成人桡骨近端形态学对称性的三维偏差分析

目的:利用测量三维形态的方法量化验证成人双侧近端桡骨的解剖形态学对称性。方法:提取15名正常志愿者的 CT平扫来三维重建桡骨近端的解剖结构，并且测量两侧桡骨模型的表面积和体积；然后使用三维偏差分析法可视化和定 量化地分析两侧桡骨近端模型的解剖对称性。结果:两侧桡骨近端体积的平均百分比差异为4.43%±3.90%（P=0.595），表 面积的平均百分比差异为2.79%±2.41%（P=0.321）。偏差结果中，最大负偏差的均值±标准差为（-1.14±0.41）mm，最大正 偏差的均值±标准差为（1.00±0.37）mm；桡骨近端的非关节面部分是主要的偏差分布区域。结论:成人双侧桡骨近端具有 满足临床需求的解剖对称性，这为采用健侧桡骨近端形态指导解剖重建治疗桡骨近端骨折提供了可靠依据。在涉及桡骨 近端关节面重建的复杂骨折治疗，开展计算机辅助与三维打印技术结合的术前规划将有效增加患者的获益。

An anatomical symmetry study of proximal radii in adults using three-dimensional deviation analysis

Objective To quantitatively analyze the anatomical symmetry of bilateral proximal radii in adults based on threedimensional morphological measurement. Methods The anatomical data of the left and right proximal radii for threedimensional reconstruction were extracted from computed tomography scans of 15 normal individuals. After that both bone volume and surface area of the left and right proximal radii models were measured, the anatomical symmetry between the right and left proximal radii were quantified and visualized using three-dimensional deviation analysis. Results The mean percentage difference in bone volume between the left and right proximal radii was 4.43%±3.90% (P=0.595), and that in surface area was 2.79%±2.41% (P=0.321). The results of the three-dimensional deviation analysis showed that the mean±standard deviation of the maximal negative deviation was (-1.14±0.41) mm, while that of the maximal positive deviation was (1.00±0.37) mm. Moreover, the relatively high deviations were mainly distributed in those regions which were away from the joint facets. Conclusion The bilateral proximal radii in adults show an excellent anatomical symmetry, which satisfies the clinical requirements and provides a reliable basis for proximal radial fracture reduction guided by the morphological model of the contralateral proximal radius. In the treatment of complex fractures involving the articular surface of proximal radii, the preoperative planning that combines computer-aided and three-dimensional printing technologies will effectively increase the benefits for the patients.