Objective To investigate the key parameters of three-dimensional anatomy of the proximal humerus and compare the differences between male and female, and between left and right sides in Chinese by volume rendering technique with multi-slice spiral CT (MSCT) so as to provide a reference for a new prosthesis of the proximal humerus which can adjust to the anatomical characteristics of Chinese. Methods A total of 100 healthy volunteers were collected from Chongqing of China, including 59 males and 41 females with an average age of 40.4 years (range, 21-57 years). The humeral retroversion angle (RA), neck-shaft angle (NSA), medial offset (MO), and posterior offset (PO) were measured by volume rendering technique with MSCT. The average values were compared between male and female and between left and right sides, the correlation of these parameters was also analysed. Results In 100 volunteers (200 sides), the RA was (19.9 ± 10.6)°, the NSA was (134.7 ± 3.8)°, the MO was (4.0 ± 1.1) mm, and the PO was (2.6 ± 1.3) mm. There were significant differences in RA and MO between left and right sides (Plt; 0.05); there was no significant difference in NSA and PO between left and right sides (P gt; 0.05). The PO and RA of both sides in male were significantly larger than those in female (P lt; 0.05); the NSA and MO in male were similar to those in female (P gt;0.05). PO was correlated positively with RA (r=0.617, P=0.000); MO was not correlated with NSA (r= —0.124, P=0.081). Conclusion Because of significant side differences in RA and MO, and significant gender differences in RA and PO, the differences should be considered in the design of new proximal humeral prosthesis and proximal humerus reconstruction.
Objective To investigate and analyze the three-dimensional anatomic structure of glenoid bone in some Chinese people so as to provide the accurate anatomic data to design the new prosthesis of glenoid bone for Chinese people. Methods A total of 90 volunteers with two healthy shoulders (52 males and 38 females, aging 19-60 years with an average of 39.6 years) were selected. Five parameters were measured by use of three-dimensional computed tomography, volumerendering technique (VRT) and multiplanar reformation (MPR), including the maximum antero-posterior width (MAPW),antero-posterior radius of curvature (APROC), maximum supero-inferior height (MSIH), supero-inferior radius of curvature(SIROC) and version angle (VA) of glenoid. All parameters were measured two times, and the average values were analysed by SPSS13.0. The level of significance was set at P lt; 0.05. Results The average MAPW was (2.51 ± 0.32) cm, the average APROC was (5.50 ± 1.21) cm, the average MSIH was (3.45 ± 0.29) cm, the average SIROC was (3.98 ± 0.55) cm, and the average VA was (— 0.03 ± 4.66)°. There were no significant differences (P gt; 0.05) in MAPW, APROC, MSIH, SIROC and VA between two sides. There were significant differences (P lt; 0.05) in MAPW, MSIH, SIROC and VA, and no significant difference (P gt; 0.05) in APROC between female and male. MAPW was correlated with APROC, MAPW was correlated with MSIH, APROC was correlated with SIROC, and the correlation coefficient was 0.298, 0.495 and 0.262, respectively. Conclusion There are no significant differences in MAPW, APROC, MSIH, SIROC and VA of glenoid between two sides. There are sexual significant differences in MAPW, MSIH, SIROC and VA. The data and its statistical results may serve as guidel ines for the design of the glenoid component.
ObjectiveTo investigate the effectiveness of tibio-talo-calcaneal arthrodesis with full thread headless compression screws via combined minimal incisions.MethodsBetween January 2012 and December 2016, 36 patients (36 feet) with ankle diseases underwent tibio-talo-calcaneal arthrodesis with parallel double thread headless compression screws via minimal anterior and lateral oblique incisions. There were 14 males and 22 females with an average age of 53.8 years (range, 18-76 years). There were 19 cases of left feet and 17 cases of right feet. There were 21 cases of talar necrosis, 7 cases of post-traumatic arthritis, 3 cases of rheumatoid arthritis, 2 cases of tuberculosis infection (inactive), 1 case of talar absence, 1 case of Charcot’s disease, and 1 case of pigmented villonodular synovitis of ankle and subtalar joints. Preoperative American Orthopaedic Foot and Ankle Society (AOFAS) score and visual analogue scale (VAS) score were 53.7±2.5 and 5.9±0.2, respectively. The operation time was recorded and the wound healing and complications were observed. The bone healing was assessed by X-ray film and CT scanning. The function and pain of joint were evaluated by AOFAS and VAS scores.ResultsThe mean operation time was 49.8 minutes (range, 33-82 minutes). Incision infection occurred in 1 patient (2.8%) at 3 weeks after operation, and recovered after debridement. The other incisions healed by first intention without complications. Thirty-five patients were followed up with an average of 18.5 months (range, 12-29 months). Imaging examination showed fusion of the ankle and subtalar joints with an average fusion time of 10.9 weeks (range, 8-15 weeks). After 1 year, the AOFAS score (84.7±0.6) and VAS score (0.3±0.1) were significantly higher than preoperative scores (t=12.596, P=0.000; t=30.393, P=0.000).ConclusionIt is an effective surgical method of tibio-talo-calcaneal arthrodesis with full thread headless compression screws via combined minimal incisions for end-stage ankle disease because of the less complications incidence and the higher postoperative fusion rate.