肱骨近段髓腔CT测量与假体柄设计的相关研究

Proximal endosteal part of the humerus: relevance to artificial humeral stem

目的 :为设计适合国人的肱骨头假体柄提供相关髓腔参数。方法 :10 0根成对防腐肱骨 (男 2 8对 ,女 2 2对 )按肱骨头扭转角置于冠状位 ,行解剖颈下缘及其下 2 0、40mm和髓腔狭窄部 4平面CT扫描 ,由CT软件测量冠 (ML)、矢状位 (AP)髓腔内参数。结果 :测得部分参数值为狭窄位置 ( 166.3 7± 17.14 )mm ,颈下缘髓腔宽ML( 3 2 .85± 4.2 1)mm ,AP( 2 8.45± 4.3 8)mm ,狭窄部髓腔宽ML( 10 .2 9± 2 .0 8)mm ,AP( 13 .0 9± 2 .97)mm ;进一步分组比较提示性别间多数参数差异显著 ,而左右间无显著差异。结论 :本文结果可供设计适合国人的人工肱骨假体柄提供参考值 ,在设计和选择假体时需考虑干骺端性别差异。

Objective: To provide endosteal parameters of the proximal humerus for designing of humeral prosthesis stem fitting Chinese. Methods: 100 embalmed cadaveric humeri (50 pairs: 28 males and 22 females) were scanned in medial-lateral(ML) according to the humeral retroversion by CT. Images of the humerus in the transverse planes at the lowest border of neck(LBN), 20 mm and 40 mm distal of LBN(LBN-20 and LBN-40) and isthmus were obtained. Intracortical parameters were measured exactly by image analytic computer software. Results: Part values of the parameters for the position of isthmus was 166.37±17.14 mm, the canal width(CW)of LBN was 32.85±4.21 mm in ML, 28.45±4.38 mm in anterior-posterior (AP),and CW of isthmus was10.29±2.08 mm in ML, 13.09±2.97 mm in AP. Notable differences were observed between male and female in many parameters, but not between right and left. Conclusion: This study can provide anatomical parameters for designing the humeral stem fitting Chinese. The difference of metaphyseal gender on designing and selecting of prostheses need to be considered.