肩胛骨高级塌陷与健康腕部三维腕关节排列的计算机辅助对比分析

IF 2.1 2区 医学 Q2 ORTHOPEDICS Journal of Hand Surgery-American Volume Pub Date : 2024-11-14 DOI:10.1016/j.jhsa.2024.09.021
Mikko Alanen, Samuli Aspinen, Theresa Höglund, Robert Sippo, Eero Waris
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引用次数: 0

摘要

目的:肩胛骨分离经常导致对位不良和肩胛骨后方塌陷(SLAC)。以前的分析依赖于在侧位X光片上对肩胛骨、新月形骨和头骨之间腕骨角度的肉眼观察。然而,SLAC 进展过程中的三维腕关节排列仍不清楚。本研究旨在分析 SLAC 腕关节的三维腕关节错位情况:方法:利用基于分割和数值建模的计算机辅助锥形束计算机断层扫描分析软件,我们定义了三维腕关节轴线,并沿桡侧坐标(掌侧和尺侧为正坐标)检查了 18 个 SLAC 腕关节的对齐情况和腕高比。这些结果与之前报道的从 121 只健康腕部获得的正常对齐值进行了比较:结果:在矢状面上,平均肩胛骨角、月三关节角、月角和帽状掌骨角分别为-100°(标清,11°);20°(标清,11°);7°(标清,12°)和18°(标清,8°),而健康腕关节的角度分别为-58°(标清,9°);12°(标清,8°);-17°(标清,11°)和8°(标清,6°)。矢状面肩胛角的接收者操作特征曲线下面积最大(0.999),阈值≤-76°,表明存在病变。在冠状面上,SLAC 腕关节的腕关节排列保持不变,但头骨有轻微的尺侧倾斜:结论:SLAC 腕关节的腕关节错位不仅影响到射干关节和中腕关节,还延伸至第三腕掌关节,矢状面和冠状面上的错位都很明显。在SLAC腕关节中,矢状面月状三关节角度向正方向增大,这是由于月状关节的角度大于三关节的角度:这些研究结果有望促进三维成像技术的计算机辅助诊断工具的发展。临床意义:这些研究结果有望促进三维成像技术的计算机辅助诊断工具的发展,未来,此类工具可在临床实践中突出显示异常值,最大限度地减少诊断错误。
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Comparative Computer-Aided Analysis of Three-Dimensional Carpal Alignment in Scapholunate Advanced Collapse and Healthy Wrists.

Purpose: Scapholunate dissociation frequently results in malalignment and scapholunate advanced collapse (SLAC). Previous analyses have relied on visual observations of carpal angles among the scaphoid, lunate, and capitate on lateral radiographs. However, the 3-dimensional carpal alignment during SLAC progression remains unclear. The purpose of this study was to analyze 3-dimensional carpal malalignment in SLAC wrists.

Methods: Using computer-aided cone-beam computed tomography analysis software based on segmentation and numerical modeling, we defined three-dimensional carpal axes and examined alignment and carpal height ratio in 18 SLAC wrists along the radial coordinate (positive in palmar and ulnar directions). These results were compared with previously reported normal alignment values obtained from 121 healthy wrists.

Results: In the sagittal plane, mean scapholunate, lunotriquetral, lunocapitate, and capitometacarpal angles were -100° (SD, 11°); 20° (SD, 11°); 7° (SD, 12°); and 18° (SD, 8°); respectively, whereas the angles were -58° (SD, 9°); 12° (SD, 8°); -17°(SD, 11°); and 8° (SD, 6°); respectively, in healthy wrists. The sagittal scapholunate angle exhibited the highest area under the receiver operating characteristic curve (0.999), with a threshold value of ≤-76°, indicating pathology. In the coronal plane, the carpal alignment of SLAC wrists remained unchanged, excluding a minimal ulnar tilt of the capitate.

Conclusions: Carpal malalignment in SLAC wrists not only affects the radio- and midcarpal joints, but also extends to the third carpometacarpal joint, with malalignment evident in both the sagittal and coronal planes. In SLAC wrists, the sagittal lunotriquetral angle increases in the positive direction, due to the lunate angulating more than the triquetrum.

Clinical relevance: These findings have potential to contribute to the development of computer-aided diagnostic tools for 3-dimensional imaging technology. In the future, such tools could highlight abnormal values and minimize diagnostic errors in clinical practice.

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来源期刊
CiteScore
3.20
自引率
10.50%
发文量
402
审稿时长
12 weeks
期刊介绍: The Journal of Hand Surgery publishes original, peer-reviewed articles related to the pathophysiology, diagnosis, and treatment of diseases and conditions of the upper extremity; these include both clinical and basic science studies, along with case reports. Special features include Review Articles (including Current Concepts and The Hand Surgery Landscape), Reviews of Books and Media, and Letters to the Editor.
期刊最新文献
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