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1.
目的 评估大收肌腱转位重建内侧髌股韧带治疗髌骨脱位的术式可行性及可能的风险,探讨转位肌腱固定方法。 方法 解剖观察30侧尸体标本的大收肌腱及内侧髌股韧带形态及其周围血管神经等毗邻关系;测量收肌结节至内侧髌股韧带股骨止点距离、收肌结节至大收肌腱移行部距离;并在尸体标本上模拟手术。 结果 大收肌腱长度(收肌结节至收肌裂孔距离)为(105±14)mm(77~129 mm),内侧髌股韧带轴长长度为(46±6)mm(33~57 mm),收肌结节至内侧髌股韧带股骨止点距离为(9±2)mm(6~13 mm),收肌结节至大收肌腱移行部距离为(124±11)mm(102~144 mm)。 结论 长约55 mm的大收肌腱通过转位固定于髌骨内侧缘重建内侧髌股韧带可行,大收肌腱作为重建内侧髌股韧带的供体是一个良好的选择。 相似文献
2.
Richa Gupta Kanchan Kapoor Anshu Sharma Suman Kochhar Rajeev Garg 《Surgical and radiologic anatomy : SRA》2013,35(3):181-189
Background
Transpedicular stabilization of subaxial cervical spine is a very delicate procedure that requires thorough understanding of the pedicle anatomy to minimize the rate of neurovascular complications. The current study was conducted to investigate the morphometric details including dimensions and axis of typical cervical vertebrae (C3–C6) for transpedicular screw insertion surgery.Methods
The current study was conducted on 100 sides of 50 dry and 160 sides of 80 vertebrae on computerized tomography scans of typical cervical vertebrae. Parameters that were studied bilaterally included distance between medial aspect of the pedicle and dural sac, pedicle height, pedicle width, interpedicular distance, lateral and medial cortical thickness, transverse pedicle angle and chord length.Results
Distance between medial aspect of the pedicle and dural sac was found to be 2.2 ± 0.99 mm. Mean pedicle height (6.5 ± 1.1 mm) was found to be greater than pedicle width (4.9 ± 0.9 mm) in all the vertebrae. Mean transverse pedicle angle and chord length was observed to be 39.4° and 32.1 mm, respectively. Mean interpedicular distance, medial and lateral cortical thickness was observed to be 21.8 ± 1.6, 1.43 ± 0.4 and 0.79 ± 0.2 mm, respectively.Conclusions
The present study highlights a three-dimensional orientation of subaxial cervical pedicle anatomy, while emphasizing the risks involved in the view of comparatively smaller values of pedicle dimensions of subaxial cervical vertebrae. This knowledge about typical cervical vertebrae, its pedicle and their adjacent neurovascular structures may enhance the safety of transpedicular screw insertion. 相似文献3.
Background
Reconstruction of the medial patellofemoral ligament (MPFL) is the most frequent surgical procedure performed in patients with patellar instability. Recently, concerns regarding physeal injury during femoral tunnel placement for anatomical MPFL reconstruction in children have been discussed.Methods
This is the first case to report partial posterior physeal growth arrest and subsequent flexion deformity of the distal femur after MPFL reconstruction in a skeletally immature patient. The cause and treatment are discussed.Results
Postoperative knee extension deficit and recurrent patellar instability were successfully treated with revision surgery including, distal femoral extension osteotomy, medialization of the tibial tuberosity, trochleoplasty and MPFL graft tensioning.Conclusion
This case highlights that care should be taken during femoral tunnel placement for anatomic graft fixation to avoid physeal injuries in skeletally immature patients. 相似文献4.
Rastislav Hromádka Aleš Antonín Kuběna Martin Šmíd Stanislav Popelka 《Surgical and radiologic anatomy : SRA》2014,36(5):473-479
Purpose
Several methods to restore the appropriate length of the humerus in the case of proximal humeral fractures treated by hemiarthroplasty have been previously published. Our study evaluates the possibility of using the medial calcar of humerus for humeral length reconstruction not based on preoperative planning.Methods
Preparations of 320 dry humeral bones were used for the purpose of the study. Points of interest were marked on each bone: the most proximal point of the humeral head, the crest of greater tuberosity, diameters of the head, the anatomical and surgical necks. Proximal parts of bones were then scanned from two angles with a digital camera and all measurements were performed on calibrated photographs. We compared accuracy in humeral length reconstruction using insertion of the pectoralis major and the area of medial calcar where usually a fracture develops.Results
The distance between the top part of the humeral head and the insertion of pectoralis major was 54.1 ± 6.0 mm. The distance between the lateral margin of the anatomical neck and the medial calcar was 51.4 ± 4.3 mm. We compared these data with diameters of the humeral head.Conclusions
The site of the fracture can be used for the reconstruction of the humeral length with greater accuracy than area of the pectoralis major insertion. We suggest that to obtain the final distance between the lateral margin of the artificial head and medial calcar of the fracture 2–3 mm should be added to the diameter of the head. 相似文献5.
Hyung-Sun Won Hong-Fu Liu Jun-Ho Kim Dai-Soon Kwak In-Hyuk Chung In-Beom Kim 《Surgical and radiologic anatomy : SRA》2016,38(10):1183-1189
Introduction
The aim of this study was to clarify the morphological characteristics of the intermuscular aponeurosis between the flexor carpi ulnaris (FCU) and flexor digitorum superficialis (FDS; IMAS), and that between the FCU and flexor digitorum profundus (FDP; IMAP), and their topographic relationships with the ulnar nerve.Materials and methods
Fifty limbs of 38 adult cadavers were studied.Results
The IMAS extended along the deep surface of the FCU adjoining the FDS, having the appearance of a ladder, giving off “steps” that decreased in width from superficial to deep around the middle of the forearm. Its proximal part divided into two bands connected by a thin membrane, and was attached to the medial epicondyle and the tubercle (the most medial prominent part of the coronoid process of the ulna), respectively. The IMAP extended deep between the FCU and FDP from the antebrachial fascia, and its distal end was located on the posterior border of the FCU. The IMAP became broader toward its proximal part, and its proximal end was attached anterior and posterior to the tubercle and the olecranon, respectively. The ulnar nerve passed posterior to the medial epicondyle and then medial to the tubercle, and was crossed by the deep border of the IMAS at 58.3 ± 14.1 mm below the medial epicondyle.Conclusion
The deep border of the IMAS and aberrant tendinous structure passing across the ulnar nerve, or the parts of the IMAS and IMAP passing posterior to the ulnar nerve are potential causes of ulnar nerve compression.6.
Trifon Totlis George A. Konstantinidis Marinos T. Karanassos George Sofidis Nikolaos Anastasopoulos Konstantinos Natsis 《Surgical and radiologic anatomy : SRA》2014,36(1):3-9
Purpose
This study aimed at summarizing the non-pathologic bony structures which are involved in the pathogenesis of snapping scapula and evaluate their incidence, morphology and correlation to gender, side and age.Methods
The angulation in the sagittal plane between the supraspinatus and infraspinatus portion of the medial border was measured in 140 dried scapulae. In 264 dried scapulae the medial scapular border morphology was classified into three types and the presence of the Luschka’s tubercle and the teres major tubercle or process was recorded. Correlation to gender, side and age was examined using SPSS.Results
The mean angulation between the supraspinatus and infraspinatus portion of the medial border was 154.6° ± 8.8°. Τhe medial scapular border was straight in 99 (37.5 %), convex in 135 (51.1 %) and concave in 30 bones (11.4 %). The Luschka’s tubercle was present in eight bones (3 %), while teres major tubercle was found in 114 scapulae (43.2 %). A teres major process was present in 18 bones (6.8 %). The process was curved towards the chest wall in nine bones (3.4 %), while in the other nine scapulae (3.4 %) it had no curvature.Conclusions
The non-pathologic bony structures which predispose to snapping scapula are not rare and include the concave medial scapular border, the Luschka’s tubercle and the teres major process curved towards the chest wall. Orthopaedic surgeons should bear in mind these non-pathologic bony structures in order not to be overlooked during the diagnostic procedure of a snapping scapula since they usually require surgical treatment. 相似文献7.
Murat Bozkurt Serhan Unlu Nurdan Cay Nihal Apaydin Metin Dogan 《Surgical and radiologic anatomy : SRA》2014,36(8):741-746
Background
The anatomic and the kinematical relationships between the femur and the tibia have been previously examined in both normal and diseased knees. However, less attention has been directed to the effect of these relationships on the meniscal diseases. Therefore, we aimed to investigate the impact of femorotibial incongruence on both lateral and medial meniscal tears.Materials and methods
A total of 100 images obtained from MRI of 100 patients (39 males and 61 females) were included in the study. Diameters of the medial and the lateral femoral condyles, thicknesses of the menisci, and diameters of the medial and the lateral tibial articular surfaces were measured.Results
The medial meniscus tear was detected in 40 (40 %) patients. However, no lateral meniscus tear was found. Significant relationships were found between the diameters of the posterior medial femoral condyle and the medial tibial superior articular surface and between the diameters of the posterior lateral femoral condyle and the lateral tibial superior articular surface. The mean values for the diameter of the medial condyle of the femur, the lateral condyle of the femur, the medial superior articular surface of the tibia, and the lateral superior articular surface of the tibia were found to be significantly higher in cases with meniscus tear compared to cases without meniscus tear. However, no significant difference was present regarding the thicknesses of the medial and the lateral menisci. A positive relationship between the diameter of the posterior medial femoral condyle and the tibial medial superior articular surface was found in cases with (n = 40) (r 2 = 0.208, p = 0.003) and without tear (n = 60) (r 2 = 0.182, p = 0.001). In addition, a significant positive relationship was found between the diameter of the posterior medial femoral condyle and the medial tibial superior articular surface in cases with and without tear.Conclusion
The impact of femorotibial incongruence on the medial meniscus tear is important for the understanding of the lesions. 相似文献8.
Dustin Woyski Anthony Olinger Barth Wright 《Surgical and radiologic anatomy : SRA》2013,35(8):713-719
Purpose
Tears of the gluteus medius are most prevalent in middle-aged females. Recently, focus has been placed on diagnosis and treatment of tears, but an explanation for the increased prevalence still eludes researchers. We compared the area of insertion of the gluteus medius on the femur as well as three separate moment arm measures between males and females to determine if a smaller insertion area and/or decreased hip efficiency existed in females.Methods
The gluteus medius was dissected on 37 embalmed cadaveric hips (23 M, 14 F; mean age 66.4 years) to expose its insertion on the femur, which was then outlined. Three-dimensional scans were taken of each insertion, and area measurements calculated. Reference points were placed on analogous structures within each hip, and moment arms were calculated using the x, y, z coordinates of these points. The gluteus medius insertion and three moment arm lengths were compared between the genders.Results
Gluteus medius insertion area was found to be smaller in females (M 602.35 ± 116.01 mm, F 534.96 ± 98.60 mm, p = 0.034). The gluteal moment arms were also shorter in females (GMA1, M 69.87 ± 7.03 mm, F 63.22 ± 4.64 mm, p = 0.001) (GMA2, M 83.18 ± 6.69 mm, F 75.06 ± 6.23 mm, p = 0.000) with pelvic moment arms being comparable between the genders. Stature and age were not found to influence these outcomes.Conclusions
Our results suggest that in an equally massive male and female, the female will place greater mechanical demands on the gluteus medius, due to decreased efficiency as well as a relatively smaller insertion area. 相似文献9.
Purpose
The sphenoid ostium (SO) provides a natural portal for entering the sphenoid sinus and beyond up to the skull base. It is not always easy to locate the ostium during the endoscopic approach. The present study was designed to establish readily identifiable anatomical landmarks for locating the sphenoid ostium.Methods
Cadaveric dissection was performed in 30 hemisections of head and neck and various measurements were taken from fixed anatomical landmarks in the nasal cavity to the sphenoid ostium. The size, shape and position of sphenoid ostium were determined in relation to the anterior wall of the sphenoid sinus and the superior turbinate.Results
The mean distance from the supero-lateral angle of the posterior choana to the SO was found to be 21.21 ± 6.02 mm. The mean distance of the SO from the midline was 4.85 ± 2.89 mm. In all the specimens, the SO was situated within 1 cm of the midline. The mean distance between the inferior end of the SO and the postero-inferior edge of the superior turbinate was 8.03 ± 3.52 mm. The SO was present on an average distance of 55.1 ± 3.54 mm from the limen nasi. In 93.3 % of the specimens, the SO was situated between 5 and 6 cm of the inferior end of the limen nasi. The angle between the anterior nasal spine and the SO was found to be remarkably constant. In 93.3 % of the specimens, it was from 25° to 30°.Conclusions
The sphenoid ostium could be localized medial to the superior turbinate between 1.5 and 3 cm above the supero-lateral angle of the posterior choana, within 1 cm of the midline and within 1 cm of the postero-inferior edge of the superior turbinate. 相似文献10.
Casey A. Slattery Christopher Y. Kweon Mia S. Hagen Albert O. Gee Richard V. Williamson 《The Knee》2018,25(6):1165-1170
Background
While degenerative changes to the articular cartilage of the anterior and distal portions of the femoral condyles have been well studied in the literature, the changes that occur on the posterior femoral condyle are not as clear. The purpose of this study was to assess the difference in articular cartilage thickness between the medial and lateral posterior femoral condyles in knees undergoing unicompartmental knee arthroplasty.Methods
A retrospective review of prospectively gathered data on 107 consecutive patients undergoing unicompartmental knee arthroplasty performed by a single surgeon was performed. The remaining articular cartilage thickness after resection of the posterior femoral condyle was measured and simple analysis conducted to compare cartilage thickness between medial and lateral posterior femoral condyles.Results
Ninety-two medial unicompartmental arthroplasties and 15 lateral unicompartmental arthroplasties were performed during the 16?month study period. The majority of lateral UKA patients were female and had lower BMI than medial UKA patients. The articular cartilage thickness on the medial posterior femoral condyle was 3?mm?±?1?mm (mean?±?standard deviation) and 1?mm?±?1?mm on the lateral side (p-value < 0.001).Conclusions
There is a significant difference in articular cartilage thickness between the medial and lateral posterior femoral condyles in patients undergoing unicompartmental knee arthroplasty. This coincides with a potentially inherently different pattern of articular cartilage degeneration between the medial and lateral compartments of the knee and has implications on implant designs and resurfacing techniques about the knee. 相似文献11.
Aylin Okur Mahmut Özkırış Halil İbrahim Serin Zeliha Kapusuz Gencer Seyhan Karaçavuş Leyla Karaca Mecit Kantarcı Levent Saydam 《Surgical and radiologic anatomy : SRA》2014,36(7):627-632
Objectives
To investigate the angulations and length of the styloid process (SP) on three-dimensional computed tomography (3D-CT) images between the patients having elongated SP complaints and those without any stylalgia symptoms.Patients and methods
One hundred patients underwent 3D-CT evaluation of the bilateral temporomandibular joints to investigate for symptomatic elongated styloid process (ESP) at our institution. The differences between the mean angulations and lengths of the SP and comparisons between patient and control groups were analyzed by student t test.Results
In study group, mean length of styloid processes was 40.7 ± 10.8 mm on the right and 40.3 ± 10.9 mm on the left. Mean medial angles of SP were measured as 22.60 ± 4.0 on the right side and 22.60 ± 4.5 on the left side. In the same group, mean anterior angles of SP were 16.10 ± 6.9 on the right and 16.70 ± 7.1 on the left side. The “in-group” comparisons of lengths, medial and anterior angles did not produce statistically significant results. The comparison of medial angulations between the symptomatic and asymptomatic patients was the only statistically meaningful result in our study.Conclusion
3D-CT has several advantages according to conventional tomography for visualization of head and neck anatomy. The increase of medial angulation of SP may be responsible for the development of complaints in ESP. 相似文献12.
John J. Elias Kerwyn C. Jones S. Cyrus Rezvanifar Joseph N. Gabra Melanie A. Morscher Andrew J. Cosgarea 《The Knee》2018,25(2):262-270
Background
Continued patellar instability can occur following medial patellofemoral ligament (MPFL) reconstruction. Computational simulation of function was used to investigate the influence of the lateral position of the tibial tuberosity, trochlear dysplasia and patella alta on lateral patellar tracking following MPFL reconstruction.Methods
Multibody dynamic simulation models were developed to represent nine knees being treated for recurrent patellar instability. Knee extension against gravity and dual limb squatting were simulated with and without simulated MPFL reconstruction. Graft resting lengths were set to allow 10 mm and five millimeters of patellar lateral translation at 30° of knee flexion. The bisect offset index, lateral tibial tuberosity to posterior cruciate ligament tibial attachment (TT–PCL) distance, lateral trochlear inclination, and Caton–Deschamps index were quantified at every five degrees of knee flexion to characterize lateral tracking, lateral position of the tibial tuberosity, trochlear dysplasia, and patella alta, respectively. For the pre-operative and post-operative conditions and each type of motion, bisect offset index was correlated with the anatomical parameters using stepwise multivariate linear regression.Results
For both motions, the pre-operative and post-operative bisect offset indices were significantly correlated with lateral trochlear inclination and lateral TT–PCL distance. For both motions, the adjusted r2 decreased with MPFL reconstruction, but was still approximately 0.5 for MPFL reconstruction allowing five millimeters of lateral translation.Conclusion
MPFL reconstruction decreases but does not eliminate lateral maltracking related to trochlear dysplasia and a lateralized tibial tuberosity. Patients with these pathologies are likely at the highest risk for instability related to maltracking following MPFL reconstruction. 相似文献13.
Turan Koç İsmail Yağmurhan Gilan Gökçe Deniz Külekçi Zeliha Kurtoğlu 《Surgical and radiologic anatomy : SRA》2014,36(2):189-194
Objective
Bilateral large variant veins were encountered in the lower extremity. It was aimed to identify the structural characteristics of this rare case and then, regarding the structural features, to overview its formation process and denomination.Material and method
During the routine dissection of a 93-year-old male cadaver, bilateral large variant veins were found at the thigh. Valves of the veins were examined and evaluated together with the vascular wall histology.Results
The variant vein was loosely attached to the sciatic nerve by fibrous tissue and had anastomoses with the popliteal vein in the popliteal fossa on each side. The popliteal veins were hypoplastic on both sides. The right variant vein was passing through the fibers of the adductor magnus muscle 56.2 mm above the adductor hiatus, which corresponds to the third perforating branch of deep femoral vein. The left one was turning to the front over the adductor magnus muscle, at the lower border of quadratus femoris muscle. The left variant vein was corresponding to the descending branch of the medial circumflex femoral vein. Both variant veins had one incomplete and three well-developed valves.Conclusion
In accordance with the findings, the variant vein was concluded to be an embryonic remnant, rather than an acquired one subsequent to any obstruction of the femoral vein. Regarding their connection with the popliteal vein but not with the internal iliac vein, both variant veins were denominated as “lower type persistent sciatic vein”. Such a variation would be important with respect to the risk of complication during popliteal sciatic nerve blockade. 相似文献14.
Christopher J. Maugans Matthew G. Scuderi Frederick W. Werner Stefanos F. Haddad John P. Cannizzaro 《The Knee》2017,24(2):264-270
Purpose
The purpose of this study was to determine whether a modified step-cut tibial tubercle osteotomy (Maquet–Fulkerson hybrid) might produce comparable or better results than a standard oblique anteromedialization tibial tubercle osteotomy (Fulkerson type) and thus warrant the surgical need for additional cuts.Methods
Six pairs of cadaveric knees were evaluated prior to and after tibial tubercle osteotomies. Simulation was done via a shallow knee bend simulator through 20 to 70° of knee flexion for the intact specimens and following the surgical procedures. The variables tested were trochlear contact forces and pressures and patellar motion.Results
Testing showed a decreased force (P = 0.027), peak contact pressure (P = 0.01) and contact area (P = 0.034) on the lateral trochlea of the femur for both types of osteotomies. There was no significant difference in the lateral femoral peak pressure or in the medial femoral peak pressure between the oblique cut and the step-cut. Also, there was no difference in patellar motion after either procedure.Conclusion
We conclude that both osteotomies decrease lateral patellofemoral trochlear pressure. The oblique osteotomy may decrease lateral pressure to a greater extent. Regarding biomechanical testing, there was no demonstrable advantage to performing a step-cut osteotomy. 相似文献15.
Jin Mei Steve F. Morris Weiping Ji Hao Li Renpeng Zhou Maolin Tang 《Surgical and radiologic anatomy : SRA》2013,35(8):695-700
Purpose
The posterior forearm is an excellent donor site for the vascular pedicled cutaneous flaps; yet, there is surprisingly little detailed anatomical information based on clinical decision making. This study was undertaken to evaluate the anatomical basis of the dorsal forearm perforator flaps and to provide anatomical landmarks to facilitate flap elevation.Methods
Thirty cadavers were available to perform this anatomical study after arterial injection. Twenty fresh cadavers were injected with a modified lead oxide–gelatin mixture, selected for 3-dimensional reconstruction using special software (MIMICS) and the arterial territory measured with Scion Image. Other ten were injected with red latex preparation, and perforators were identified through dissection.Results
(1) The average number of posterior interosseous artery cutaneous perforators in the dorsal forearm was 5 ± 2, the average diameter was (0.5 ± 0.1) mm, and the pedicle length was (2.5 ± 0.2) cm. The average cutaneous vascular territory was (22 ± 15) cm2. Cutaneous perforators could be found along the line extending from the lateral epicondyle to the radial border of the head of ulna. (2) Dorsal branch of anterior interosseous artery supplied blood to distal third of dorsal forearm; its average diameter was 0.8 mm.Conclusion
The free transplantation of the posterior interosseous perforator artery flaps or rotary flap pedicled by dorsal branch of anterior interosseous artery for defect reconstruction is feasible. 相似文献16.
Zhenghao Fu Yizhao Chen Weiping Jiang Shuo Yang Jing Zhang Wangming Zhang Shizhong Zhang Yiquan Ke 《Surgical and radiologic anatomy : SRA》2014,36(2):181-188
Purpose
To delineate the pterygoid canal (PC) configuration and its position in relation to surrounding important anatomical landmarks using three-dimensional reconstructive technology based on CT for the Chinese.Methods
The computerized tomography arteriography (CTA) data of 137 patients were retrospectively evaluated using neuroimaging three-dimensional reconstructive software. The morphological parameters of the PC as well as the spatial relationship and distance between the PC relative to internal carotid artery (ICA) and the foramen rotundum were evaluated.Results
83.9 % of the PC can be identified by our neuroimaging three-dimensional reconstructive software. The mean distance from the PC to the ICA was 2.6 ± 1.2 mm. The mean distance between medial aspects of bilateral ICA was 19.6 ± 2.7 mm. The distal vertical and horizontal distances between the PC and foramen rotundum were 5.2 ± 3.2 and 6.1 ± 2.8 mm, respectively. All the proximal end of the PC were inferior-lateral to the ICA. The PC mainly (92.9 %) ran posteriorly with a medial to lateral direction. The distance from the PC to ICA was positively correlated with the distance between bilateral ICA and the distal diameter of the PC. The vertical distance between the PC and foramen rotundum was positively correlated with the length of the PC and the horizontal distance between the PC and foramen rotundum.Conclusions
Understanding the configuration and spatial relationship of the PC may be helpful to improve the accuracy and safety of operation during the expanded transnasal endoscopic approaches to skull base. The three-dimensional reconstructive virtual anatomic technology may be a useful tool to delineate the PC configuration and its position to surrounding important anatomical landmarks. 相似文献17.
Eun-Ju Jeon Beomcho Jun Ji-Nam Song Ju-Eun Kim Dong Hee Lee Ki-Hong Chang 《Surgical and radiologic anatomy : SRA》2013,35(6):471-475
Purpose
In this study, we evaluated the surgical and radiologic anatomy of a cochleostomy produced via posterior tympanotomy for cochlear implantation (CI).Materials and methods
Twenty computed tomography (CT) images of the temporal bone from patients aged between 20 and 60 years were selected. The inclusion criterion was a radiologically normal temporal bone CT scan. Three-dimensional (3D) reconstructed images were obtained using high-resolution axial temporal bone CT scans. Eight points were used to evaluate the surgical anatomy of the posterior tympanotomy and cochleostomy. The length of lines between the points and the angles between the lines were measured.Results
The mean length of line AB (superior-inferior length of the posterior tympanotomy for CI) was 6.48 ± 0.26 mm, while line AC (width of the chorda tympani and facial nerves) was 3.60 ± 0.2 mm. The mean angle of ABC (angle at which the chorda tympani nerve branched from the facial nerve) was 18.40° ± 1.05°. The mean length of line AD (distance from the facial ridge to the point of cochleostomy) was 9.58 ± 0.47 mm.Conclusions
3D imaging of the facial recess and round window can be used to identify the facial recess before surgery. This may help to avoid injury to the chorda tympani nerve during posterior tympanotomy, and make it easier to insert the electrode array during CI by creating a large enough posterior tympanotomy to avoid injury to the facial nerve, which can cause immediate or delayed facial palsy. 相似文献18.
Taweechok Wisanuyotin Chanchai Tidchom Kowit Chaisiwamonkhol Prathana Chowchuen Permsak Paholpak Winai Sirichativapee Weerachai Kosuwan Polasak Jeeravipoolvarn 《Surgical and radiologic anatomy : SRA》2014,36(6):573-577
Purpose
To investigate the geometry of the clavicle and to assess the reliability of Picture Archiving Communication System (PACS) for its measurement.Methods
One hundred pairs of dry clavicles from 78 males and 22 females were measured on radiographs using PACS. Measurements included all of the following parameters: length, width, medial and lateral angulation. The intraclass correlation coefficient (ICC) for the inter-observer and intra-observer reliability was calculated.Results
The mean left clavicle length among males and females was 149.25 ± 9.64 and 133.30 ± 8.32 mm, respectively. The respective mean right clavicle length among the males and females was 147.77 ± 9.99 and 132.08 ± 6.92 mm. The clavicles from male cadavers were significantly longer, wider and thicker than those from females, on both the left and right (P < 0.05). Among both the male and female clavicles, the left side was significantly longer than the right (P < 0.05). There was good to excellent intra-observer reliability (ICC > 0.70) for all parameters. Inter-observer reliability was also found good to excellent for all parameters except for medial clavicular angulation; for which there was fair reliability (ICC = 0.697).Conclusion
The geometry of the clavicle is influenced by sex and side. Use of PACS as a measurement tool is reliable. Data from this study will be useful for pre-contouring plate or improving future designs of the anatomical plate of the clavicle. 相似文献19.
Matthias Graf Salomon Diether Lazaros Vlachopoulos Sandro Fucentese Philipp Fürnstahl 《Medical & biological engineering & computing》2014,52(6):511-520
Modeling ligaments as three-dimensional strings is a popular method for in vivo estimation of ligament length. The purpose of this study was to develop an algorithm for automated generation of non-penetrating strings between insertion points and to evaluate its feasibility for estimating length changes of the medial patellofemoral ligament during normal knee flexion. Three-dimensional knee models were generated from computed tomography (CT) scans of 10 healthy subjects. The knee joint under weight-bearing was acquired in four flexion positions (0°–120°). The path between insertion points was computed in each position to quantify string length and isometry. The average string length was maximal in 0° of flexion (64.5 ± 3.9 mm between femoral and proximal patellar point; 62.8 ± 4.0 mm between femoral and distal patellar point). It was minimal in 30° (60.0 ± 2.6 mm) for the proximal patellar string and in 120° (58.7 ± 4.3 mm) for the distal patellar string. The insertion points were considered to be isometric in 4 of the 10 subjects. The proposed algorithm appears to be feasible for estimating string lengths between insertion points in an automatic fashion. The length measurements based on CT images acquired under physiological loading conditions may give further insights into knee kinematics. 相似文献
20.