Clinical Study Based on DR Imaging Measurement of Ulnar Coronoid Process
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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。 
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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 $，n=102）
指标 男性 女性 t P a（mm） 8.68±1.49 6.91±1.10 6.89 <0.001* b（mm） 13.95±1.53 11.71±1.26 8.11 <0.001* c（mm） 38.33±2.88 33.47±2.76 8.66 <0.001* d（mm） 52.71±5.44 47.33±4.84 5.27 <0.001* a：尺骨冠突桡侧安全置钉距离；b：尺骨冠突尺侧安全置钉距离；c：尺骨冠突近端安全置钉距离；d：尺骨冠突远端的安全置钉距离。*P < 0.05。
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表 3 左侧、右侧一般情况比较（$ \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。
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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。
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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。
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