肱骨近端骨折的地图研究

王星; 郭小波; 李云飞; 靳江涛

doi:10.11659/jjssx.11E022088

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肱骨近端骨折的地图研究

临床研究 | 更新时间：2023-10-23

- 肱骨近端骨折的地图研究
- Map study of proximal humerus fractures
- 局解手术学杂志 2023年32卷第10期页码：915-920
- 作者机构：
  
  1.长治医学院研究生院，山西长治 046000
  2.晋城大医院脊柱微创科，山西晋城 048000
  3.晋城市人民医院麻醉科，山西晋城 048000
- 作者简介：
  
  靳江涛，E-mail：bobo4310@163.com
- 基金信息：
- DOI：10.11659/jjssx.11E022088
  中图分类号： R681.7
- 纸质出版日期：2023-10-25，
  
  收稿日期：2022-11-16，
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王星,郭小波,李云飞等.肱骨近端骨折的地图研究[J].局解手术学杂志,2023,32(10):915-920.

WANG Xing,GUO Xiao-bo,LI Yun-fei,et al.Map study of proximal humerus fractures[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(10):915-920.
王星,郭小波,李云飞等.肱骨近端骨折的地图研究[J].局解手术学杂志,2023,32(10):915-920. DOI： 10.11659/jjssx.11E022088.

WANG Xing,GUO Xiao-bo,LI Yun-fei,et al.Map study of proximal humerus fractures[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(10):915-920. DOI： 10.11659/jjssx.11E022088.

摘要

目的

应用3D技术和骨折地图技术将肱骨近端骨折患者的CT数据立体化，分析肱骨近端骨折线的分布特征，从而提高医师对该类骨折的认识及提供标准化骨折切割模型。

方法

回顾性分析162例患者肱骨近端骨折线的分布情况。应用Mimics Research 21.0软件将所有数据进行三维重建，建立模型。将提取的三维模型导入到3-matic Research 13.0软件，复位骨折碎片后在E-3D medical 18.08软件中使其与3D模板完全重合，在模板表面绘制光滑曲线。将所有曲线叠加到模板上，生成三维骨折线图和热图。线性回归分析骨折位置与年龄、性别、患肢的左右侧的相关性。

结果

在生成的肱骨近端骨折热图上，红色区域集中分布于肱骨头基底、大结节基底、小结节基底、肱骨解剖颈。4部分骨折是最常见的类型，共87例（53.7%），单独绘制了4部分骨折的特征性骨折地图。累及大结节的红色条带沿着结节间沟外侧缘纵行向近端走行至大结节最高点，累及小结节的红色条带较宽，在小结节中下部横向延伸至肱骨头内侧基底，肱骨外科颈外侧出现3条红色细小条带向内侧环绕延伸。简单线性回归分析显示，性别和骨折位置显著相关(

0.001)，而与年龄、患肢的左右侧无相关性（

0.05）。多元线性回归分析显示，在加入年龄后，性别与骨折位置的相关性更加显著(

0.001)。

结论

4部分骨折在肱骨近端骨折中最常见，本研究构建了肱骨近端骨折地图，可提高医师对肱骨近端骨折的认识，提供标准化骨折切割模型，指导术前规划及术中操作。

Abstract

Objective

The 3D technology and fracture mapping technology were applied to stereoscopic CT data of patients with proximal humerus fractures， and the distribution characteristics of proximal humerus fracture lines were analyzed in order to improve the understanding of these fractures of physicians and provide standardized fracture cutting models.

Methods

The distributions of the proximal humeral fracture lines in 162 patients were retrospectively analyzed.The Mimics Research 21.0 software was applied to the 3D reconstruction of all the data and the establishment of the model.The extracted 3D model was imported into the 3-matic Research 13.0 software，the reduction of fracture fragments was conducted and made it completely overlap with the 3D template in E-3D medical 18.08 software，and the smooth curve was drawn on the template surface.All curves were superimposed on the template to generate a three-dimensional bone fracture line map and a heat map.The linear regression analysis was performed to analyze the correlation between fracture location and age，gender，and right and left sides of the affected limb.

Results

On the generated heat map of proximal humerus fractures，the red areas were concentrated on the base of the humeral head，the base of the greater tuberosity，the base of the lesser tuberosity，and the anatomic neck of the humerus.The 4-part fracture was the most common type，with 87 cases （53.7%），and its characteristic fracture maps were drawn separately.The red bands involving the greater tubercle longitudinally and proximally along the lateral margin of the intertubercular sulcus to the highest point of the greater tubercle， and the red bands involving the lesser tubercle were wider and extend transversely in the lower and middle portion of the lesser tubercle to the medial base of the humeral head， there were three thin red bands on the lateral aspect of the surgical neck of the humerus extending around the inside.The simple linear regression analysis showed that fracture location only had significant correlation with gender （P<0.001），while which had no correlation with age or right and left sides of the affected limb （P>0.05）.Multiple linear regression analysis showed that the correlation between gender and fracture location was more significant with age （P<0.001）.

Conclusion

The 4-part fracture is the most common in proximal humerus fractures.The proximal humerus fracture map constructed in this study can improve the understanding of proximal humerus fractures of physicians，provide a standardized fracture cutting model， and guide the preoperative planning and intraoperative operations.

关键词

肱骨近端骨折计算机断层扫描三维图像骨折地图热图4部分骨折

Keywords

proximal humerus fracturecomputed tomographythree-dimensional imagesfracture mapheat map4-part fracture

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