目的 测量肩峰形态和Aragão提出的角度与肩峰分型相关联，为中国人群的肩峰分型提供更客观的测量方式。 方法 在118例中国人正常、干燥的肩胛骨标本上，肩峰根据Bigliani分型，分为Ⅰ、Ⅱ、Ⅲ3种类型，测量肩峰长度距离，肩峰宽度距离，肩峰—关节盂距离，肩峰—喙突距离，肩峰尖端—肩峰角与水平线构成肩峰倾斜角，肩峰尖端—喙突中点延长线与喙突中点—关节盂上结节延长线构成∠a，肩峰尖端—肩峰角延长线与肩峰角—关节盂上结节延长线构成∠b；肩峰尖端—肩峰角与肩峰尖端—关节盂上结节构成∠c。 结果 左右两侧肩胛骨的肩峰分型并无显著性差异（P=0.460）。肩峰长度距离（P=0.374），肩峰宽度距离（P=0.912），肩峰-喙突距离（P=0.536），∠a（P=0.107）在肩峰分型无显著性差异。肩峰-关节盂距离（P<0.001），肩峰倾斜角（P=0.005），∠b（P=0.003）和∠c（P<0.001）在肩峰分型上有显著性差异。ROC曲线分析中，区分Ⅰ和Ⅱ型肩峰时，仅肩峰-关节盂距离的P值<0.05，截断值为31.09 cm；区分Ⅱ和Ⅲ型肩峰时，肩峰-关节盂距离EG，∠b和∠c均P<0.05，截断值分别为28.26 cm、37.46°和73.98°。 结论 区分Ⅰ和Ⅱ型肩峰中，肩峰-关节盂距离≥31.09 cm时，肩峰可归类为Ⅰ型；区分Ⅱ和Ⅲ型肩峰中，肩峰-关节盂距离≥28.26 cm或∠b≥37.46°或∠c≥73.98°时，肩峰可归类为Ⅱ型，这一结果对临床具有参考价值。
Abstract
Objective To measure acromial morphology and the angles proposed by Aragão, providing a more objective measurement method for acromion classification in the Chinese population. Methods A total of 118 normal, dry scapula specimens from Chinese individuals, the acromion was classified into three types (type I, type II and type III) according to the Bigliani classification. Measured parameters included the following: the acromial length, acromial width, acromion-glenoid distance, acromion-coracoid distance, the acromial inclination angle formed by the line from the acromion tip to the acromial angle and the horizontal line, ∠a formed by the extension line from the acromion tip to the midpoint of the coracoid and the extension line from the midpoint of the coracoid to the superior glenoid tubercle, ∠b formed by the extension line from the acromion tip to the acromial angle and the extension line from the acromial angle to the superior glenoid tubercle, and ∠c formed by the line from the acromion tip to the acromial angle and the line from the acromion tip to the superior glenoid tubercle. Results There was no significant difference in the acromion classification of the left and right scapulae (P=0.460). There were no significant difference in the acromial length (P=0.374), acromial width (P=0.912), acromion-coracoid distance (P=0.536), and ∠a (P=0.107) among the different acromion types. However, there were significant differences in the acromion-glenoid distance (P<0.001), acromial inclination angle (P=0.005), ∠b (P=0.003), and ∠c (P<0.001) among the different acromion types. In ROC curve analysis, when differentiating between Type I and Type II acromion, only the distance from the acromion to the glenoid (EG) showed a P-value <0.05, with a truncation value of 31.09 cm. In distinguishing between Type II and Type III acromion, the acromion-glenoid distance (EG), ∠b, and ∠c all showed P-values <0.05, with respective truncation values of 28.26 cm, 37.46°, and 73.98°. Conclusions In distinguishing between Type I and Type II acromion, an acromion classified as Type I when the distance from the acromion to the glenoid is ≥31.09 cm. In the differentiation between Type II and Type III acromion, if the acromion-glenoid distance ≥28.26 cm, or ∠b≥37.46°, or ∠c≥73.98°, the acromion can be classified as Type II. These findings have reference value for clinical practice.
关键词
肩胛骨 /
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肩峰 /
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肩峰分型 /
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参数测量
Key words
Scapula /
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Acromion /
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Types of acromion /
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Parameter measurements
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基金
南方医科大学第三附属医院院长基金（YP202210）；深圳市”医疗卫生三名工程”项目资助（No.SZZYSM202108013）；广东省名中医传承工作室建设项目（粤中医办函[2023]108号）
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