三维成像重建肱骨远端髓腔内骨嵴的形态学特点:与实际标本观察对比(英文)

Morphological characteristics of the distal intramedullary bony crista of the human humerus using three dimensional imaging An observational comparison with practical samples

背景：作者的前期实验发现肱骨远端髓腔内存在骨性突起，但对其具体形态特点和临床意义还不清楚。目的：观察肱骨远端髓腔内骨性突起的形态学特征，并分析其潜在的临床意义。设计、时间及地点：CT扫描测量与实体标本观察对比，于2007-06／12在南昌大学第一附属医院CT室和骨科实验室完成。材料：80根干燥成人肱骨，均由南昌大学医学院解剖教研室提供，左49根，右31根，排除肱骨无骨折及病损。方法：应用16层CT对80根肱骨远段1／3进行扫描，三维重建成像后，从冠状面、矢状面和横截面观察并描述鹰嘴窝上髓腔内骨性突起的形态特点，然后将20根肱骨远段1/3存冠状面上从中线纵行削开，对髓腔内骨嵴行直观观察。主要观察指标：骨嵴主要存在于内侧还是外侧，骨嵴基底部范围，骨嵴排列特点。结果：鹰嘴窝上髓腔内1．9-3．2cm内（平均2．6cm）存在骨性突起，骨质与皮质骨相近。基底部位于后方，内、外侧分别呈倒八字形排列。骨崤以一侧为主，其中59根以内侧为主，21根以外侧为主，呈二三行平行排列；另一侧骨嵴则较紊乱。结论：描述了以前未有记载的肱骨远端髓腔内骨嵴的形态，对肱骨远端骨折内固定和肘关节人工关节置换均有一定的临床意义。

BACKGROUND： The bony crista has been found in the distal humeral medullary cavity, but its specific morphological characteristics and clinical significance are not clear. OBJECTIVE： To study the morphology of bony crista inside the distal intramedullary of the human humerus and its potential clinical relevance. DESIGN, TIME AND SETTING： CT scanning and measurement as well as visualized observation to the specimen for the dry adult humeri was performed at CT Room and Department of Orthopaedics, First Affiliated Hospital, Nanchang University from June to December 2007. MATERIALS： A total of 80 dry adult humeri （left： 49; right： 31 ） were purchased from the Department of Anatomy, Medical College of Nanchang University, excluding the fractured and lesion humerus. METHODS： The low 1/3 of eighty human humeri were scanned by 16 layer spiral CT. The morphotogical features of the intramedullary bony prominence above the olecranon fossa was described in terms of coronal plane, sagittal plane and transverse section after three-dimensional reconstruction. The low 1/3 of twenty humeri were then split vertically in the middle line in coronal plane, to view the intramedullary bony crista directly. MAIN OUTCOME MEASURES： The bony crista mainly located on the medial or lateral side, the range of the basilar part of the bony crista, alinement characteristic of the bony crista. RESULTS： The extent of intramedullary bony crista ranged from 1.9 to 3.2 cm （mean 2.6 cm） above the olecranon fossa, the density similar to cortical bone, with an basement posterior, and medial part and lateral side intero-inferiorly incline. 59 out of the 80 humeri, medial side dorminated; on the rest humeri the lateral side dorminated. 2 or 3 parallel lines on the dorminate side, irregular alignment on the other side. CONCLUSION： The study described the morphology of the distal intrameduilary bony crista of the humerus, which has never been reported so far. In addition, its clinical relevance in terms of the internal fixation of fracture on the distal humerus and elbow arthroplasty was also demonstrated.