IF 2.9 2区 医学 Q1 ORTHOPEDICS
Jia Guo, Erica Kholinne, Jiyeon Park, Hui Ben, In-Ho Jeon
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引用次数: 0

摘要

背景:异位骨化(HO)是指关节附近软组织中的骨形成异常,常见于肘部创伤或手术后,导致疼痛和功能受限。以往的研究主要根据骨性标志物来描述异位骨化的分布特征,缺乏对其在创伤后肘关节周围软组织分布特征的详细调查。本研究旨在:(1)使用计算机断层扫描(CT)建立肌肉引导的分类系统,绘制HO与肘部肌肉-肌腱单元的相对位置图;(2)研究HO位置与严重程度之间的相关性:在一项回顾性研究中,分析了56名外伤后出现HO和肘关节僵硬的患者。采用CT成像技术将HO分为七类:后方--肩胛骨顶端--肱三头肌(P-O-T);后内侧--内侧沟--尺侧屈肌(PM-MG-FCU);后外侧--外侧沟-- anconeus(PL-LG-AN);内侧--内上髁--屈肌(M-ME-FLEX);外侧--外上髁--伸肌(L-LE-EXT);前方--肱尺关节--肱肌(A-HU-B);以及前方--肱骨桡侧--上提肌(A-HR-SP)。根据CT形态对HO的严重程度进行分级(1-3级),并评估HO位置与严重程度之间的相关性:结果:PM-MG-FCU是最常见的HO位置(67.9%)。结果:PM-MG-FCU是最常见的HO位置(67.9%),HO严重程度与位置之间存在显著相关性,2级和3级HO发生率较高,其特点是PL-LG-AN、P-O-T和PM-MG-FCU出现广泛的成熟骨形成和骨桥发育:结论:以肌肉为导向的分类系统有效地划分了肘部肌肉-肌腱单位附近的HO分布。围绕肱骨舌骨、肱三头肌和FCU(尺侧屈肌)的HO位置与较高的放射学严重程度相关,为治疗策略提供了有价值的见解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Muscle-guided mapping of post-traumatic heterotopic ossification of the elbow: a novel computed tomography-based study.

Background: Heterotopic ossification (HO) involves abnormal bone formation in soft tissues near joints, commonly occurring after elbow trauma or surgery, leading to pain and functional limitations. Previous studies have primarily characterized HO distribution based on bony landmarks, lacking a detailed investigation into the characteristics of its distribution in periarticular soft tissue in post-traumatic elbows. This study aimed to (1) develop a muscle-guided classification system using computed tomography (CT) to map HO relative to elbow muscle-tendon units and (2) investigate correlations between HO location and severity.

Methods: In a retrospective study, 56 patients with HO and elbow stiffness following trauma were analyzed. CT imaging was used to classify HO into 7 categories: Posterior - olecranon tip - triceps brachii; Posteromedial - medial gutter - flexor carpi ulnaris (PM-MG-FCU); Posterolateral - lateral gutter - anconeus; Medial - medial epicondylar - flexor muscles; Lateral - lateral epicondylar - extensor muscles; Anterior - humeroulnar joint - brachialis; and Anterior - humeroradial - supinator. HO severity was graded (1-3) based on CT morphology, and correlations between HO location and severity were assessed.

Results: PM-MG-FCU was the most common HO location (67.9%). Significant correlations were found between HO severity and location, with higher rates of HO in grades 2 and 3, characterized by extensive mature bone formation and bone bridge development occurring in the posterolateral - lateral gutter - anconeus, posterior - olecranon tip - triceps brachii, and PM-MG-FCU.

Conclusion: The muscle-guided classification system effectively delineated HO distribution near elbow muscle-tendon units. HO locations surrounding the anconeus, triceps brachii, and flexor carpi ulnaris correlate with higher radiographic severity, providing valuable insights for treatment strategies.

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来源期刊
CiteScore
6.50
自引率
23.30%
发文量
604
审稿时长
11.2 weeks
期刊介绍: The official publication for eight leading specialty organizations, this authoritative journal is the only publication to focus exclusively on medical, surgical, and physical techniques for treating injury/disease of the upper extremity, including the shoulder girdle, arm, and elbow. Clinically oriented and peer-reviewed, the Journal provides an international forum for the exchange of information on new techniques, instruments, and materials. Journal of Shoulder and Elbow Surgery features vivid photos, professional illustrations, and explicit diagrams that demonstrate surgical approaches and depict implant devices. Topics covered include fractures, dislocations, diseases and injuries of the rotator cuff, imaging techniques, arthritis, arthroscopy, arthroplasty, and rehabilitation.
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