应用虚拟复位技术对移位肱骨近端骨折骨缺损的定量分析

IF 2 3区医学 Q3 CRITICAL CARE MEDICINE

Injury-International Journal of the Care of the Injured Pub Date : 2025-08-07 DOI:10.1016/j.injury.2025.112671

Xueliang Cui , Xiangxu Chen , Wenjun Xie , Sheng Zhang , Hui Chen

{"title":"应用虚拟复位技术对移位肱骨近端骨折骨缺损的定量分析","authors":"Xueliang Cui , Xiangxu Chen , Wenjun Xie , Sheng Zhang , Hui Chen","doi":"10.1016/j.injury.2025.112671","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and Objective</h3><div>Medial column disruption in proximal humeral fractures (PHFs) is associated with poor outcomes following reduction and internal fixation. Current assessments of unstable medial columns rely on qualitative descriptors such as disrupted hinges and insufficient osseous contact, often overlooking the quantification of bone defects. This study aims to quantitatively analyze bone defect characteristics in varus PHFs using advanced computer image processing techniques.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted on 202 patients diagnosed with varus proximal humeral fractures who received treatment at two tertiary hospitals between January 2017 and December 2022. Three-dimensional (3D) fracture models were reconstructed using Mimics software based on preoperative computed tomography (CT) scans, followed by virtual reduction procedures performed in 3-matic software. Comprehensive demographic and morphological data were collected, including patient age, gender distribution, fracture classification, and quantitative parameters of bone defects the volume of bone defect (VBD), extent of bone defect area (EBDA), main defect region (MDR), and maximal defect height (MDH).</div></div><div><h3>Results</h3><div>Quantile regression demonstrated that age exhibited strong positive associations with VBD across all quantiles (<em>P</em> < 0.001). EBDA and MDH showed consistently significant positive associations with VBD at every quantile level (all <em>P</em> < 0.001). For Sex, males showed no statistically significant differences compared to females (all <em>P</em> > 0.05). Among fracture classifications, 2-part fracture and 3-part fracture had comparable VBD values to 4-part fracture in most quantiles (all <em>P</em> > 0.05), except for 2-part fracture at Q90 (<em>P</em> = 0.017).</div></div><div><h3>Conclusion</h3><div>This study demonstrates that all varus PHFs with significant displacement are associated with bone defects. Age, EBDA, and MDH are positively correlated with VBD, highlighting the importance of considering these factors in surgical planning.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 10","pages":"Article 112671"},"PeriodicalIF":2.0000,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A quantitative analysis of bone defects in displaced proximal humeral fractures using virtual reduction technique\",\"authors\":\"Xueliang Cui , Xiangxu Chen , Wenjun Xie , Sheng Zhang , Hui Chen\",\"doi\":\"10.1016/j.injury.2025.112671\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background and Objective</h3><div>Medial column disruption in proximal humeral fractures (PHFs) is associated with poor outcomes following reduction and internal fixation. Current assessments of unstable medial columns rely on qualitative descriptors such as disrupted hinges and insufficient osseous contact, often overlooking the quantification of bone defects. This study aims to quantitatively analyze bone defect characteristics in varus PHFs using advanced computer image processing techniques.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted on 202 patients diagnosed with varus proximal humeral fractures who received treatment at two tertiary hospitals between January 2017 and December 2022. Three-dimensional (3D) fracture models were reconstructed using Mimics software based on preoperative computed tomography (CT) scans, followed by virtual reduction procedures performed in 3-matic software. Comprehensive demographic and morphological data were collected, including patient age, gender distribution, fracture classification, and quantitative parameters of bone defects the volume of bone defect (VBD), extent of bone defect area (EBDA), main defect region (MDR), and maximal defect height (MDH).</div></div><div><h3>Results</h3><div>Quantile regression demonstrated that age exhibited strong positive associations with VBD across all quantiles (<em>P</em> < 0.001). EBDA and MDH showed consistently significant positive associations with VBD at every quantile level (all <em>P</em> < 0.001). For Sex, males showed no statistically significant differences compared to females (all <em>P</em> > 0.05). Among fracture classifications, 2-part fracture and 3-part fracture had comparable VBD values to 4-part fracture in most quantiles (all <em>P</em> > 0.05), except for 2-part fracture at Q90 (<em>P</em> = 0.017).</div></div><div><h3>Conclusion</h3><div>This study demonstrates that all varus PHFs with significant displacement are associated with bone defects. Age, EBDA, and MDH are positively correlated with VBD, highlighting the importance of considering these factors in surgical planning.</div></div>\",\"PeriodicalId\":54978,\"journal\":{\"name\":\"Injury-International Journal of the Care of the Injured\",\"volume\":\"56 10\",\"pages\":\"Article 112671\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2025-08-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Injury-International Journal of the Care of the Injured\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0020138325005315\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Injury-International Journal of the Care of the Injured","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0020138325005315","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}

引用次数: 0

摘要

背景与目的肱骨近端骨折（phf）的内侧柱断裂与复位和内固定后的不良预后相关。目前对不稳定内侧柱的评估依赖于定性描述，如铰链断裂和骨接触不足，往往忽略了骨缺陷的量化。本研究旨在利用先进的计算机图像处理技术定量分析内翻性phf的骨缺损特征。方法对2017年1月至2022年12月在两家三级医院接受治疗的202例肱骨近端内翻骨折患者进行回顾性队列研究。基于术前计算机断层扫描（CT），使用Mimics软件重建三维（3D）骨折模型，然后在3-matic软件中进行虚拟复位程序。收集患者年龄、性别分布、骨折分型、骨缺损定量参数、骨缺损体积（VBD）、骨缺损面积（EBDA）、主要缺损区域（MDR）、最大缺损高度（MDH）等人口学和形态学综合数据。结果分位数回归显示，年龄与VBD在所有分位数中均表现出强烈的正相关(P <；0.001)。在每个分位数水平上，EBDA和MDH均与VBD呈显著正相关(P <；0.001)。在性别方面，男性与女性相比没有统计学上的显著差异(P >；0.05)。在骨折分类中，2部分骨折和3部分骨折的VBD值在大多数分位数上与4部分骨折相当(所有P >；Q90处2部分骨折除外（P = 0.017）。结论所有内翻的phf移位均与骨缺损相关。年龄、EBDA和MDH与VBD呈正相关，强调了在手术计划中考虑这些因素的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

A quantitative analysis of bone defects in displaced proximal humeral fractures using virtual reduction technique

Background and Objective

Medial column disruption in proximal humeral fractures (PHFs) is associated with poor outcomes following reduction and internal fixation. Current assessments of unstable medial columns rely on qualitative descriptors such as disrupted hinges and insufficient osseous contact, often overlooking the quantification of bone defects. This study aims to quantitatively analyze bone defect characteristics in varus PHFs using advanced computer image processing techniques.

Methods

A retrospective cohort study was conducted on 202 patients diagnosed with varus proximal humeral fractures who received treatment at two tertiary hospitals between January 2017 and December 2022. Three-dimensional (3D) fracture models were reconstructed using Mimics software based on preoperative computed tomography (CT) scans, followed by virtual reduction procedures performed in 3-matic software. Comprehensive demographic and morphological data were collected, including patient age, gender distribution, fracture classification, and quantitative parameters of bone defects the volume of bone defect (VBD), extent of bone defect area (EBDA), main defect region (MDR), and maximal defect height (MDH).

Results

Quantile regression demonstrated that age exhibited strong positive associations with VBD across all quantiles (P < 0.001). EBDA and MDH showed consistently significant positive associations with VBD at every quantile level (all P < 0.001). For Sex, males showed no statistically significant differences compared to females (all P > 0.05). Among fracture classifications, 2-part fracture and 3-part fracture had comparable VBD values to 4-part fracture in most quantiles (all P > 0.05), except for 2-part fracture at Q90 (P = 0.017).

Conclusion

This study demonstrates that all varus PHFs with significant displacement are associated with bone defects. Age, EBDA, and MDH are positively correlated with VBD, highlighting the importance of considering these factors in surgical planning.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Injury-International Journal of the Care of the Injured 医学-急救医学

CiteScore

4.00

自引率

8.00%

发文量

699

审稿时长

96 days

期刊介绍： Injury was founded in 1969 and is an international journal dealing with all aspects of trauma care and accident surgery. Our primary aim is to facilitate the exchange of ideas, techniques and information among all members of the trauma team.