肱骨大结节侧面观分型及其临床意义*

目的： 通过对肱骨大结节侧面观分型，探究其临床意义。方法： 选取2018 年6 月~2020 年6 月西南医科大 学附属中医医院患者292 例肩胛骨CT图像，根据肱骨大结节侧面观大结节的形态，进行分型；同时测量患者大 结节最高点与肱骨头最高点的距离、冈上肌、冈下肌、小圆肌、小结节止点的边长面积、及结节间沟的宽度、深 度。结果： 肱骨大结节依据侧面观形态可分为3 种类型，丘型46.92%、平坦型26.71%、弧型26.37%。132 名肩 袖损伤患者的CT三维重建图分析中，弧型23.5%、平坦型17.4%、丘型59.1%。丘型的冈上肌止点边长均小于平 坦型和弧型边长，差异具有统计学意义；丘型的冈上肌止点面积均小于平坦型和弧型，差异具有统计学意义。结 论： 肱骨大结节不同的侧面观分型对于预防、治疗肩峰下撞击综合征及肩袖损伤具有临床指导意义。

Lateral classification of greater tuberosity of humerus and its clinical significance

Objective To explore the clinical significance of the greater tuberosity of humerus through the lateral classification. Methods CT images of shoulder of 292 patients in the Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University from June 2018 to June 2020 were collected and the greater tubercle was classified according to the morphology on the side of the humerus. The distance between the highest point of the greater tuberosity and the highest point of the humerus， the side length and area of supraspinatus， infraspinatus， teres minor and the resting point of the small tubercle， and the width and depth of the intertubercular groove were also measured. Results The lateral view of greater tubercle of humerus could be divided into three types mound 46.92%， flat 26.71%， and arc 26.37%. Among 132 patients with rotator cuff injury， arc type was 23.5%， flat type was 17.4% and mound type was 59.1%. The side length of supraspinatus muscle insertion point in mound shape was significantly shorter than that in flat shape and arc shape， and the difference was statistically significant. The area of supraspinatus muscle insertion in mound shape was significantly smaller than that in flat shape and arc shape. Conclusion Different lateral view of the greater tuberosity of the humerus has clinical significance for the prevention and treatment of subacromial impingement syndrome and rotator c uff injury.