| Objective:The indicators of the coracoid process and its adjacent structures were measured by autopsy and imaging.Analyze the correlation between the data.To explore the morphology of the coracoid process and its surrounding structures.To guide the diagnosis and treatment of shoulder joint diseases.Methods:In the dry bone anatomy group,50 pairs(100 cases)of complete pairs of scapula specimens were selected from the anatomy room of Qingdao university.and respectively measured the width and thickness of the tip of the coracoid process.Length,width and thickness of horizontal component coracoid process.Middle point width and thickness of coracoid process.Length,width and thickness of vertical component coracoid process.The distance from the tip of the coracoid process to the tuberosity of the upper glenoid cavity and the shortest distance from the tip of the coracoid process to the glenoid cavity,long diameter of the glenoid and the short diameter of the glenoid after numbering.And carry out statistical analysis.The cadaver group selected 15 frozen cadaver specimens(30 shoulder joint specimens in total)from the autopsy laboratory of Qingdao university,and all 15 specimens were fixed with formalin.The morphology of the ligaments around the coracoid process and the adjacent relationship with the coracoid process were observed and the length of the ligaments attached to the coracoid process was measured.Finally,statistical analysis was carried out.Image group recruit 20 healthy volunteers,volunteers in the affiliated hospital of Qingdao university image division of shoulder joint line shoulder joint 3D-SPACE sequence MRI examination,a total of scanning 20 cases of shoulder joint,and through the workstation for multi-plane reorganization(MPR),observe the imaging effect of ligament around coracoid,measuring coracoid safe distance,and carry on statistical analysis.Result:Anatomy of dry bone of coracoid process and surrounding structuresIn 100 scapular specimens,the average values of the data are: the horizontal part of the coracoid process(41.60 ± 4.17)mm,the width of the horizontal part of the coracoid process(14.94 ± 2.32)mm,and the thickness of the horizontal part of the coracoid process(8.54 ± 1.41)mm.Midpoint width(14.68 ± 1.95)mm,midpoint thickness at horizontal portion(9.69 ± 1.57)mm.Vertical length of coracoid process(27.94 ± 3.18)mm,vertical width of coracoid process(10.34 ± 1.74)mm,vertical coracoid process(12.09 ± 2.90)mm.The shortest distance from the coracoid to the glenoid(20.51 ± 2.89)mm,the shortest distance from the tip of the coracoid process to the glenoid cavity(18.58 ± 4.64)mm.There is a correlation between the left and right sides of each data.There was a correlation between the vertical height of the coracoid process and the shortest distance from the tip of the coracoid process to the glenoid cavity(P <0.05,r = 0.676).Long diameter of the glenoid cavity(35.46±3.29)mm and short glenoid cavity(26.11±3.20)mm,respectively.Left and right side group average: on the left side of the glenoid cavity length to diameter(35.28+3.81)mm,the right side of the glenoid cavity length to diameter(35.24+3.31)mm,on the left side of the glenoid cavity diameter(25.83+3.18)mm,short short on the right side of glenoid cavity diameter(26.38+3.23)mm,left and right side of the glenoid cavity diameter short correlation(P<0.05,r=0.882,R2=0.777),the linear relation is: y(short on the right side of glenoid cavity diameter)= 2.907+0.869x(on the left side of the glenoid cavity short diameter).There was a correlation between the long diameter of the glenoid joint(P<0.05,r=0.810,R2=0.657),and the linear relationship was y(short glenoid joint diameter)=-1.816+0.787x(long diameter of the glenoid joint).Frozen cadaver specimens of coracoid process and surrounding tissuesIn the 30 shoulder joint specimens,the average length of the tendon attached to the coracoid process was: pectoralis minor tendon(14.31±3.66)mm,conjoint tendon(15.67±2.91),acromiocoracoid ligament(27.63±7.47)mm,trapezoid ligament(16.80±1.59)mm,conical ligament(9.84±2.41)mm,and the distance between the tip of the coracoid process and the lateral margin of the trapezoid ligament(25.95±2.92)mm.Left pectoralis minor tendon(14.41±3.95)mm,right pectoralis minor tendon(14.22±3.51)mm,left conjoint tendon(15.84±3.19)mm,right conjoint tendon(15.50±2.72)mm,left acromiocoracoid ligament(28.72±8.07)mm,right acromiocoracoid ligament(26.57±7.68)mm,left trapezoid ligament(16.31±1.92)mm,right trapezoid ligament(17.10±1.43)mm,left conical ligament(10.28±2.78)mm,right conical ligament(10.12±2.61)mm,The distance between the tip of the left coracoid process and the lateral margin of the trapezoid ligament was(26.39±2.68)mm,while the distance between the tip of the right coracoid process and the lateral margin of the trapezoid ligament was(25.52±3.19)mm.Imaging observation of coracoid process and surrounding tissuesBy observing the multi-plane reconstruction images of the 3d-space sequence of 20 cases of shoulder joint,it was found that the coracoid process and the surrounding ligaments had a good display effect.The mean distance between the tip of the coracoid process and the lateral margin of the trapezoid ligament was(24.13±2.53)mm.There was no significant difference in the distance between the tip of the coracoid process and the lateral margin of the oblique ligament between the anatomical group and the cadaver group(p>0.05).Conclusion:1.There was a strong correlation between the left and right side of the coracoid process in Chinese.The shape of the contralateral scapula can be judged clinically by observing one side of the scapula,which can be applied to the surgery of the shoulder joint and 3D printing technology.2.The vertical height of the coracoid process and the shortest distance from the tip of the coracoid process to the glenoid cavity were correlated.It is suggested that the higher the vertical part of the coracoid process is,the shorter the distance between the tip of the coracoid process and the articular pelvis will be,which may provide anatomical basis for clinical judgment of subcoracoid impact.3.There was a positive correlation between the long diameter of the glenoid and the short diameter of the glenoid.The linear equation is: y(short diameter of the glenoid cavity)=-1.816+0.787x(long diameter of the glenoid cavity).In this study,the error of measuring the diameter of the best fitting circle of the glenoid cavity was reduced.The measurement accuracy of articular pelvis bone defect was improved.The calculation procedure of glenoid index is simplified.It can be used to predict the range of articular pelvis bone defect and improve the prognosis.4.The ‘safe distance' of the coracoid process was redefined according to the distribution of the footprint of the coracoid ligaments.It was defined as the distance from the tip of the coracoid process to the lateral margin of the trapateral ligament.In addition,the ‘safe distance' of the coracoid process was accurately measured by combining with MPR of 3d-space sequence,so as to satisfy the preoperative evaluation of patients with anterior articular defect by clinical imaging,which has high clinical application value. |
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