欢迎访问《解剖学报》官方网站!今天是 English
人类学

基于CT三维重建肩胛下角的形态学分型特点及临床意义

  • 胡定祥 ,
  • 李长辉 ,
  • 陈亮 ,
  • 马晨曦 ,
  • 黄河 ,
  • 郑瑞清
展开
  • 1. 泸县人民医院骨科,四川 泸州 646100; 2. 泸县人民医院放射科,四川 泸州 646100; 3. 泸县人民医院康复科,四川 泸州 646100

收稿日期: 2020-03-11

  修回日期: 2020-04-05

  网络出版日期: 2021-10-06

Morphological classification and clinical significance of inferior angle of scapula based on CT three-dimensional reconstruction

  • HU Ding-Xiang ,
  • LI Chang-Hui ,
  • CHEN Liang ,
  • MA Chen-Xi ,
  • HUANG He ,
  • ZHENG Rui-Qing
Expand
  • 1.Department of Orthopedics, People’s Hospital of Lu Xian County, Sichuan Luzhou 646100, China; 2.Department of Radiology, People’s Hospital of Lu Xian County, Sichuan Luzhou 646100, China; 3.Recovery Units, People’s Hospital of Lu Xian County, Sichuan Luzhou 646100, China

Received date: 2020-03-11

  Revised date: 2020-04-05

  Online published: 2021-10-06

摘要

目的  探讨CT三维重建下的肩胛下角形态学分型特点及临床意义。   方法  采集290个肩胛骨三维重建影像资料,g是肩胛下角,n是盂下结节,m是肩胛冈与肩胛骨内侧缘交点,k是肩胛上角,r是肩胛冈盂切迹,h是g点到mr垂线的交点,观察肩胛下角形态学特点,并测量相关数据。测量g点最厚部分,gn、gm、gh的长度,∠ngm、∠gmk(肩胛骨在冠状面上的投影)、∠gmk’(肩胛骨在矢状面上的投影)的度数。   结果  CT 三维重建图像显示,肩胛下角大体有3种类型:副角型 (175,60.34%)、U型(81,27.93%)和V型(34,11.73%),此外,副角型的g点最厚部分及gn与V型差异有显著性 (P<0.05);在gm上,副角型比U型和V型长(P<0.05);在gh上,V型比副角型和U型短(P<0.05);在∠gmk’上,副角型比U型大(P<0.05)。双侧肩胛下角在∠ngm上差异有显著性 (P<0.05)。   结论  基于 CT 三维重建结果,将肩胛下角分为3种类型,以副角型为主,V型少见。

本文引用格式

胡定祥 , 李长辉 , 陈亮 , 马晨曦 , 黄河 , 郑瑞清 . 基于CT三维重建肩胛下角的形态学分型特点及临床意义[J]. 解剖学报, 2021 , 52(5) : 767 -771 . DOI: 10.16098/j.issn.0529-1356.2021.05.014

Abstract

Objective  To research the morphological classification of inferior angle of scapula based on CT 3D reconstruction and its clinical significance.    Methods  A total of 290 scapular bones data were collected from People’s Hospital of Lu Xian County and measured based on CT 3D reconstruction.The scapular bones images were reconstructed by CT 3D technique.Reference points: g was the inferior scapular angle, n was the inferior glenotubular nodule, m was the intersection of the scapular ganglion and the medial edge of the scapula, k was the upper scapular angle, r was the notch of the scapular glenoid, h was the intersection of point g to mr. The parameters of inferior angles of 290 scapular bones, including the thickness of point g (the thickest part of inferior angle of the scapula), the length of the line gn, line gm, and line gh, and the angle of ∠ngm, ∠gmk (the projection of the scapular coronal plane), and ∠gmk’(the projection of the scapular sagittal plane) were observed and measured by CT 3D technique.    Results  Under the CT three-dimensional reconstruction, the inferior angle of scapula was classified into three types: accessory angle-type (175, 60.34%), U-type (81, 27.93%) and V-type (34, 11.73%). In addition, there was a significant difference between the auxiliary angle type and the Ⅴ type on the thickest part of the g point and gn (P<0.05); U-type and V-type with paragonal gm-significant difference (P<0.05); There was a significant difference between the auxiliary angle type and the U shape on gh (P<0.05); there was a significant difference between the auxiliary angle type and the U shape on ∠gmk’ (P<0.05). There was a significant difference in the inferior angle of the bilateral scapula on mngm (P<0.05).    Conclusion  Based on the result  of CT three-dimensional reconstruction, the inferior angle of scapulae have three anatomical types, with the accessory angle-type as the main type, and the morphology and classification of it are of certain clinical implication.

参考文献

[1]Farooque K, Khatri K, Dev C, et al.Mechanism of injury and management in traumatic anterior shoulder dislocation with concomitant humeral shaft and ipsilateral scapula fracture:a case report and review of the literature[J].J Med Case Rep, 2014, 8(1):431-431
[2]Cooperstein R, Haneline M, Young M.The location of the inferior angle of the scapula in relation to the spine in the upright position: a systematic review of the literature and meta-analysis[J].Chiropractic & Manual Therapies, 2015, 23(1):1-8
[3]Chang AC, Phadnis J, Eardleyharris N, et al.Inferior angle of scapula fractures: a review of literature and evidence- based treatment guidelines[J].Journal of Shoulder and Elbow Surgery, 2016, 25(7):1170-1174
[4]Akcal A, Gorgulu T, Savas SA, et al.Circumflex scapular artery myocutaneous andor vascularized scapular chimeric flap[J].Journal of Surgical Research, 2016, 206(1):126-132
[5]Ho MW, Brown JS, Shaw RJ.Refining the indications for scapula tip in mandibular reconstruction[J].International Journal of Oral & MaxilloEACial Surgery, 2017, 46(6):712-715
[6] Sundine MJ, Sharobaro VI, Ljubic I, et al.Inferior angle of the scapula as a vascularized bone graft: an anatomic study[J].J Reconstr Microsurg,2000,16(3):207-211
[7]Fu ZhG, Zhang K.Judet approach for scapular fracture[J].Chinese Journal of Shoulder and Elbow ( Electronic Edition), 2014, 2(1):57-62
[8]Noguchi T, Mautner J F, Duncan S.Dorsal Plate Fixation of Scapular Fracture[J].Journal of Hand Surgery, 2017, 42(10):843-843
[9]Bartonicek J, Fric V.Scapular body fractures:results of operative treatment[J].Int orthop, 2011, 35(5):747-753
[10]Cole PA, Gilbertson JA, Cole PA.Functional outcomes of operative management of scapula0550 fractures in a geriatric cohort[J].J Orthop Trauma, 2017, 31(1):e1-e8
[11] Sundine MJ, Sharobaro VI, Ljubic I, et al.Inferior angle of the scapula as a vascularized bone graft: an anatomic study [J].J Reconstr Microsurg, 2000, 16(3):207-211
[12]Min KD, Hwang SH, Kim JB, et al.Treatment of Scapula Fractures of the Inferior Angle Causing Pseudowinging Scapula[J].Journal of the Korean Orthopaedic Association, 2014, 49(2):165-171
[13]Ferrari S, Ferri A, Bianchi B, et al.Donor site morbidity after scapular tip free flaps in head-and-neck reconstruction[J].Microsurgery, 2015, 35(6):447-450
[14]Dietrich TJ, Agten C A, Fürnstahl P, et al.The Legend of the Luschka Tubercle and Its Association With Snapping Scapulae: Osseous Morphology of Snapping Scapulae on CT Images[J].AJR Am J Roentgenol, 2017, 209(1):159-166
[15]张磊, 覃波, 郭晓光, 等.肩胛下角的解剖形态学分型及临床意义[J].中国临床解剖学杂志, 2018, 36(2):132-136
[16]Da CB, Armijoolivo S, Gadotti I, et al.Reliability of scapular positioning measurement procedure using the palpation meter (PALM)[J].Physiotherapy, 2010, 96(1):59-67
[17]Park IH, Chung CH, Yong JC, et al.Clinical Experiences with the Scapular Fascial Free Flap[J].Archives of Plastic Surgery, 2016, 43(5):438-445
[18]李建赤, 黄必留, 梁江声, 等.肩胛骨结构特点与骨折不同内固定手术疗效的分析[J].中国临床解剖学杂志, 2012, 30(5):573-575
[19]高明暄, 聂德军, 常彦峰, 等.内, 外侧联合双柱内固定治疗例肩胛骨体部移位骨折患者疗效分析[J].浙江大学学报医学版, 2019, 48(6):651-656
[20]沈美华, 任鹏, 肖虎, 等.基于血管造影的胸背动脉三维可视化研究[J].中国修复重建外科杂志, 2015, 29(3):326-330
[21]Santanelli F, Longo B, Germano S, et al.Total breast reconstruction using the thoracodorsal artery perforator fl ap without implant[J].Plast Reconstr Surg, 2014, 133(2):251-254
[22]Yoo J, Dowthwaite SA, Fung K, et al.A new angle to mandibular reconstruction: The scapular tip free flap[J].Head & Neck, 2013, 35(7):980-986
[23]张 军, 陈 晓, 曹烈虎, 等.重建接骨板治疗肩胛骨颈部及体部骨折的近期临床疗效分析[J].中华骨与关节外科, 2016, 9(1):40-40
[24]Distefano JG, Park AY, Nguyen TQD, et al.Optimal screw placement for base plate fixation in reverse total shoulder arthroplasty[J].J Shoulder Elbow Surg, 2011, 20(3):467-476
文章导航

/