基于CT三维重建的中国人肩胛冈解剖形态学分型及临床意义

doi:10.16098/j.issn.0529-1356.2019.06.016

解剖学报 ›› 2019, Vol. 50 ›› Issue (6): 791-795.doi: 10.16098/j.issn.0529-1356.2019.06.016

基于CT三维重建的中国人肩胛冈解剖形态学分型及临床意义

张磊^1,2郭晓光^1,2代平¹ 杨彬¹杨琴¹ 张艳丽¹汪国友^1,2扶世杰^1,2*

1.西南医科大学附属中医医院骨伤科，四川泸州 646000; 2.泸州市院士工作站，四川泸州 646000

收稿日期:2018-11-06 修回日期:2018-12-07 出版日期:2019-12-06 发布日期:2019-12-06
通讯作者: 扶世杰 E-mail:fushijieggj@126.com
基金资助:
四川省教育厅科研项目;泸州市院士工作站在建项目

Classification and clinical significance of Chinese scapular spine based on CT three-dimensional reconstruction

ZHANG Lei^1,2 GUO Xiao-guang ^1,2 DAI Ping¹ YANG Bin¹ YANG Qin¹ ZHANG Yan-li¹WANG Guo-you ^1,2 FU Shi-jie^1,2*

1.Department of Orthopedics, the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Sichuan Luzhou 646000, China; 2.Academician Workstation in Luzhou, Sichuan Luzhou 646000, China

Received:2018-11-06 Revised:2018-12-07 Online:2019-12-06 Published:2019-12-06
Contact: FU Shi-jie E-mail:fushijieggj@126.com

摘要/Abstract

摘要：

目的探讨基于CT三维重建的肩胛冈形态学分型及临床意义。方法收集四川省泸州市西南医科大学附属中医医院280例成年人肩胛骨CT平扫及三维重建数据，对肩胛冈进行解剖形态学分探讨其对临床工作的指导意义。测量内容包括肩胛冈周围结构的7个距离和9个点的厚度。结果 CT三维重建下肩胛冈共分为5型（细薄型、木棒型、粗厚型、梭型、S型）。其中，细薄型14个，占14.64%；木棒型63个，占22.50%；粗厚型78个，占27.86%；梭型89个，占31.79%；S型9个，占3.21%。细薄型的B厚度（9.36±3.61）mm，明显薄于另外4型(P<0.05)；粗厚型的AC（84.36±6.00）mm、AD（118.79±9.15）mm，长于其他4型；在F厚度（11.01±2.13）mm、H厚度（12.02±1.68）mm、Ⅰ厚度（11.77±2.35）mm、K厚度（9.43±0.97）mm上为5型中最厚。梭型的BC长度（16.66±9.97）mm最短、K厚度（4.45±1.58）mm为除细薄型外最薄（P<0.05）。结论 CT三维重建下肩胛冈共分为5型（细薄型、木棒型、粗厚型、梭型、S型），其中，梭型最多，S型最少；粗厚型肩胛冈骨量最丰富，为优质的自体骨移植来源，也可作为较好的内置物固定位置；相反，细薄型肩胛冈骨量最少，内固定强度相对较差。不同肩胛冈分型对其相关的手术方式存在一定的影响。

关键词: 肩胛冈, 解剖形态学, 分型, CT三维重建, 人

Abstract:

Obje Objective To explore the morphological classification and clinical significance of scapular spine based on CT three dimensional reconstruction. Methods The scapular spines of 280 adults in the Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University were classified by CT plain scan and three-dimensional reconstruction, and its guiding significance for clinical work was discussed. Measurement content the distance between the seven structures of the scapular region and the thickness of the nine points. Results Under the CT 3D reconstruction, the scapular spines were divided into five types: thin shape, wood rod shape, thick shape, fusiform shape and S shape. There were 14 cases of thin shape, accounting for 14.64%; and 63 cases of wood rod shape, accounting for 22.50%; and 78 cases of wood rod shape, accounting for 27.86%; and 89 cases of thick shape, accounting for 27.86%; and 89 cases of fusiform shape, accounting for 31.79%, and 9 cases of S shape, accounting for 3.21%. In the thin shape, the thickness of B (9.36±3.61) mm was obviously thinner than the other four types (P<0.05); In thick shape, the length of AC (84.36±6.00) mm and AD (84.36±6.00) mm was longer than the other four types, and the thickness of F, H, Ⅰ, K was the thickest (P<0.05); In the fusiform shape, the length of BC was the shortest, and the thickness of K was the thinnest except for the thin shape (P<0.05). Conclusion Under the CT 3D reconstruction, the scapular spines are divided into five types: thin shape, wood rod shape, thick shape, fusiform shape and S shape. Among them, fusiform shape is the most, and S shape is the least; The scapular spine of thick shape is the most abundant bone, which is the high quality source of autologous bone graft, and can also be used as a better fixed position for internal implants. On the contrary, the scapular spine of thin shape has the least amount of bone, and the internal fixation strength is relatively poor. Different types of scapular spines have certain effects on their operative method.

Key words: Scapular spine, Anatomical morphology, Classification｜CT three-dimensional reconstruction｜Human

张磊郭晓光代平杨彬杨琴张艳丽汪国友扶世杰. 基于CT三维重建的中国人肩胛冈解剖形态学分型及临床意义[J]. 解剖学报, 2019, 50(6): 791-795.

ZHANG Lei GUO Xiao-guang DAI Ping YANG Bin YANG Qin ZHANG Yan-li WANG Guo-you FU Shi-jie. Classification and clinical significance of Chinese scapular spine based on CT three-dimensional reconstruction[J]. Acta Anatomica Sinica, 2019, 50(6): 791-795.

参考文献

［1］ Armitage BM, Wijdicks CA, Tarkin IS, et al. Mapping of scapular fractures with three－dimensional computed tomography ［J］. J Bone Joint Surg Am, 2009, 91(9): 2222-2228.

［2］ Lantry JM, Roberts CS. Operative treatment of scapular fractures: a systematic review ［J］. Injury, 2008, 39(3): 271-283.

［3］ Fu ZhG, Zhang K. Judet approach for scapular fracture ［J］. Chinese Journal of Shoulder and Elbow(Electronic Edition), 2014, 2(1): 57-62. (in Chinese)

付中国, 张堃. Judet入路治疗肩胛骨骨折［J］. 中华肩肘外科电子杂志, 2014, 2(1): 57－62.

［4］ Goss TP. The scapula: coracoid, acromial, and avulsion fractures ［J］. Am J Ortho, 1996, 25(2): 106-115.

［5］ Tu?ek M, Chochola A, Klika D. Epidemiology of scapular fractures ［J］. Acta Orthop Belg, 2017, 83(1): 8-15.

［6］ Crosby LA, Hamilton A. Scapula fractures after reverse total shoulder arthroplasty: classification and treatment ［J］. Clin Orthop Relat Res, 2011, 469(9): 2544-2549.

［7］ Stevens CG, Murphy MR, Stevens TD, et al. Bilateral scapular fractures after reverse shoulder arthroplasties ［J］. J Shoulder Elbow Surg, 2015, 24(2): e50-55.

［8］ Wang HJ, Giambini H, Hou DB, et al. Classification and morphological parameters of the scapular spine: implications for surgery ［J］. Medicine, 2015, 94(45): e1986.

［9］ Audigé L, Kellam JF, Lambert S, et al. The AO foundation and orthopaedic trauma association (AO/OTA) scapula fracture classification system: focus on body involvement ［J］. J Shoulder Elbow Surg, 2014, 23(2): 189-196.

［10］ Bartoní?ek J, Tu?ek　M, Fri?V. Fractures of the scapular neck: diagnosis, classifications and treatment［J］. Int Orthop, 2014, 38(10): 2163-2173.

［11］ Tatro JM, Gilbertson JA, Schroder LK. Five to ten－year outcomes of operatively treated scapular fractures ［J］. J Bone Joint Surg Am, 2018, 100(10): 871-878.

［12］ As－Sultany M, Tambe A. Nonunion of a scapular spine fracture: case report and management with open reduction, internal fixation, and bone graft ［J］. Int J Shoulder Surg, 2008, 2(3): 64-67.

［13］ Bartoní?ek J. Scapular body fractures: results of operative treatment ［J］. Int Orthop, 2011, 35(5): 747-753.

［14］ Lu M, Liu YJ, Shen XZh, et al. Bone block from scapular spinetransversely fixed with bone allograft pin for repairing bony Bankart ［J］. Orthopedic Journal of China, 2018, 26(14): 1333-1337.(in Chinese)

鹿鸣, 刘玉杰, 申学振, 等. 肩胛冈骨块移植骨横钉固定修复骨性Bankart损伤［J］. 中国矫形外科杂志, 2018, 26(14): 1333-1337.

［15］ Park AY, DiStefano JG, Nguyen TQ, et al. Congruency of scapula locking plates: implications for implant design ［J］. Am J Orthop (Belle Mead NJ), 2012, 41(4): E53-56.

［16］ Zhang ZhH, Wang LB, Cui WM, et al. Anatomy of the scapulae safety prediction ［J］. Acta Anatomica Sinica, 2017, 48(1): 65-69. (in Chinese)

张振华, 王立博, 崔雯铭, 等. 肩胛骨安全区的解剖［J］. 解剖学报, 2017, 48(1): 65-69.

［17］ Xu GL, Xu LY, Zhang ZhH, et al. Positioning data evaluation and clinical significance of the scapula glenoid ［J］. Acta Anatomica Sinica, 2016, 47(5): 670-671. (in Chinese)

徐高磊, 许路阳, 张振华, 等. 肩胛骨关节盂的位置数据测量及其临床意义［J］. 解剖学报, 2016, 47(5): 670－671.

［18］ Fu ZhG. Reverse shoulder arthroplasty ［J］. Chinese Journal of Shoulder and Elbow(Electronic Edition), 2017, 5(3): 237. (in Chinese)

付中国. 反肩置换术［J］. 中华肩肘外科电子杂志, 2017, 5(3): 237.

［19］ Lu Y. Shoulder replacement for the treatment of proximal humerus fractures－from half shoulder to reverse shoulder ［J］. Chinese Journal of Shoulder and Elbow(Electronic Edition), 2016, 4(2): 128. (in Chinese)

鲁谊. 肩关节置换治疗肱骨近端骨折——从半肩到反肩［J］. 中华肩肘外科电子杂志, 2016, 4(2): 128.

［20］ Zhou HS, Chung JS, Yi PH, et al. Management of complications after reverse shoulder arthroplasty ［J］. Curr Rev Musculoskelet Med, 2015, 8(1): 92－97.

［21］ Ascione F, Kilian CM, Laughlin MS, et al. Increased scapular spine fractures after reverse shoulder arthroplasty with a humeral onlay short stem: an analysis of 485 consecutive cases ［J］. J Shoulder Elbow Surg, 2018, 27(12): 2183－2190.

［22］ Kennon JC, Lu C, McGee－Lawrence ME. Scapula fracture incidence in reverse total shoulder arthroplasty using screws above or below metaglene central cage: clinical and biomechanical outcomes ［J］. J Shoulder Elbow Surg, 2017, 26(6): 1023-1030.

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基于CT三维重建的中国人肩胛冈解剖形态学分型及临床意义

Classification and clinical significance of Chinese scapular spine based on CT three-dimensional reconstruction

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