4.A study of the correlation between glenohumeral joint congruence and stability in recurrent shoulder dislocations.
Zheng XU ; Fei DAI ; Jinsong YANG ; Qing ZHANG ; Ming XIANG
Chinese Journal of Reparative and Reconstructive Surgery 2023;37(9):1094-1097
OBJECTIVE:
To investigate the correlation between glenohumeral joint congruence and stability in recurrent shoulder dislocations.
METHODS:
Eighty-nine patients (89 sides) with recurrent shoulder dislocation admitted between June 2022 and June 2023 and met the selection criteria were included as study subjects. There were 36 males and 53 females with an average age of 44 years (range, 20-79 years). There were 40 cases of left shoulder and 49 cases of right shoulder. The shoulder joints dislocated 2-6 times, with an average of 3 times. The three-dimensional models of the humeral head and scapular glenoid were reconstructed using Mimics 20.0 software based on CT scanning images. The glenoid track (GT), inclusion index, chimerism index, fit index, and Hill-Sachs interval (HSI) were measured, and the degree of on/off track was judged (K value, the difference between HSI and GT). Multiple linear regression was used to analyze the correlation between the degree of on/off track (K value) and inclusion index, chimerism index, and fit index.
RESULTS:
Multiple linear regression analysis showed that the K value had no correlation with the inclusion index ( P>0.05), and was positively correlated with the chimerism index and the fit index ( P<0.05). Regression equation was K=-24.898+35.982×inclusion index+8.280×fit index, R 2=0.084.
CONCLUSION
Humeral head and scapular glenoid bony area and curvature are associated with shoulder joint stability in recurrent shoulder dislocations. Increased humeral head bony area, decreased scapular glenoid bony area, increased humeral head curvature, and decreased scapular glenoid curvature are risk factors for glenohumeral joint stability.
Female
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Male
;
Humans
;
Adult
;
Shoulder Joint/diagnostic imaging*
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Shoulder Dislocation/diagnostic imaging*
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Joint Dislocations
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Scapula/diagnostic imaging*
;
Thorax
6.Imageological measurement of the sternoclavicular joint and its clinical application.
Ming LI ; Bo WANG ; Qi ZHANG ; Wei CHEN ; Zhi-Yong LI ; Shi-Ji QIN ; Ying-Ze ZHANG
Chinese Medical Journal 2012;125(2):230-235
BACKGROUNDDislocation of the sternoclavicular joint is rare. However, posterior dislocation compressing important structures in the mediastinum may be fatal. Early diagnosis and prompt therapy of sternoclavicular joint dislocation are important. Computed tomography (CT) is an optimal means to investigate sternoclavicular joint anatomy; however, there are few reports on the imageological anatomical features of the sternoclavicular joint. The study investigated imageological anatomical features, and a new plate was devised according to these data to treat sternoclavicular joint dislocation.
METHODSFifty-three healthy Chinese volunteers examined with chest CT were included in the study. The coronal, sagittal, and axial images of the sternoclavicular region were reconstructed. The sternal head diameter in the inferolateral-to-superomedial direction, length of the clavicular notch, and angle between the clavicular notch and sternum were measured on coronal images. The angle between the presternum and trunk was measured on sagittal images. The following dimensions were measured on axial images: anteroposterior dimensions of the sternal head, clavicular notch, and presternum; width of the sternoclavicular joint; distance between bilateral clavicles; and minimal distance from the presternum to the underlying structures in the thoracic cavity. A new plate was designed according to the above data and was used to repair six sternoclavicular joint dislocations. All cases were followed up with a range of 9 to 12 months.
RESULTSThe proximal clavicle is higher than the presternum in a horizontal position. On axial images, the anteroposterior dimension of the sternal head was longer than the presternum, and the center region of the presternum was thinner than the edges. The left sternoclavicular joint space was (0.82 ± 0.21) cm, and the right was (0.87 ± 0.22) cm. Among the structures behind the sternum, the left bilateral innominate vein ran nearest to the presternum. The distance from the anterior cortex of the sterna to the left bilateral innominate vein was (2.38 ± 0.61) cm. The dislocated joints were reduced anatomically and fixed with the new plate. All cases obtained satisfactory outcomes in follow-up visits.
CONCLUSIONSNormal sternoclavicular joint parameters were measured on CT images, which can facilitate treatment of sternoclavicular joint dislocation or subluxation. This newly designed plate can be used to treat sternoclavicular joint dislocation effectively and safely.
Adult ; Female ; Humans ; Joint Dislocations ; diagnostic imaging ; Male ; Middle Aged ; Sternoclavicular Joint ; diagnostic imaging ; Tomography, X-Ray Computed ; Young Adult
7.Arthroscopic reconstruction of coracoclavicular ligament by suspensory fixation for management of acute acromioclavicular joint dislocation and MRI follow-up study.
Wei YIN ; Hongxing LI ; Ding ZHOU ; Xianzhe HUANG ; Weihong ZHU
Journal of Central South University(Medical Sciences) 2020;45(4):400-405
OBJECTIVES:
To explore the safety and effectiveness of arthroscopic reconstruction of coracoclavicular ligament by suspensory fixation to manage the acute acromioclavicular joint dislocation.
METHODS:
From January 2016 to December 2017, 18 cases of acute acromioclavicular joint dislocation were carried out with arthroscopic reconstruction of coracoclavicular ligament by double Endobutton plate suspensory fixation. Anteroposterior view X-ray plain radiographs were obtained on the second day, 6 months and 12 months after the surgery, MRI was performed in 1 year after operation. Meanwhile, subjective and objective scoring were obtained by Vsual Analogue Scale (VAS), Rating Scale of the American Shoulder and Elbow Surgeons (ASES) and University of California at Los Angeles Shoulder Rating Scale (UCLA).
RESULTS:
All patients were followed up for 12 to 30 months (an average of 18 months). There was no patient with infection, neurovascular injury, loosening and breakage of internal fixation, re-dislocation of acromioclavicular joint, clavicular fracture, coracoid process fracture, etc. Postoperative X-ray showed that all acromioclavicular joints were completely relocated. The follow-up of MRI after 1 year showed no obvious dislocation of acromioclavicular joint and good recovery of acromioclavicular space. Postoperative shoulder joint function, VAS, ASES, UCLA and acromioclavicular distance were significantly improved compared with those before surgery, with statistically significant differences (all <0.05).
CONCLUSIONS
Arthroscopic reconstruction of coracoclavicular ligament by suspensory fixation to manage the acute acromioclavicular joint dislocation has the advantages of minimal invasive, rapid functional recovery and less complications and satisfactory early clinical results.
Acromioclavicular Joint
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diagnostic imaging
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surgery
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Follow-Up Studies
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Humans
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Joint Dislocations
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diagnostic imaging
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surgery
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Magnetic Resonance Imaging
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Shoulder Dislocation
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diagnostic imaging
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surgery
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Treatment Outcome
8.A method of measuring the displacement of the distal radioulnar joint on the three-dimensional CT imaging.
Li-ying SUN ; Guang-lei TIAN ; Sai-nan ZHU ; Shan-lin CHEN ; Wen TIAN ; Chun LI ; Yun-tao ZHANG ; Yong-wei PAN ; Yan-bo RONG
Chinese Journal of Surgery 2010;48(16):1217-1220
OBJECTIVESTo establish a clinical method for measuring the displacement of the distal radioulnar joint (DRUJ) precisely irrespective of ulnar variance, and to derive normal population translation references with palmar and dorsal stress.
METHODSThirty-seven normal distal forearms were scanned with computed tomography using an apparatus designed by Pirela-Cruz. Each extremity was scanned in two positions: maximal ulnar palmar and dorsal stress. The digital imaging and communications in medicine (DICOM) CT images were then imported into Mimics 10.0 for three-dimensional reconstruction. On the DRUJs 3D images, choose the most prominent point of the palmar and dorsal margins of the sigmoid notch and the excavate ulna fovea as the reference points A, B and C. A perpendicular line was then drawn from the point C to a line connecting points A and B with the intersection D. Calculate the ratio of AD/AB and DB/AB. Two observers measured all the DRUJs independently and one repeated the measurements one month later to determine the interobserver and intraobserver reliability.
RESULTSThe mean ratio values of palmar (AD/AB) and dorsal (DB/AB) translation were 0.39 ± 0.07 and 0.37 ± 0.07, and the normal references (x(-) ± 2 s) were from 0.25 to 0.50 and from 0.23 to 0.50, respectively. No significant differences were observed in terms of positions, genders and dominant hands. The intraclass correlation coefficient (ICC) values for interobserver and intraobserver reliability (DB/AB, AD/AB) were 0.84, 0.80, 0.93 and 0.92, respectively.
CONCLUSIONSThis new method could accurately measure the displacement of DRUJs with acceptable reliability, even with ulna positive or negative variance. Instability of DRUJ may be indicated when AD/AB is less than 0.25 or BD/AB is less than 0.23.
Adult ; Aged ; Female ; Humans ; Imaging, Three-Dimensional ; Joint Dislocations ; diagnostic imaging ; Joint Instability ; diagnostic imaging ; Male ; Middle Aged ; Radius ; diagnostic imaging ; Tomography, X-Ray Computed ; Ulna ; diagnostic imaging ; Wrist Joint ; diagnostic imaging ; Young Adult
9.Evaluation of Lateral Pterygoid Muscle Contraction in Patients with Temporomandibular Disorders Based on 3D-T2 Weighted Imaging.
Xiao-Huan ZHANG ; Meng-Qi LIU ; Min HU ; Yan-Yi WANG ; Zhi-Ye CHEN
Acta Academiae Medicinae Sinicae 2021;43(4):579-583
Objective To evaluate lateral pterygoid muscle(LPM)contraction in the patients with temporomandibular disorders(TMD)based on 3D-T2 weighted imaging(3D-T2WI).Multiplanar reconstruction(MPR)was employed to measure the length of LPM in the images taken in closed-and open-mouth positions. Methods Seventeen TMD patients [age of(29.82±10.70)years,males/females=8/9] and 13 normal volunteers [control,age of(23.54±3.31)years,males/females=6/7] received 3D-T2WI of the temporomandibular joints in closed-and open-mouth positions from November 2019 to April 2020 in Department of Radiology,Hainan Hospital of Chinese PLA General Hospital.According to the position of the discs,the subjects were classified into the following groups:TMD with disc displacement without reduction(TMD-DDwoR),TMD with disc displacement with reduction(TMD-DDwR),TMD without disc displacement(TMDwoDD),and normal control without disc displacement(NCwoDD).MPR was employed to measure the maximal length of the superior belly of LPM.One-way analysis of variance,receiver operating characteristic curve,and permutation test were employed for the statistical analyses. Results The contraction of LPM was significantly shorter in TMD-DDwoR group [(3.36±1.96)mm] than in TMDwoDD group [(7.90±3.95)mm],NCwoDD group [(8.77±3.13)mm](
Adult
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Female
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Humans
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Joint Dislocations
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Magnetic Resonance Imaging
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Male
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Muscle Contraction
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Pterygoid Muscles/diagnostic imaging*
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Temporomandibular Joint Disc
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Temporomandibular Joint Disorders/diagnostic imaging*
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Young Adult
10.Study on the rotary angle, plain radiographs and CT appearance in unilateral locked facet of cervical spine.
Hai-Chao HE ; Bao-Lin ZHAO ; Qing-San ZHU ; Hong-Shun MA ; Ying LAI ; Jing-Xin LIU ; Zhong-Wen LÜ
China Journal of Orthopaedics and Traumatology 2010;23(12):925-928
OBJECTIVETo study the rotary angle and image features, so as to help early diagnosis.
METHODSFour adult cervical spine (C1-T1) specimens were used, including 2 males and 2 females,ranging in age from 28 to 40 years old. X-ray and CT examination were performed before the experiment. C2-C4 and C5-T1 were fixed respectively using self-made clamp. Unilateral locked facet of cervical spine was simulated under the violence of inflection and rotation, in which the muscle contraction was partially simulated, and at last the plain radiographs and CT of unilateral locked facet of cervical spine were analyzed.
RESULTSIn unilateral locked facet of cervical spine, the average rotary angle was 19.75 degrees, and average forward shift of vertebral was 3.68 mm. The intervertebral foramina below the injury plane were showed at 0 degrees,10 degrees, 180 degrees,190 degrees; the intervertebral foramina above the injury plane were showed at 150 degrees,160 degrees, 00 degrees, -10 degrees, and the facet was locked or in disorder at the injury plane. The intervertebral foramina at the anterior oblique position was bigger in interlocking side, but it was smaller in the opposite side. CT scan showed rotary spine, the naked facet sign; coronal plane reconstruction showed bilateral asymmetry; sagittal plane reconstruction obviously showed unilateral locked facet.
CONCLUSIONX-ray and CT both can independently diagnose unilateral locked facet of cervical spine. CT and three-dimensional reconstruction are more better than X-ray to diagnosing it.
Adult ; Cervical Vertebrae ; diagnostic imaging ; injuries ; pathology ; Female ; Humans ; Joint Dislocations ; diagnostic imaging ; Male ; Rotation ; Tomography, X-Ray Computed ; methods