【作者】 段满生；

【导师】 蒋电明；

【作者基本信息】 重庆医科大学 ， 外科学， 2002， 硕士

【摘要】 目的：测量国人肱骨近段的相关解剖数据，为设计适合中国人的肱骨头假体提供参考值。方法：50根成对防腐肱骨(男14对，女11对)按肱骨头扭转角置于冠状位和矢状位，行肱骨全长，头颈矢状面，解剖颈下缘及其下20mm、40mm，髓腔狭窄部四平面CT扫描，由CT软件测量冠、矢状位髓腔内外参数共61项，包括头心—干轴距，头位置，头干角，头—结节高度差，头厚度，头半径，关节面张角，解剖颈直径，髓腔狭窄部位置，解剖颈下缘及其下20mm、40mm和狭窄部四个平面髓腔的最大冠、矢状径，皮质骨厚度等。并在此基础上得出张口指数，张口变化和皮髓指数。结果：所得数据行统计学处理，得出各参数均值、标准差、最大值、最小值和部分参数的分布规律及其间的相关性，包括性别、左右分组参数的均值和标准差。同时行t检验比较组间差异显示：性别间大多参数差异显著，而左右间大多参数差异不显著。并与西方人相应参数对比，差异有非常显著性意义(P<0.01)。结论：有必要设计符合国人肱骨解剖特点的假体，假体尺寸规格应多样化，并且在设计和选择假体时需考虑性别差异。更多还原

【Abstract】 Objective：Measurement of Chinese proximal humeri for the design of humeral prosthesis component by CT osteometry. Methods：Fifty paired embalmed cadaveric humeri (twenty-five pairs:fourteen from male donors and eleven from female donors) were scanned in medial-lateral(ML) and anterior-posterior(AP) position according to the humeral retroversion by CT. Images of the humeri in the transverse planes at the lowest border of neck(LBN),20mm and 40mm distal of LBN(LBN-20、LBN-40), isthmus, head-neck anterior-posterior(HN-AP)were obtained. Sixty-one extracortical and intracortical parameters were measured exactly by image analytic computer software that included offset, head position, head-shaft angle, head to tuberosity height (HT), head thickness, curvature radius, articular surface arc (SA), neck diameter, isthmus position, proximal and distal border of isthmus, maximum coronal and sagittal diameter of medullary canal and thickness of cortical bone in four planes, including LBN, LBN-20,LBN-40 and isthmus. Additionally, flare index (FI), flare variation (FV) and cortico-medullary index (CMI) were also gained. All the measurements were<WP=6>underwent statistical analysis by SAS system .Results: Based upon the results of this analysis ,the means ,standard deviation, minimum and maximum of all parameters were obtained.The principles of the frequency distribution, correlation and confidence in part parameters were also found.The means and standard deviation of all parameters in male and female, right and left were acquired .In addition,profound differences were observed between male and female,the Chinese and the Caucasian .However, there were no significance difference between right and left.Conclusion:The author consider that it is mandatory to design the humeral components fitting the feature of the humeri of the Chinese and diversifying the size, consider the difference of gender on designing and selecting of prostheses.更多还原