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 ; Male ; Humans ; Adult ; Shoulder Joint/diagnostic imaging* ; Shoulder Dislocation/diagnostic imaging* ; Joint Dislocations ; Scapula/diagnostic imaging* ; Thorax

Bone Neoplasms ; diagnostic imaging ; pathology ; Child ; Humans ; Male ; Osteochondroma ; diagnostic imaging ; pathology ; Scapula ; Tomography, X-Ray Computed

Infraglenoid tubercle avulsion fractures are extremely rare injuries. We report a 38-year-old male with glenoid cavity fracture and infraglenoid tubercle avulsion of the left shoulder following a fall from bike. He refused surgery and was treated nonoperatively. Follow-up radiography and CT at 18 months revealed a malunited infraglenoid tubercle with signs of early glenohumeral osteoarthritis. He did not have shoulder instability or pain and had a fair-good functional outcome. There are no previously published data on the anatomic outcome of nonoperatively treated displaced infraglenoid tubercle avulsion fractures based on CT.
Adult ; Bicycling ; injuries ; Humans ; Male ; Scapula ; injuries ; Shoulder Fractures ; diagnostic imaging ; therapy ; Tomography, X-Ray Computed

OBJECTIVETo observe the microvascular distribution of the transmidline scapular flap supplied by the contralateral circumflex scapular artery.

METHODSThe integument and deep tissues of 6 fresh cadavers were dissected and radiographed after vermilion mixture was injected to the unilateral circumflex scapular artery.

RESULTSThe vascular tree passed the midline and reached to the contralateral acromion. The vessel density was the highest in the irrigating side of the back, which was higher in the middle area. In the contralateral side,the high vessel density concentrated in the upper part of the back.

CONCLUSIONSThe result revealed the direct evidence for the clinical application of the transmidline scapular flap. In design and elevating of the transmidline scapular flap, it should be slanting to the upper part of the contralateral back.

Arteries ; anatomy & histology ; Cadaver ; Diagnostic Imaging ; methods ; Female ; Humans ; Male ; Scapula ; transplantation ; Surgical Flaps ; blood supply

Adult ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; diagnostic imaging ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Recovery of Function ; Scapula ; diagnostic imaging ; injuries ; physiopathology ; surgery ; Tomography, X-Ray Computed

OBJECTIVETo investigate the effect of treatment methods of non-operation and surgical operation for scapular fracture.

METHODSA retrospective analysis of 52 patients (male 37, female 15, ranging in age from 20 to 48 years, meanly 31 years)with scapular fractures was done. According to Hardegger classification: the scapular body fracture in 24 cases, the surgical neck fracture in 12 cases, the anatomical neck fracture in 3 cases, the glenoidal lip fracture in 6 cases, the scapular spine fracrure in 7 cases. Of all 52 patients,17 cases were treated conservatively, and 35 were undergone surgical internal fixation. When followed up,the clinical examination was done and the X-ray films were taken to measure glenopolar angle (GPA). Hardegger function evaluation system was adopted. The results were analysed statiscally.

RESULTSFifty-two cases were all followed up for 9 weeks to 48 months. Among 17 patients treated by non-operation, Hardegger function evaluation system showed that the result were excellent in 7 cases, good in 6, fair in 2 and poor in 2; the X-ray film results showed that there were 14 cases of GPA > 20 degrees and 3 cases of GPA < 20 degrees. Of 35 patients treated by surgical operation, Hardegger function evaluation system showed that the result were excellent in 20 cases,good in 12 and fair in 3; the X-ray film results showed that there were 33 cases of GPA > 20 degrees and 2 cases of GPA < 20 degrees. There was no significant difference between the two groups (P = 0.27).

CONCLUSIONBefore treatment of scapular fracture, with CT 3D -recontruction, complete understanding of fragments displacement, and correction indication selection, and perform early exercises, both of the two procedures can provide satisfactory outcome.

Adult ; Female ; Fractures, Bone ; diagnostic imaging ; physiopathology ; surgery ; therapy ; Humans ; Male ; Middle Aged ; Radiography ; Retrospective Studies ; Scapula ; diagnostic imaging ; injuries ; physiopathology ; surgery ; Treatment Outcome ; Young Adult

BACKGROUND AND OBJECTIVEElastofibroma dorsi has an extremely low incidence. At present, comparative study on imaging manifestations and pathologic findings of elastofibroma dorsi has not been reported in China. This study was to investigate clinical manifestations, computed tomography (CT) and magnetic resonance imaging (MRI) appearances, and pathologic features of elastofibroma dorsi and to improve preoperative imaging diagnosis of this disease.

METHODSThe clinical manifestations, imaging findings, and pathologic appearances of 6 cases of elastofibroma dorsi were retrospectively analyzed and related literatures were reviewed. All patients were examined with MRI, and 4 of them were examined with CT scan.

RESULTSAll patients were above 30 years old without obvious symptoms. The tumors presented as a lenticular soft-tissue mass in the deep subscapular region. The tumor's density on plain CT scan or signal intensity on MR T1-weighted image was approximately equal to that of muscle with some interlaced fat-like areas within mass suppressed by fat-suppression MR sequences, which corresponded to dense collagen tissue and interspersed mature adipose tissue observed microscopically.

CONCLUSIONSCT and MRI can reflect the histological features of elastofibroma dorsi. On the basis of their imaging characteristics, a correct preoperative diagnosis of elastofibroma dorsi can easily be made.

Adult ; Aged ; Female ; Fibroma ; diagnosis ; diagnostic imaging ; pathology ; surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Scapula ; diagnostic imaging ; pathology ; Soft Tissue Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; surgery ; Tomography, X-Ray Computed

OBJECTIVETo investigate surgical methods and effects of unstable scapular fracture.

METHODSFrom October 2008 to August 2011, 14 patients with unstable scapular fracture were treated. There were 12 males and 2 females with an average age of 38.7 years (ranging, 21 to 55 years).The time from injury to hospitalization was 1 hour to 10 days (mean 3 days). Among patients,3 patients had scapular body fracture,4 patients had scapular neck and body fracture,4 patients had scapular neck and acromion fracture,2 patients had glenoid cavity and coracoid fracture, 1 patient with scapular spine and coracoid fracture. All patients were treated by operation, Hardegger classification system was applied to evaluate the function.

RESULTSAll patients were followed up for 2 to 36 months (mean 12.4 months). The healing time ranged from 6 to 8 weeks. No infection and internal fixation failure occurred. The effect result of Hardegger scoring system was excellent in 9 cases, good in 3 cases, fair in 2 cases.

CONCLUSIONSurgical treatment for unstable scapular fracture can reconstruct stability of shoulder joint, promote early rehabilitation of joint function, and maximally restore shoulder function.

Adult ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; diagnostic imaging ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Radiography ; Recovery of Function ; Scapula ; injuries ; physiopathology ; surgery ; Young Adult

OBJECTIVETo investigate the method and effect of treatment of complex scapular body fractures by locking reconstructive plate through modified posterior approach.

METHODSFrom August 2005 to November 2009, 27 patients with complex scapula body fractures were treated by locking reconstruction bone plate fixation,including 19 males and 8 females with an average age of 36 years old ranging from 16 to 64 years. The time after injury was 0.5 hours to 11 days (averaged 3 days). Of all the patients, 9 cases were associated with ipsilateral clavicle fracture, 2 cases were associated with acromioclavicular joint dislocation,16 cases were associated with multiple rib fractures, 1 case were associated with humeral shaft fractures, 5 cases were associated with pleural effusion, atelectasis, lung contusion etc. After operating,shoulder functional recovery were followed up.

RESULTSTwenty-four patients were followed up from 2 to 35 months with an average of 19 months. According to Hardegger shoulder function,the results were excellent in 15 cases, good in 7 cases, general in 2 cases.

CONCLUSIONThis method had the advantage of less trauma and clear exposure, firm and reliable fixation, and early activities.

Adolescent ; Adult ; Bone Plates ; Female ; Fractures, Bone ; diagnostic imaging ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; instrumentation ; Recovery of Function ; Scapula ; diagnostic imaging ; injuries ; physiopathology ; surgery ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVE: To investigate forensic diagnosis application of three-dimentional reconstruction with spiral computed tomography in fracture of anatomical complicated bones. METHODS: Selected eleven patients of bone fracture who were examined with SCT 3D and conventional X-ray examination. The location, number and characteristics were observed and analyzed. RESULTS: In all of eleven patients with bone fractures, X-ray examination could detect thirty-four rib fracture, one scapula fracture, two nasal fracture, one metacarpal bone incomplete fracture and one left tibia-fibula fracture, one pubis fracture. While there were forty-seven rib fracture, one scapula smash fracture, one nasal fracture with obvious displacement and eliminate one misplace, one left tibia-fibula obsolete fracture and one sacroiliac joint dislocation, one No 5 lumbar vertebrae pedicle of vertebrae arch fracture. Combining 3D reconstruction images, coronary and sagittal reconstruction images could show clearly the fracture line, location of fracture, number of fracture, displacement and recovery. CONCLUSION 3D reconstruction technique of SCT is a very useful examination method in the objective forensic diagnosis of anatomical complicated bones fracture, it excels the routine X-ray examination.
Adult ; Aged ; Female ; Forensic Medicine ; Fractures, Bone/pathology* ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Nasal Bone/injuries* ; Rib Fractures/diagnostic imaging* ; Scapula/injuries* ; Tomography, Spiral Computed/methods* ; Young Adult