基于3D模型并肩胛骨接骨板设计的肩胛骨测量
Scapula measurement based on 3D model and scapula plate design
目的 测量肩胛骨关键部位数据，为设计类“F”形实用性肩胛骨接骨板系统提供解剖数据支持。 方法 采集50例正常成人肩胛骨CT数据，男女各25例，导入计算机建立3D模型，测量肩胛骨骨折主要固定区域数据并分析。 结果 肩胛颈CD=（10.35±0.95）mm、外侧缘DE=（72.99±6.53）mm和EF=（52.14±6.73）mm、肩胛体HJ=（36.42±2.23）mm和HK=（41.00±2.57）mm，颈-外侧缘∠CDE=（127.89±6.02）°、外侧缘扭转角∠DEF1=（167.20±3.67）°和∠DEF2=（172.46±4.76）°，各点厚度：C=（15.65±1.99） mm、D=（17.53±2.83）mm、G=（10.21±1.83）mm、H=（9.74±1.99） mm、I=（9.62±1.65） mm、J1=（10.21±1.35） mm、J2=（9.12±1.36）mm、K1=（7.22±1.99）mm、K2=（8.58±2.22） mm。其中，CD、DE、EF，∠DEF2，点D、G、H、I、J1、J2厚度，男女分组差异有统计学意义（P＜0.05）。 结论 根据测量数据，结合解剖及手术特点，可以设计合理实用的类“F”形肩胛骨锁定接骨板系统。
Objective To provide anatomical data for the design of the F-shaped scapular plate system through measurement of the scapula. Methods The CT data of 50 normal adult scapulae from 25 males and females, respectively, were imported into the computer and 3D model was established to measure and analyze the scapular fracture of the main fixed area. Results Scapula neck CD=（10.35±0.95）mm, lateral DE=（72.99±6.53）mm and EF=（52.14±6.73）mm, scapular body HJ=（36.42±2.23）mm and HK=（41.00±2.57）mm. Neck-lateral ∠CDE=（127.89±6.02）°, Lateral twist angle∠DEF1（167.20±3.67）° and ∠DEF2=（172.46±4.76）°. The thickness of the points: C=（15.65±1.99）mm, D=（17.53±2.83）mm, G=（10.21±1.83）mm, H=（9.74±1.99）mm, I=（9.62±1.65）mm, J1=（10.21±1.35）mm, J2=（9.12±1.36）mm, K1=（7.22±1.99）mm, K2=（8.58±2.22）mm. There were differences between the male and female group in terms of CD, DE, EF, ∠DEF2, point D, G, H, I, J1, J2 (P<0.05). Conclusion According to the obtained data and taking into consideration the anatomical and surgical characteristics, a reasonable and practical F-shaped scapular locking plate system can be designed.
/ Scapula / 3D model / Measurement / Locking plate
[1] Dienstknecht T, Horst K, Pishnamaz M, et al. A meta-analysis of operative versus nonoperative treatment in 463 scapular neck fractures[J]. Scand J Surg, 2013, 102(2):69-76.
[2] Panigrahi R, Madharia D, Das DS, et al. Outcome Analysis of Intra-Articular Scapula Fracture Fixation with Distal Radius Plate: A Multicenter Prospective Study[J]. Arch Trauma Res, 2016, 5(4):e36406.
[3] Schroder LK, Gauger EM, Gilbertson JA, et al. Functional Outcomes After Operative Management of Extra-Articular Glenoid Neck and Scapular Body Fractures[J]. J Bone Joint Surg Am, 2016, 98(19):1623-1630.
[4] Yuan Z, Zhang F, Liang G, et al. Ring versus non-ring plate for the treatment of displaced scapular body fractures: a retrospective study with a mean follow-up of 5 years[J]. J Int Med Res, 2018, 46(7) 2731-2742.
[5] Fandridis E, Anastasopoulos PP, Alexiadis G, et al. Posterior subdeltoid and external rotators preserving approach for reduction and fixation of displaced extra-articular fractures of the scapula[J]. Eur J Orthop Surg Traumatol, 2018, 28(4):585-591.
[6] Noguchi T, Mautner JF, Duncan SFM. Dorsal Plate Fixation of Scapular Fracture[J]. J Hand Surg Am, 2017, 42(10):843.e1-e5.
[7] Cole PA Jr, Gilbertson JA, Cole PA Sr. Functional outcomes of operative management of scapula fractures in a geriatric cohort[J]. J Orthop Trauma, 2017, 31(1):e1-e8.
[8] Ao R, Yu B, Zhu Y, et al. Single lateral versus medial and lateral plates for treating displaced scapular body fractures: a retrospective comparative study[J]. J Shoulder Elbow Surg, 2018, 27(2):231-236.
[9] 杨国义, 杨旭, 杜洋, 等. 双入路双重建钛板内固定治疗不稳定型肩胛颈骨折[J]. 中华创伤骨科杂志, 2013, 15(4):293-297.
[10]余杰锋. 肩胛骨解剖钢板的研制及其有限元力学分析[D]. 广州: 广州医科大学, 2014:1-55.
[11]张彦群, 宋展昭. 肩胛骨颈部骨折解剖钢板的设计制作与临床应用[J]. 中国矫形外科杂志, 2007, 15(6):404-407,410.
[12]王雷舰. 肩胛骨的形态测量与应用研究[D]. 青岛:青岛大学, 2014：1:17.
[13]韩铭, 单涛, 尚超. 肩胛骨的骨性测量及其临床意义[J]. 解剖学杂志, 2014, 37(3):372-374.
陕西省卫生计生科研基金项目(2016C005)
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