Digital analysis of external fixation area of proximal humerus fractures in elderly patients

Abstract Introduction The purpose is based on anatomical basis, combined with three-dimensional measurement, to guide the clinical repositioning of proximal humeral fractures, select the appropriate pin entry point and angle, and simulate surgery. Methods 11 fresh cadaveric specimens were collected,...

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Autores principales: Baorui Xing, Yadi Zhang, Xiuxiu Hou, Yunmei Li, Guoliang Li, Guangpu Han
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Publicado: BMC 2021
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spelling oai:doaj.org-article:4a5ae06851b94869bde2be1d45693c522021-11-28T12:24:39ZDigital analysis of external fixation area of proximal humerus fractures in elderly patients10.1186/s12891-021-04826-01471-2474https://doaj.org/article/4a5ae06851b94869bde2be1d45693c522021-11-01T00:00:00Zhttps://doi.org/10.1186/s12891-021-04826-0https://doaj.org/toc/1471-2474Abstract Introduction The purpose is based on anatomical basis, combined with three-dimensional measurement, to guide the clinical repositioning of proximal humeral fractures, select the appropriate pin entry point and angle, and simulate surgery. Methods 11 fresh cadaveric specimens were collected, the distance of the marked points around the shoulder joint was measured anatomically, and the vertical distance between the inferior border of the acromion and the superior border of the axillary nerve, the vertical distance between the apex of the humeral head and the superior border of the axillary nerve, the vertical distance between the inferior border of the acromion and the superior border of the anterior rotator humeral artery, and the vertical distance between the apex of the humeral head and the superior border of the anterior rotator humeral artery were marked on the 3D model based on the anatomical data to find the relative safety zone for pin placement. Results Contralateral data can be used to guide the repositioning and fixation of that side of the proximal humerus fracture, and uniform data cannot be used between male and female patients. For lateral pining, the distance of the inferior border of the acromion from the axillary nerve (5.90 ± 0.43) cm, range (5.3-6.9) cm, was selected for pining along the medial axis of the humeral head, close to the medial cervical cortex, and the pining angle was measured in the coronal plane (42.84 ± 2.45)°, range (37.02° ~ 46.31°), and in the sagittal plane (28.24 ± 2.25)°, range (19.22° ~ 28.51°). The pin was advanced laterally in front of the same level of the lateral approach point to form a cross-fixed support with the lateral pin, and the pin angle was measured in the coronal plane (36.14 ± 1.75)°, range (30.32° ~ 39.61°), and in the sagittal plane (28.64 ± 1.37)°, range (22.82° ~ 32.11°). Two pins were taken at the greater humeral tuberosity for fixation, with the proximal pin at an angle (159.26 ± 1.98) to the coronal surface of the humeral stem, range (155.79° ~ 165.08°), and the sagittal angle (161.76 ± 2.15)°, with the pin end between the superior surface of the humeral talus and the inferior surface of the humeral talus. The distal needle of the greater humeral tuberosity was parallel to the proximal approach trajectory, and the needle end was on the inferior surface of the humeral talus. Conclusion Based on the anatomical data, we can accurately identify the corresponding bony structures of the proximal humerus and mark the location of the pin on the 3D model for pin placement, which is simple and practical to meet the relevant individual parameters.Baorui XingYadi ZhangXiuxiu HouYunmei LiGuoliang LiGuangpu HanBMCarticleElderlyProximal humerus3D modelAnatomic measurementSimulated screw placementDiseases of the musculoskeletal systemRC925-935ENBMC Musculoskeletal Disorders, Vol 22, Iss 1, Pp 1-12 (2021)
institution DOAJ
collection DOAJ
language EN
topic Elderly
Proximal humerus
3D model
Anatomic measurement
Simulated screw placement
Diseases of the musculoskeletal system
RC925-935
spellingShingle Elderly
Proximal humerus
3D model
Anatomic measurement
Simulated screw placement
Diseases of the musculoskeletal system
RC925-935
Baorui Xing
Yadi Zhang
Xiuxiu Hou
Yunmei Li
Guoliang Li
Guangpu Han
Digital analysis of external fixation area of proximal humerus fractures in elderly patients
description Abstract Introduction The purpose is based on anatomical basis, combined with three-dimensional measurement, to guide the clinical repositioning of proximal humeral fractures, select the appropriate pin entry point and angle, and simulate surgery. Methods 11 fresh cadaveric specimens were collected, the distance of the marked points around the shoulder joint was measured anatomically, and the vertical distance between the inferior border of the acromion and the superior border of the axillary nerve, the vertical distance between the apex of the humeral head and the superior border of the axillary nerve, the vertical distance between the inferior border of the acromion and the superior border of the anterior rotator humeral artery, and the vertical distance between the apex of the humeral head and the superior border of the anterior rotator humeral artery were marked on the 3D model based on the anatomical data to find the relative safety zone for pin placement. Results Contralateral data can be used to guide the repositioning and fixation of that side of the proximal humerus fracture, and uniform data cannot be used between male and female patients. For lateral pining, the distance of the inferior border of the acromion from the axillary nerve (5.90 ± 0.43) cm, range (5.3-6.9) cm, was selected for pining along the medial axis of the humeral head, close to the medial cervical cortex, and the pining angle was measured in the coronal plane (42.84 ± 2.45)°, range (37.02° ~ 46.31°), and in the sagittal plane (28.24 ± 2.25)°, range (19.22° ~ 28.51°). The pin was advanced laterally in front of the same level of the lateral approach point to form a cross-fixed support with the lateral pin, and the pin angle was measured in the coronal plane (36.14 ± 1.75)°, range (30.32° ~ 39.61°), and in the sagittal plane (28.64 ± 1.37)°, range (22.82° ~ 32.11°). Two pins were taken at the greater humeral tuberosity for fixation, with the proximal pin at an angle (159.26 ± 1.98) to the coronal surface of the humeral stem, range (155.79° ~ 165.08°), and the sagittal angle (161.76 ± 2.15)°, with the pin end between the superior surface of the humeral talus and the inferior surface of the humeral talus. The distal needle of the greater humeral tuberosity was parallel to the proximal approach trajectory, and the needle end was on the inferior surface of the humeral talus. Conclusion Based on the anatomical data, we can accurately identify the corresponding bony structures of the proximal humerus and mark the location of the pin on the 3D model for pin placement, which is simple and practical to meet the relevant individual parameters.
format article
author Baorui Xing
Yadi Zhang
Xiuxiu Hou
Yunmei Li
Guoliang Li
Guangpu Han
author_facet Baorui Xing
Yadi Zhang
Xiuxiu Hou
Yunmei Li
Guoliang Li
Guangpu Han
author_sort Baorui Xing
title Digital analysis of external fixation area of proximal humerus fractures in elderly patients
title_short Digital analysis of external fixation area of proximal humerus fractures in elderly patients
title_full Digital analysis of external fixation area of proximal humerus fractures in elderly patients
title_fullStr Digital analysis of external fixation area of proximal humerus fractures in elderly patients
title_full_unstemmed Digital analysis of external fixation area of proximal humerus fractures in elderly patients
title_sort digital analysis of external fixation area of proximal humerus fractures in elderly patients
publisher BMC
publishDate 2021
url https://doaj.org/article/4a5ae06851b94869bde2be1d45693c52
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