一种新的肱骨近端放射学分类系统。

Rudy Sangaletti, Salahulddin Abuljadail, Mustafa Akkaya, Luigi Zanna, Thorsten Gehrke, Mustafa Citak
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引用次数: 0

摘要

据报道,股骨近端和远端存在不同的解剖变异。在这种情况下,我们研究的目标是回答以下问题:我们是否也能识别肱骨近端的不同解剖变异?回顾了200张肱骨近端前后位(AP)X线片,其性别分布和性别偏侧性相同。测量肱骨近端解剖颈水平处的干骺端直径(X)和离大结节顶点10cm处的髓内直径(Y)。基于这两个测量值(Y/X)建立了一个新的比率。射线照片显示不同的解剖变异:A型:Y/X 0.4。两名观察者在两个不同的疗程中独立且盲目地回顾AP射线照片。根据第25和第75个百分位数确定了三个不同的解剖组(A、B和C)。女性中C型的比例较高,男性中A型的比例也较高。观察者之间的可靠性很高,Cronbachα为0.97(ICC 0.96-0.98)。观察者1的观察者内部可靠性为0.98。根据3种不同的解剖类型(A、B和C)建立了肱骨近端的新放射学分类。需要进一步的研究来确定这种新的分类系统是否可以作为骨水泥或非骨水泥全肩关节置换术无菌松动的指标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Novel Radiological Classification System of the Proximal Humerus.

Different anatomical variants have been reported for the proximal and distal femur. Given this context, the goal of our study was to answer the following question: Can we also identify different anatomical variants of the proximal humerus?Two hundred anteroposterior (AP) radiographs of the proximal humerus with an equal gender distribution and equal laterality per gender were reviewed. The metaphyseal diameter of the proximal humerus at the level of the anatomical neck (X) and the intramedullary diameter at 10 cm from the apex of the greater tuberosity (Y) were measured. A new ratio was established, based on both measurements (Y/X). Radiographs showed different anatomical variants: type A: Y/X < 0.3, type B: Y/X = 0.3-0.4, type C: Y/X > 0.4. Two observers reviewed the AP radiographs independently and blindly in 2 different sessions.Three different anatomical groups (A, B and C) were identified based on the 25th and 75th percentiles. A higher percentage of type C was observed among females and a higher percentage of type A among males. A high inter-observer reliability was noted, with a Cronbach's alpha of 0.97 (ICC 0.96-0.98). The intra-observer reliability for observer 1 had a Cronbach's alpha of 0.98.A novel radiological classification of the proximal humerus has been established based on 3 different anatomical types (A, B and C). Further studies are needed to establish whether the novel classification system can be used as an indicator for aseptic loosening of cemented or cementless total shoulder arthroplasty.

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