肩锁关节的形态学特征研究

A study of morphological characteristics of acromioclavicular joints

目的:探讨肩锁关节的形态学特征。方法:纳入100例接受肩部X线和CT检查且肩锁关节正常的患者,分别在过锁骨远端后沿冠状位CT片、过锁骨远端中线冠状位CT片、肩锁关节正位X线片上测量锁骨远端高度、肩峰高度、锁骨远端上沿与纵轴线成角、肩峰下沿与纵轴线成角,比较不同性别、侧别的肩锁关节形态学特征,分析不同方法测量结果的差异。结果:(1)不同性别的肩锁关节形态学特征比较。在过锁骨远端后沿冠状位CT片、过锁骨远端中线冠状位CT片、肩锁关节正位X线片上,男性锁骨远端高度、肩峰高度均大于女性[锁骨远端高度:(10.44±1.93)mm,(9.53±1.56)mm,t=2.565,P=0.012;(12.49±1.76)mm,(11.20±1.73)mm,t=3.681,P=0.000;(12.47±1.66)mm,(11.18±1.68)mm,t=3.598,P=0.000;肩峰高度:(8.51±1.49)mm,(7.28±1.57)mm,t=3.223,P=0.002;(7.26±1.49)mm,(6.37±1.24)mm,t=3.973,P=0.000;(8.47±1.38)mm,(7.25±1.48)mm,t=3.898,P=0.000];男性锁骨远端上沿与纵轴线成角、肩峰下沿与纵轴线成角与女性比较,差异均无统计学意义。(2)不同侧别的肩锁关节形态学特征比较。在过锁骨远端中线冠状位CT片、肩锁关节正位X线片上,左侧锁骨远端上沿与纵轴线成角大于右侧(90.15°±8.48°,85.75°±10.88°,t=-2.269,P=0.025;90.12°±8.39°,85.68°±10.76°,t=-2.248,P=0.031);左侧锁骨远端高度、肩峰高度、肩峰下沿与纵轴线成角与右侧比较,差异均无统计学意义。在过锁骨远端后沿冠状位CT片上,左侧锁骨远端高度、肩峰高度、锁骨远端上沿与纵轴线成角、肩峰下沿与纵轴线成角与右侧比较,差异均无统计学意义。(3)不同方法测量的肩锁关节形态学特征比较。在过锁骨远端中线冠状位CT片上测量的锁骨远端高度、肩峰高度、锁骨远端上沿与纵轴线成角、肩峰下沿与纵轴线成角,与在肩锁关节正位X线片上测量的结果比较,差异均无统计学意义。结论:男性的锁骨远端高度和肩峰高度均大于女性,左侧的锁骨远端上沿与纵轴线成角大于右侧,在过锁骨远端中线冠状位CT片和肩锁关节正位X线片上测量的肩锁关节形态学特征数据无显著差异。

Objective:To explore the mopbological characeristics of acromioclavicular joint.Methods:One bundred subjects with nor-mal acromioclavicular joints who were confimed by shoulder X-nay and CT examinations were enrolled in the study.The distal clavicle height,acromion height,angle between the superior border of distal clavidle and the longitudinal axis as well as angle between the inferior border of acromion and the longitudinal axis were measured on the coronal CT films taken a the posterior border of distal clavicle,coronal CT films taken at the midline of distal cavicle and anteroposterior X-ray films of acromioclavicular joints respectively.The morpbological characteristics of the acromioclavicular joints were compared between males and females as well a between left side and right side,and the differences in results measured using different methods were analyzed.Results:①The distal clavicle height and acromion height were grea-ter in males than that in females on the coronal CT films taken at the posterior border of distal clavidle,coronal CT films taken at the midline of distal davicle and anteroposterior X-nay films of acromioclavicular joints(distal clavide height:10.44+1.93 vs9.53±1.56 mm,t=.2.565,P=0.012;12.49+1.76vs11.20+1.73 mm,t=3.681,P=0.000;12.47+1.66vs 11.18+1.68 mm,1=3.598,P=0.000;ac-romion height:8.51+1.49 vs7.28+1.57 mm,t=3.223,P=0.002;7.26+1.49 vs6.37+1.24 mm,t=3.973,P=0.000;8.47+1.38 vs 7.25+1.48 mm,t=3.898,P=0.000),while,the angle between the superior border of distal clavicle and the longiudinal axis as well as the angle between the inferior border of acromion and the longiudinal axis were not significanly different between males and females.②On the coronal CT films laken at the midline of distal clavicle and anteroposterior X-ray films of acromioclavicular joints,the angle be tween the superior border of distal clavicle and the longitudinal axis was grealer on the left side compared to the right side(90.15+8.48 vs 85.75±10.88 degrees,t=-2.269,P=0.025;90.12+8.39 vs 85.68±10.76 degrees,t=-2.248,P=0.031),while,the distal elavi-cle height,acromion beight and the angle between the inferior border of acromion and the longitudinal axis were not signifcantly diferent between left side and right side.On the coronal CT films taken at the posterior border of the distal dlavicle,the distal clavicle beight,acromi-on height,angle between the superior border of distal clavicle and the longitudinal axis as well as angle between the inferior border of acro-mion and the longitudinal axis were not significantly different between left side and right side.③The differences in distal clavide beight,ac romion height,angle between the superior border of distal clavicle and the longiudinal axis as well as angle between the inferior border of acromion and the longitudinal axis were not statistically significant between the results measured on the coronal CT films taken at the mid-line of distal clavicle and the ones measured on anteroposterior X-ray films of acromioclavicular joints.Conclusion:The distal clavicle height and acromion height are greater in males than that in females,and the angle between the superior border of distal clavicle and the longitdinal axis is greater on the left side compared to the right side,furthermore,there are no stalistical differences in the dala of morpho-logical characteristics of acromioclavicular joints between the results meas ured on the coronal CT films taken at the midline of distal clavicle and the ones measured on anteroposterior X-ray films of acromioclavicular joints.