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。
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.
关键词
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肱骨 /
三维重建 /
解剖参数 /
测量
Key words
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Humerus /
3D reconstruction /
Anatomical parameters /
Measurement
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参考文献
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基金
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）
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