| Objective: By measuring the anatomical data of humerus(head-shaft Angle and humerus head diameter)of normal adults and the data related to the implantation rate of medial support screw,finding out how the humerus anatomy influence the implantation of medial screw.Method: Choosing the patients who have gotten proximal humeral fractures and been treated with locking plate In our hospital from 2018/01/01 to 2019/06/30,selecting the patients with implantation of double medial support screw,along with postoperative x-rays,to measure the related data of imaging,including the angle of medial support screw trajectory with the locking plate,and the distance from bolt hole to the top of the locking plate implanted,take the average value as a foundation for measuring value,mark the Angle as &,and distance as D.According to the inclusion and exclusion criteria,patients admitted to our hospital were randomly selected from October 2019 to December 2019 who received X-ray examination of shoulder joint without fracture and the X-ray images were measured.Specific measurement method 1.In consideration of the magnification effect of X-ray examination,the data measured on the image may be inconsistent with the actual data.When the patientunderwent X-ray examination,a metal ball with a size of 2.5cm was placed on the same vertical surface.Finally,the actual diameter of the humerus was calculated according to the proportion between the diameter of the humerus and the metal ball measured on the imaging.2.The middle point of the humerus diameter was marked as point B,the furthest point from the humerus head to the diameter was marked as point A,AB was connected,and BC line was made at the point B.the line was parallel to the humerus,and the Angle formed by the line AB and BC was the head-shaft angle.3.Basic value was applied to patients with X ray film,place the top of plate on the position where is 5 mm under the edge of greater tuberosity,from the edge of the plate,make a distance of the line segment L along the direction of the humerus,repass L the lower end of the line segment,based on line segment L side,Angle &,observe whether the Angle on the other side inside the head of the humerus or not,mark the inside one as success,or failure.Result: Measured by this study: The overall average humeral head diameter of men is 46.9mm,and the average neck-shaft angle is 136.0 °,while the overall average humeral head diameter of women is 40.4mm,and the average neck-shaft angle is 135.7 °.1.The overall implantation rate of the medial support screw is much higher in men than in women.2.The diameter of the humeral head is an important factor,The larger the diameter of the humeral head,the more possible it is to implant the medial support screw.3.Within the range of human anatomy,the smaller the neck stem angle is,the more favorable it is to implant the medial support screw.Conclusion: The diameter of the humeral head of males is significantly larger than that of females,which also results in the probability of implanting the medial support screw in male patients is much higher than that of females.Therefore,it is necessary to implant the medial support screw in male patient as many as possible during the operation.1.Because the humeral head diameter of women is smaller,the overall medial support screw implantation in women is low.So it is important to measure accurately the imaging data before surgery,if necessary,the steel plate can be moved down slightly,and the seventh hole in the locking steel plate can be used as the medial support Screw implantation hole.2.You would better reduce the angle-shaft to 130-135°,because it is benefit for the inplantation of the medial screw. |
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