盂肱关节骨性结构对肩关节前向不稳定的影响  

Influence analysis of glenohumeral bone structure on anterior shoulder instability

作　　者：陈毅 秦萌阳[3,4] 庞龙 郭斌 张春森 唐新 CHEN Yi;QIN Mengyang;PANG Long;GUO Bin;ZHANG Chunsen;TANG Xin(Department of Orthopedics,Sports Medicine Center,West China Hospital,Sichuan University,Chengdu Sichuan,610041,P.R.China;Department of Orthopedics,the Fifth People’s Hospital of Datong City,Datong Shanxi,037009,P.R.China;Department of Radiology,West China Hospital,Sichuan University,Chengdu Sichuan,610041,P.R.China;Department of Radiology,Huaihe Hospital,Henan University,Kaifeng Henan,475000,P.R.China;Department of Orthopedics,the First People’s Hospital of Jinzhong City,Jinzhong Shanxi,030600,P.R.China)

机构地区：[1]四川大学华西医院骨科运动医学中心,成都610041 [2]大同市第五人民医院骨科,山西大同037009 [3]四川大学华西医院放射科,成都610041 [4]河南大学淮河医院放射科,河南开封475000 [5]晋中市第一人民医院骨科,山西晋中030600

出　　处：《中国修复重建外科杂志》2024年第12期1433-1438,共6页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：国家自然科学基金资助项目(82072514、82272569)。

摘　　要：目的通过对盂肱关节骨性结构行三维CT重建分析,明确其对肩关节前向不稳定的影响。方法回顾性分析2012年2月—2024年1月收治的48例单侧肩关节前脱位患者(不稳组)及46例非肩关节疾病就诊患者(对照组)临床资料。两组患者性别、侧别比较差异无统计学意义(P>0.05);不稳组患者年龄小于对照组,差异有统计学意义(P<0.05)。行肩胛盂三维CT重建检查,测量肩胛盂高度、肩胛盂宽度、肩胛盂高宽比、肩胛盂倾斜角、肱骨头包含角及肩胛盂扭转角等盂肱关节形态学参数。比较两组上述指标差异,并分男、女性别分别比较两组上述指标差异;采用随机森林模型分析肩关节前向不稳定的影响因素。结果两组间比较以及男、女性别两组间比较均显示,不稳组的肩胛盂高宽比大于对照组,肩胛盂宽度和肱骨头包含角小于对照组,差异有统计学意义(P<0.05);两组肩胛盂高度、肩胛盂倾斜角及肩胛盂扭转角比较差异均无统计学意义(P>0.05)。随机森林模型准确度为0.84,结果示肩关节前向不稳定的影响因素前4位分别是肩胛盂高宽比、肱骨头包含角、年龄、肩胛盂宽度。结论肩胛盂高宽比和肱骨头包含角是肩关节前向不稳定的重要影响因素。Objective To investigate the effect of glenohumeral bone structure on anterior shoulder instability by three-dimensional CT reconstruction.Methods The clinical data of 48 patients with unilateral anterior shoulder dislocation(instability group)and 46 patients without shoulder joint disease(control group)admitted between February 2012 and January 2024 were retrospectively analyzed.There was no significant difference in gender and side between the two groups(P>0.05).The patients were significantly younger in the instability group than in the control group(P<0.05).The glenoid joint morphological parameters such as glenoid height,glenoid width,ratio of glenoid height to width,glenoid inclination,the humeral containing angle,and glenoid version were measured on three-dimensional CT reconstruction of the glenoid.The differences of the above indexes between the two groups were compared,and the differences of the above indexes between the two groups were compared respectively in the male and the female.Random forest model was used to analyze the influencing factors of anterior shoulder instability.Results The comparison between the two groups and the comparison between the two groups in the male and the female showed that the ratio of of the instability group glenoid height to width was larger than that of the control group,the glenoid width and humeral containing angle were smaller than those of the control group,and the differences were significant(P<0.05);there was no significant difference in glenoid height,glenoid inclination,and glenoid version between the two groups(P>0.05).The accuracy of the random forest model was 0.84.The results showed that the top four influencing factors of anterior shoulder instability were ratio of glenoid height to width,the humeral containing angle,age,and glenoid width.Conclusion Ratio of glenoid height to width and the humeral containing angle are important influencing factors of anterior shoulder instability.

关 键 词：肩关节前向不稳定 盂肱关节 三维CT重建 

分 类 号：R687.4[医药卫生—骨科学]