Straight antegrade humeral nailing and risk of iatrogenic injury of supraspinatus tendon footprint: An MRI study.

Q4 Medicine Colon and Rectum Pub Date : 2023-11-01 Epub Date: 2023-01-12 DOI:10.1177/17585732221150895

Julio J Contreras, Arturo Meissner, Alfonso Valenzuela, Rodrigo Liendo, Rodrigo de Marinis, Claudio Calvo, Francisco Soza

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Abstract

Background: Straight antegrade humeral nailing (SAHN) is associated with excellent clinical results in proximal humerus fractures. The optimal entry point is the top of the humeral head. However, the anatomy is variable, and the entry point can affect supraspinatus tendon footprint (SSP-F) or fracture reduction. The aim of this study was to analyze the relationship between the SSP-F and SAHN entry point by analyzing magnetic resonance imaging (MRI) studies of the humerus.

Methods: In total 58 MRI studies of entire humerus were reviewed. The mean age was 51.6 ± 12.4 years, with 40 female patients. The distance between the SSP-F and the SAHN insertion point (critical distance: CD), the width of the footprint, and the neck-shaft angle (NSA) were measured. Univariate and multivariate analysis were performed.

Results: The mean CD was 7.51 mm ± 2.81 (0-12.9 mm) with 51.7% of proximal humerus "critical type" (CD <8 mm). The CD was found to be lower in females, with no difference found with varying age (62.5% "critical type"). CD correlated with NSA (linear regression). "Critical type" correlated with female gender and NSA (logistic regression).

Discussion: More than half of the humerus are "critical types" as to SAHN and may, therefore, be at risk for procedure-related complications.

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直顺行肱骨钉与冈上肌腱足迹医源性损伤的风险:一项MRI研究。

背景:直顺行肱骨内钉(SAHN)治疗肱骨近端骨折具有良好的临床效果。最佳进入点是肱骨头的顶部。然而，解剖结构是可变的，进入点可能影响冈上肌腱足迹(SSP-F)或骨折复位。本研究的目的是通过分析肱骨的磁共振成像(MRI)研究来分析SSP-F与SAHN进入点之间的关系。方法:对58例全肱骨MRI研究进行回顾性分析。平均年龄51.6±12.4岁，女性40例。测量了SSP-F与SAHN插入点之间的距离(临界距离:CD)、足迹宽度和颈轴角(NSA)。进行单因素和多因素分析。结果:平均CD为7.51 mm±2.81 (0-12.9 mm)，其中51.7%的肱骨近端为“关键型”(CD)。讨论:超过一半的肱骨是SAHN的“关键型”，因此可能存在手术相关并发症的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Colon and Rectum Medicine-Gastroenterology

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期刊介绍： Côlon & Rectum est une revue de formation continue dans le champ pathologique des maladies du côlon, du rectum et de l"anus. Ses domaines de veille scientifique (données publiées et factuelles) et d"enseignement (dossiers thématiques complets) concernent les cancers, les maladies inflammatoires intestinales, les troubles fonctionnels intestinaux et les maladies proctologiques. L"expertise chirurgicale, endoscopique et proctologique, est largement développée à des fins de pratique clinique (fiches techniques). La revue intéressera l"ensemble des acteurs de santé impliqués dans la prise en charge des malades souffrant de troubles colorectaux.

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