基于3D偏差分析的成人桡骨远端解剖对称性研究

An anatomical symmetry study of distal radius in adults via three-dimensional deviation analysis

目的通过形态学测量方法评估成人桡骨远端解剖的对称性。方法采集15例正常志愿者的双侧前臂薄层CT扫描数据,对桡骨远端1/3的骨性结构进行三维重建,以模型体积和表面积作为目标参数对每一例志愿者左、右侧桡骨的三维模型进行解剖测量;进一步通过3D偏差分析方法完成双侧桡骨模型解剖对称性的定量化和可视化分析。结果左、右侧桡骨远端表面积最大差异小于5.6%(P=0.004),体积差异小于9.1%(P=0.005);3D偏差分析结果显示,受试者的最大平均负偏差为-0.40 mm,最大平均正偏差为0.34 mm;3D偏差较大的区域主要分布在桡骨远端的非关节面部位。结论成人桡骨远端在关节面形态方面具有高度的解剖对称性,临床上对于桡骨远端关节内骨折的外科解剖重建,采用健侧桡骨镜像模型作为参考对象有利于指导桡骨远端骨折的精准复位重建,这对于术后桡腕关节功能的恢复具有重要意义。

Objective To evaluate the anatomical symmetry of the bilateral distal radius in adults using morphological measurement. Methods Three-dimensional reconstruction was carried out using the CT scans of 15 pairs of distal radius of the volunteers enrolled. The radial models were sectioned in distal 1/3 parts. Two geometric measurements of bilateral distal radii, volume and surface area, were obtained from each object. Furthermore, quantification and visualizationof the anatomical symmetry of bilateral distal radius were conducted using the three-dimensional deviation analysis method. Results Regarding the surface area, the maximal percent difference between the left and right distal radius was no more than 5.6%（P=0.004）. Similarly, regarding the volume, the maximal percent difference between the left and right distal radius was no more than 9.1%（P=0.005）. Results of the three-dimensional deviation analyses showed that the maximal mean negative deviation was -0.40 mm while the maximal mean positive deviation was 0.34 mm. Moreover, it was observed that the relatively high deviation distributed in those regions away from the joint facets. Conclusions The bilateral distal radii show an excellent anatomical symmetry. In clinical practice, for the anatomical reconstruction of the distal intra-articular radial fracture, the mirror model of the intact radius can be used as reference to guide the fracture reduction precisely during operation. This has great significance for the restoration of the postoperative function of the radiocarpal joint.