Clinical Study Based on DR Imaging Measurement of Ulnar Coronoid Process
-
摘要:
目的 探讨基于尺骨冠突DR影像测量分析不同因素对尺骨冠突安全置钉的影响。 方法 从云南省中医医院2020年07月至2021年11月期间随机纳入102例正常成人正侧位肘关节DR片，选择标准的肘关节正位DR片作为测量对象，以冠突尖为顶点作沿冠突两侧平行于肘关节间隙的2条直线，冠突尖到尺骨桡、尺侧皮质交点线段的长度为尺骨冠突置钉冠状面的安全置钉的距离；再选择标准肘关节侧位DR片作为测量影像，以冠突尖为点引出近、远端两条与尺骨皮质相交的安全线，冠突尖近端安全线与远端安全线的长度为尺骨冠突矢状面的安全置钉距离，比较不同性别、左右侧对安全置钉距离的差异和不同截面上安全置钉距离之间相关性分析。 结果 男性与女性尺骨冠突安全置钉距离差异有统计学意义（P < 0.05）；在冠状面上，男性桡侧与尺侧的安全置钉距离存在相关性；在矢状面上，女性近端与远端的尺骨冠突安全置钉距离存在相关性。 结论 研究尺骨冠突安全置钉距离有利于指导临床尺骨冠突骨折置钉、设计新型钢板、畸形矫正等。 Abstract:Objective To explore the influence of different factors on the safe screw placement of the ulnar coronoid process based on the DR imaging measurement of the ulnar coronoid process. Methods During the period from July 2020 to November 2021, 102 normal adult elbow joint DR films were randomly included from Yunnan Provincial Hospital of Traditional Chinese Medicine. Standard elbow joint DR films were selected as the measurement objects, with the apex of the coronoid process as the vertex and two straight lines parallel to the elbow joint space along both sides of the coronoid process. The length of the line segment from the apex of the coronoid process to the intersection of the radius and ulnar cortex of the ulna is the safe distance to place the nail on the coronal surface of the ulna coronoid process; Select the standard lateral DR film of the elbow joint as the measurement image, and use the apex of the coronoid process as a point to draw out two safety lines intersecting with the ulnar cortex at the proximal and distal ends. The length of the safety lines at the proximal and distal ends of the coronoid process is the safe nail placement distance on the sagittal plane of the ulnar coronoid process. Compare the differences in safe nail placement distance between different genders, left and right sides, and analyze the correlation between safe nail placement distances on different cross-sections. Results There was a statistically significant difference in the safe placement distance of the ulnar coronoid process between males and females （P < 0.05）; On the coronal plane, there was a correlation between the safe nail placement distance on the radial and ulnar sides in males; On the sagittal plane, there was a correlation between the safe placement distance of the ulnar coronoid process in women’ s proximal and distal ends. Conclusion Studying the safe screw placement distance of the ulnar coronoid process is beneficial to guide the clinical placement of screws for coronoid process fractures, the design of new steel plates, and the correction of deformity. -
图 1 尺骨冠突安全置钉距离测量示意图
a：尺骨冠突桡侧安全置钉距离；b：尺骨冠突尺侧安全置钉距离；c：尺骨冠突近端安全置钉距离；d：尺骨冠突远端的安全置钉距离。
Figure 1. Schematic diagram for measuring the safe distance of the ulnar coronoid process nail placement
图 2 尺骨冠突桡侧安全置钉距离与尺骨冠突尺侧安全置钉距离相关性
A：男性；B：女性；a：尺骨冠突桡侧安全置钉距离；b：尺骨冠突尺侧安全置钉距离。
Figure 2. Correlation between the radial safe nail placement distance of the ulnar coronoid process and the ulnar safe nail placement distance of the ulnar coronoid process
图 3 尺骨冠突近端安全置钉距离与尺骨冠突远端的安全置钉距离相关性
A：男性；B：女性；c：尺骨冠突近端安全置钉距离；d：尺骨冠突远端的安全置钉距离。
Figure 3. Correlation between the safe nail placement distance at the proximal and distal ends of the ulnar coronoid process （The left image shows males，and the right image shows females）
表 1 基本资料描述
Table 1. Description of basic data
指标 平均值 中位数 SD 最大值 最小值 a（mm） 7.67 7.61 1.55 11.52 2.89 b（mm） 12.68 12.30 1.78 17.31 9.06 c（mm） 35.57 35.33 3.70 48.90 27.52 d（mm） 49.65 49.54 5.74 65.37 36.11 总年龄（岁） 45.78 47.50 14.79 80 18 男性年龄（岁） 43.64 43.50 15.52 80 19 女性年龄（岁） 47.41 48.50 14.12 80 18 a：尺骨冠突桡侧安全置钉距离；b：尺骨冠突尺侧安全置钉距离；c：尺骨冠突近端安全置钉距离；d：尺骨冠突远端的安全置钉距离。 
下载: 导出CSV
表 2 男、女一般情况比较（$ \bar x \pm s $，n=102）
Table 2. Comparison of male and female situations （$ \bar x \pm s $，n=102）
指标 男性 女性 t P a（mm） 8.68±1.49 6.91±1.10 6.89 <0.001* b（mm） 13.95±1.53 11.71±1.26 8.11 <0.001* c（mm） 38.33±2.88 33.47±2.76 8.66 <0.001* d（mm） 52.71±5.44 47.33±4.84 5.27 <0.001* a：尺骨冠突桡侧安全置钉距离；b：尺骨冠突尺侧安全置钉距离；c：尺骨冠突近端安全置钉距离；d：尺骨冠突远端的安全置钉距离。*P < 0.05。
下载: 导出CSV
表 3 左侧、右侧一般情况比较（$ \bar x \pm s $，n=102）
Table 3. Comparison of left and right cases（$ \bar x \pm s $，n=102）
指标 左侧 右侧 t P a（mm） 7.89±1.83 7.52±1.32 1.18 0.24 b（mm） 12.88±1.55 12.53±1.92 0.98 0.33 c（mm） 35.79±3.74 35.41±3.69 0.51 0.62 d（mm） 50.21±5.27 49.27±6.06 0.81 0.41 a：尺骨冠突桡侧安全置钉距离；b：尺骨冠突尺侧安全置钉距离；c：尺骨冠突近端安全置钉距离；d：尺骨冠突远端的安全置钉距离。
下载: 导出CSV
表 4 尺骨冠突桡侧安全置钉距离和尺骨冠突尺侧安全置钉距离相关性分析
Table 4. Correlation analysis of safe napping distance on radial side of ulnar coronal process and safe napping distance on ulnar coronal process
指标 r P 男性 0.335 0.026* 女性 0.207 0.119 a：尺骨冠突桡侧安全置钉距离；b：尺骨冠突尺侧安全置钉距离。*P < 0.05。
下载: 导出CSV
表 5 尺骨冠突近端安全置钉距离和尺骨冠突远端的安全置钉距离相关性分析
Table 5. Correlation analysis of the safe napping distance between the proximal end of ulna coronoid process and the distal end of ulna coronoid process
指标 r P 男性 1.176 0.253 女性 0.581 <0.001* c：尺骨冠突近端安全置钉距离；d：尺骨冠突远端的安全置钉距离。*P < 0.05。
下载: 导出CSV
-
[1] 樊璐璐,赵超,曹志新. 等速训练结合康复手法松解对创伤后肘关节僵直(PTES)患者的临床治疗效果分析[J]. 现代诊断与治疗,2019,30(19):3398-3400. [2] 保超宇,潘斯学,卢钰等. X线影像下确定成人尺骨冠突置钉安全区的可行性研究[J]. 中医正骨,2022,34(12):14-17. doi: 10.3969/j.issn.1001-6015.2022.12.003 [3] 辛建海,田宝忠,王大麟. 尺侧副韧带前束与尺骨冠突关系的解剖学研究[J]. 北华大学学报(自然科学版),2021,22(5):612-616. [4] Al-Ani Z,Wright A,Ricks M,et al. The three-column concept of elbow joint stability and the Wrightington elbow fracture-dislocation classification,emphasizing the role of cross-sectional imaging[J]. Emerg Radiol,2022,29(1):133-145. doi: 10.1007/s10140-021-01978-3 [5] 潘小磊. 肘关节损伤的磁共振诊断效果分析[J]. 实用医学影像杂志,2020,21(6):688-689. [6] Masood Q M,Qulaghassi M,Grewal U,et al. Proximal ulna fractures in adults: A review of diagnosis and management[J]. J Clin Orthop Trauma,2021,20:101481. doi: 10.1016/j.jcot.2021.101481 [7] 宗双乐,苏立新,梁卫东,等. 合并尺骨干经尺骨鹰嘴骨折并肘关节前脱位的手术治疗[J]. 中华解剖与临床杂志,2022,27(2):106-109. doi: 10.3760/cma.j.cn101202-20210410-00094 [8] 李静,白雪琴,赵小春,等. 下肢负重位DR片全长拼接对全膝关节置换术的评估[J]. 临床骨科杂志,2021,24(1):38-41. [9] 曹建民. DR摄影技术在放射科的应用[J]. 影像研究与医学应用,2021,5(2):82-83. doi: 10.3969/j.issn.2096-3807.2021.02.039 [10] 吴伟. DR、MSCT检查对120例复杂性髋关节骨折成人患者的诊断价值比较[J]. 中国CT和MRI杂志,2020,18(12):158-160. doi: 10.3969/j.issn.1672-5131.2020.12.050 [11] Githens T C,Campbell S T,Salazar B,et al. Understanding the radiographic anatomy of the proximal ulna and avoiding inadvertent intraarticular screw placement[J]. J Orthop Trauma,2020,34(2):102-107. doi: 10.1097/BOT.0000000000001638 [12] Fukai A,Nimura A,Tsutsumi M,et al. Lateral ulnar collateral ligament of the elbow joint: reconsideration of anatomy in terms of connection with surrounding fibrous structures[J]. J Bone Joint Surg Am,2022,104(15):1370-1379. doi: 10.2106/JBJS.21.01406 [13] 贺韬,张云辉,李亘,等. 肘关节前内侧入路治疗冠状突骨折的解剖学研究及临床应用[J]. 中华创伤骨科杂志,2017,19(7):559-565. doi: 10.3760/cma.j.issn.1671-7600.2017.07.002 [14] 祁艳梅,王媛,陈晓飞,等. 尺骨撞击综合征的影像学研究进展[J]. 实用放射学杂志,2020,36(8):1337-1340. doi: 10.3969/j.issn.1002-1671.2020.08.041 [15] 潘斯学,保超宇,夏吉良,等. 正常成人喙突的64排128层螺旋CT数字影像资料的回顾性研究[J]. 昆明医科大学学报,2022,43(10):84-89. doi: 10.12259/j.issn.2095-610X.S20221017 [16] Schneider M T,Zhang J,Crisco J J,et al. Men and women have similarly shaped carpometacarpal joint bones[J]. J Biomech,2015,48(12):3420-3426. doi: 10.1016/j.jbiomech.2015.05.031 [17] Jepsen K J,Bigelow E M,Schlecht S H. Women build long bones with less cortical mass relative to body size and bone size compared with men[J]. Clin Orthop Relat Res,2015,473(8):2530-2539. doi: 10.1007/s11999-015-4184-2 [18] Dunsworth H M. Expanding the evolutionary explanations for sex differences in the human skeleton[J]. Evol Anthropol,2020,29(3):108-116. doi: 10.1002/evan.21834 -
点击查看大图
计量
- 文章访问数: 860
- HTML全文浏览量: 783
- PDF下载量: 3
- 被引次数: 0
