Three-Dimensional Measurement of Proximal Humerus Fractures Displacement: A Computerized Analysis
Abstract
:1. Introduction
2. Methods
2.1. Study Design
2.2. Image Acquisition
2.3. Manual Analysis
2.4. Computerized Analysis of Fracture Displacements
- Segmentation
- 2.
- Proximal humerus pre-fracture anatomy prediction
- 3.
- Anatomical positioning of the pre-fracture proximal humerus
- 4.
- Computerized reduction of bone fragments
- 5.
- Definition of the 3 humeral reference planes
- 1.
- Diaphyseal axis (): defined by the axis of the humeral diaphysis cylinder, according to the method of least squares;
- 2.
- Anatomical neck plane: defined by manual selection of 10 points on the anatomical neck and a plane fit to these points by the least squares method;
- 3.
- Anatomical neck axis (): the normal (perpendicular) vector to the plane of the anatomical neck, towards the glenoid;
- 4.
- Coronal plane axis calculation: = ^ (perpendicular to both axial and anatomical neck vectors);
- 5.
- Sagittal plane’s axis calculation: = ^ (perpendicular to both axial and coronal vectors).
- 6.
- Computerized measurements of displacement
2.5. Translation Analysis
2.6. Rotation Analysis
2.7. Comparison to Neer’s Criteria
2.8. Statistical Analyses
3. Results
3.1. Computerized Fracture Description
3.2. Humeral Head Rotation
3.3. Tuberosity Translation
3.4. Accuracy of Manual Measurements
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | Average (Minimum–Maximum) Frequency (%) |
---|---|
Age | 71 years (29–95) |
Female gender | 63 (81%) |
Laterality | Right: 41 (53%)/Left: 36 (47%) |
Dominant side | 39/77 (51%) |
Mechanism | Ground level fall: 61 (79%) |
Fall from height: 3 (4%) | |
Motor vehicle accident: 8 (10%) | |
Sports accident: 5 (7%) |
Coronal Rotation | Total | ||||||
---|---|---|---|---|---|---|---|
Valgus > 45° | Valgus 5–45° | <5° | Varus 5–45° | Varus > 45° | |||
Axial rotation | Retroversion > 45° | 0 | 2 | 0 | 6 | 2 | 10 |
Retroversion 5–45° | 0 | 11 | 1 | 10 | 1 | 23 | |
<5° | 1 | 10 | 16 | 6 | 0 | 33 | |
Anteversion 5–45° | 2 | 1 | 2 | 6 | 0 | 11 | |
Anteversion > 45° | 0 | 0 | 0 | 0 | 0 | 0 | |
Sagittal rotation | Posterior tilt > 45° | 0 | 0 | 0 | 3 | 1 | 4 |
Posterior tilt 5–45° | 1 | 17 | 3 | 17 | 1 | 39 | |
<5° | 2 | 6 | 15 | 3 | 0 | 26 | |
Anterior tilt 5–45° | 0 | 1 | 1 | 5 | 0 | 7 | |
Anterior tilt > 45° | 0 | 0 | 0 | 0 | 1 | 1 | |
Total | 3 | 24 | 19 | 28 | 3 | 77 |
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Ripoll, T.; Chelli, M.; Johnston, T.; Chaoui, J.; Gauci, M.-O.; Vasseur, H.; Poltaretskyi, S.; Boileau, P. Three-Dimensional Measurement of Proximal Humerus Fractures Displacement: A Computerized Analysis. J. Clin. Med. 2023, 12, 4085. https://doi.org/10.3390/jcm12124085
Ripoll T, Chelli M, Johnston T, Chaoui J, Gauci M-O, Vasseur H, Poltaretskyi S, Boileau P. Three-Dimensional Measurement of Proximal Humerus Fractures Displacement: A Computerized Analysis. Journal of Clinical Medicine. 2023; 12(12):4085. https://doi.org/10.3390/jcm12124085
Chicago/Turabian StyleRipoll, Thomas, Mikaël Chelli, Tyler Johnston, Jean Chaoui, Marc-Olivier Gauci, Heloïse Vasseur, Sergii Poltaretskyi, and Pascal Boileau. 2023. "Three-Dimensional Measurement of Proximal Humerus Fractures Displacement: A Computerized Analysis" Journal of Clinical Medicine 12, no. 12: 4085. https://doi.org/10.3390/jcm12124085