Three-dimensional Classification With Spiral CT For Fracture Of Surgical Neck Of Humerus And The Study Of It's Clinical Value

Objective (1) To classify fracture of humeral surgical neck with three-dimensional reconstruction of spiral CT. (2) To study the clinical value of the three-dimensional classification of humeral surgical neck..Methods (1) 20 cases of humeral surgical neck were examined with routine X-ray way, including anteroposterior position and lateral position through chest. Furthermore, those were also scanned with spiral CT, including the proximal humerus and then reconstructed three-dimensional images. (2) These 20 cases were classified with the standards of Neer's classification, according to X-ray plain film, two-dimensional CT film and three-dimensional reconstruction film. The work was done twice by two radiologists and three orthopedists respectively, with an interval of four months.Results and analysis (1) Three-dimensional reconstruction of humeral surgical neck could show spatial relation of fracture clearly, which holds more information than routine X-ray. Fractured fragments of 8 cases were only found by the former. (2) There is statistical difference in such classification using X-ray(p<0.05) and two-dimensional CT (p<0.05)respectively with an interval of four months according to Neer's classification. However, no statistical difference is found using three-dimensional (p>0.05) reconstruction. (3) New clinical classification is put out after analyzing the three-dimensional result of humeral surgical neck..Conclusion (1) The classification of humeral surgical neck, using routine X-ray examination, couldn't show the exact facts, which isn't so good for clinical practice. (2) The classification using spiral CT, can reflect three-dimensional spatial relation exactly, which is important for clinical practice. (3) The classification of spiral CT three-dimensional reconstruction, is a kind of new method and has important clinical value.