章 15

Metrics

本文评价

推荐阅读 0

[1]	江剑宏, 段仁鹏, 李晓锋. 国人胆道三维重建解剖变异应用研究[J]. 中国临床解剖学杂志, 2024, 42(1): 1-4.
[2]	郭红志, 王瑜, 张加琪, 梁海彬, 马梓玮, 冯伟, 吴忧, 司子燚. 血管铸型结合CT三维模型评估先兆子痫胎盘血管结构[J]. 中国临床解剖学杂志, 2024, 42(1): 5-10.
[3]	李佳伟, 张静, 李灿然, 兰文杰, 籍庆余, 郭志勇, 张云凤, 刘启, 陈清威, 李筱贺. 蒙古族人群股骨近端解剖参数X线测量[J]. 中国临床解剖学杂志, 2024, 42(1): 11-16.
[4]	李琨, 张燕, 郭冉, 郝咪咪, 吴轩宇, 徐艺芳, 王超群, 马文童, 张灵淇, 杨宏宇, 李志军, 张少杰, 王星. 儿童及青少年枕颈角与后枕颈角数字化测量及其临床意义[J]. 中国临床解剖学杂志, 2024, 42(1): 17-20.
[5]	李文, 杨思艺, 黄蕾, 卿霁雯, 蒋松涛, 张磊. 基于MRI探讨Lisfranc韧带的形态学特点及临床意义[J]. 中国临床解剖学杂志, 2024, 42(1): 21-25.
[6]	李凡凡, 徐阳, 王晓旭. 紫草素调节Nrf2/HO-1信号通路对实验性大鼠肉芽肿性小叶性乳腺炎的治疗作用研究[J]. 中国临床解剖学杂志, 2024, 42(1): 26-32.
[7]	王兴航, 丁佳媛, 李放, 包翠芬, 阎丽菁. 人参皂苷Rg1通过抑制NLRP3炎症小体途径减轻氧糖剥夺/复供后小胶质细胞炎症反应[J]. 中国临床解剖学杂志, 2024, 42(1): 33-41.
[8]	程莹莹, 武建军, 蔡海燕, 焦旭文, 马江波, 丁银秀. 体外炎性诱导星形胶质细胞激活及功能分析[J]. 中国临床解剖学杂志, 2024, 42(1): 42-46.
[9]	祁志, 杨力, 贾秋叶, 陈浩伦, 段兆达, 吴春云. 依达拉奉经MAPKs通路对脂多糖激活的小胶质细胞Sirt3表达调控[J]. 中国临床解剖学杂志, 2024, 42(1): 47-53.
[10]	张晶晶, 王洪新. 黄芩苷通过PDGF/P38 MAPK信号通路对肺动脉高压大鼠的保护作用[J]. 中国临床解剖学杂志, 2024, 42(1): 54-58.
[11]	乐钦, 陈荣丽, 熊婧熙, 王婷怡, 蔡志恒, 易秋实, 曾心怡. 白芨多糖对大鼠跨区皮瓣choke区的影响[J]. 中国临床解剖学杂志, 2024, 42(1): 59-64.
[12]	李笑予, 张磊, 付磊, 李东波, 汪国友. 三步接骨法治疗Sanders Ⅱ型跟骨骨折的有限元研究[J]. 中国临床解剖学杂志, 2024, 42(1): 65-70.
[13]	吴研飞, 马剑雄, 卢斌, 王颖, 柏豪豪, 靳洪震, 马信龙. CT后处理技术重建CT值与终板抗压强度的相关性研究[J]. 中国临床解剖学杂志, 2024, 42(1): 71-76.
[14]	庄万强, 唐毅, 骆勇刚, 张辉. 关节镜联合胫骨高位截骨术对髌骨位置及髌股关节功能影响的早中期回顾性研究[J]. 中国临床解剖学杂志, 2024, 42(1): 77-82.
[15]	罗鹰, 窦伟誉, 吴小杭, 陈璟昆, 彭昌贵, 潘剑英 . 微创海马钢板内固定治疗跟骨骨折并发症的影响因素[J]. 中国临床解剖学杂志, 2024, 42(1): 83-88.