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Objective To provide anatomical basis for clinical treatment of acromioclavicular joint dislocation by studying the morphology of coracoid process of human scapula. Methods A total of 500 patients with shoulder injury were selected from the Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University in Sichuan Province, and 300 patients were selected as subjects, including 159 cases of right shoulder and 141 cases of left shoulder. CT scan images and 3D reconstruction results of scapula of the subjects were collected. The basic morphological characteristics of coracoid process CT images of the subjects were observed, and the relevant parameters were measured, including the longest horizontal distance of the coracoid process tip and the thickness of the midpoint (cd, pp’), the distance from the upper part of the coracoid process scapula to the base and the thickness of the midpoint (mn, kk’). The distance from the apex of the coracoid process to the base of the coracoid process (ab), the longest horizontal distance of the recursion part of the coracoid process (ef), the distance of as (point s was the intersection of point a perpendicular to mn), the distance of hj (point h and j were the intersection of the base of the coracoid process and the recursion part respectively), and ik (point i was the intersection of point k perpendicular to mn and the coracoid process retraction). Results According to the morphological characteristics of coracoid process, they were divided into five types, including peanut 29. 7%; Short rod type accounted for 27. 4%; Melon seed type accounted for 12. 6%; Rod type accounted for 17. 0%; Wedge type accounted for 13. 3%. Through data comparison, it was found that the distance ef and distance hj on the left were larger than those on the right, P<0. 05. All types had statistical difference in comparison distance cd, P<0. 05. The melon seed type showed statistical differences with peanut type, wedge type, long stick type and short stick type in thickness pp’, distance ab and as of point p, P<0. 05. In the comparison of point K thickness kk’, there was statistical difference between melon seed type and other four types, P<0. 05. In the distance ab comparison, there was statistical difference between the short bar type and the other four types, P < 0. 05. Conclusion The study on the morphology of coracoid process can provide anatomical basis for clinical reconstruction of coracoid ligament to treat acromioclavicular joint dislocation.
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Objective To explore the anatomical morphology and characteristics of the sustentaculum tali based on CT three⁃dimensional reconstruction, so to provide anatomical support for the treatment of calcaneal fractures with screw implantation. Methods From March 2019 to March 2020, a total of 336 adult calcaneal CT three⁃dimensional reconstruction images from the Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University were collected after exclusion of inclusion criteria. The CT three⁃dimensional reconstruction of calcaneus was classified according to the β, the prolate axial intersection between sustentaculum tali and calcaneus on the normal posterior. Reference points, β; AB, the distance from the inside of sustentaculum tali to the inside of posterior talar articular surface; AC, the distance from the inside of sustentaculum tali to the outside of posterior talar articular surface; AD, the distance from the inside of sustentaculum tali to lateral of calcaneal; AE, the distance from the inside of sustentaculum tali to medial process of calcaneal tuberosity; AF, the distance from the inside of sustentaculum tali to calcaneal tuberosity; AG, the distance from the inside of sustentaculum tali to lateral process of calcaneal tuberosity. The results were statistically analyzed according to type, sex and body side. Results Under the β, the sustentaculum tali was classified into three types: typeⅠ(β<70°, 68 cases, 20.24%), type Ⅱ(70°≤β<80°, 153 cases, 45.54%), type Ⅲ(80°≤β<90°, 115 cases, 34.23%). For the distance of β, AB, AF, there were statistical differences between type Ⅲ and other types (P<0.05). For the distance of AE, there were statistical differences between type Ⅲ and typeⅠ(P<0.05). Meanwhile, for the distance of AB, AC, AD, AE, AF, AG, there were statistical differences between male and female (P<0.05). For the distance of β, AB, there were statistical differences between right and left (P<0.05). Conclusion Under the β, the sustentaculum tali is classified into three types, with the typeⅡas the main type. When treating calcaneal fractures with internal fixation, direction of screw implant can choose between 70° to 80° as soon as possible. The morphology and classification of sustentaculum tali are of certain clinical implication to treat calcaneal fractures.
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Objective@#To investigate the incidence and morphology of C-shaped root canals in mandibular premolars by cone-beam computed tomography (CBCT) imaging, which provides a reference for clinical diagnosis and treatment.@*Methods @#The CBCT scanning data of 964 mandibular first premolars and 907 mandibular second premolars in 508 cases were collected, and the root canal morphology, incidence of C-shaped root canals, bilateral symmetry and location of radicular grooves were analyzed.@*Results@#The incidence of C-shaped root canals in mandibular first premolars was 4.1% and that in mandibular second premolars was 0.6%. The incidence of C-shaped root canals of mandibular first premolars was significantly higher than that of mandibular second premolars (χ2=25.775, P < 0.001). The symmetrical ratio of C-shaped root canals in the mandibular first premolars was 29%. There were no symmetrical C-shaped root canals in the mandibular second premolars. There were significant differences in the distribution of the C-shaped root canal configuration in the root canal (P < 0.001). The C-shaped configuration mainly existed in the middle axial and apical level of the mandibular premolars. The C2 type was more common. No C-shape was found in the coronal level of the mandibular premolars. Vertucci I single tube type was the most common type of root canal for the mandibular premolars included in this study; the incidences were 81.7% and 98.3% for the mandibular first and second premolars, respectively, and the difference was statistically significant (χ2=140.544, P < 0.001). The other root canal types of mandibular first premolars were more than those of mandibular second premolars. The incidences of Vertucci Ⅱ, Ⅲ, Ⅳ, and Ⅴ and C-shaped root canals in mandibular first premolars were significantly higher than those in mandibular second premolars. C-shaped root canal mandibular premolars had radicular grooves, and most of them were located at the mesiolingual side.@*Conclusion@# The morphology of the C-shaped root canal in mandibular premolars was complicated. CBCT can provide direct and accurate imaging evidence for clinical diagnosis and treatment.
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Objective To discuss the morphological features of the fifth metacarpal bone and clinical significance by measuring the three-dimensional (3-D) reconstruction model, and to improve the clinical technique and surgical instruments. Methods A total of 114 3-D reconstruction models based on computed tomography data of fifth metacarpal bone were created. The length, the radius of head, the radius of arc, the 1/ 2 central angle of arc, the distance of head offset, the ratio of head offset, the inner diameter of the isthmus of medullary space were measured based on 3-D models. Results The fifth metacarpal bone length was(51. 55±3. 01) mm. The radius of the fifth metacarpal head was (6. 59± 0. 49)mm. The radius of the fifth metacarpal bone arc was(99. 58±26. 83)mm. The 1/ 2 central angle of fifth metacarpal bone arc was(15. 90±3. 36)°. The distance of the fifth metacarpal head offset was(0. 49±0. 26) mm. The ratio of head offset was(7. 4±3. 9)%. The inner diameter of the isthmus of medullary space was (2. 28±0. 77)mm. Conclusion The length, the radius of head, the distance of head offset, the inner diameter of the isthmus of medullary space are different between male and female, and the other parameters are not different. There is no significant difference between left and right hand.
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Objective To study the anatomical and morphological characteristics of the subtalar joint surface and to explore its clinical significance. Methods Totally 365 dry calcaneus specimens (sex, age unknown) were selected. Its long axis sum and the short axis sum were measured using Vernier caliper. The Gissane's angle (the angle was formed by two lines along the anterior and posterior articular surfaces of calcaneus respectively) and the Bohler's angle (the angular measurement was formed by a line from the posterior calcaneal margin to the margin of the posterior facet and a second line from the margin of the posterior facet to the superior margin of the anterior calcaneal process) were measured using Goniometer. Results According to the anatomical morphology, the subtalar joint surface can be divided into 5 types: type I (189, 51.78%), type II (80, 21.92%), type III (5 1, 13.97%), type IV (37, 10.14%) and type V (8, 2. 19%). The long axis sum of type III (4. 55±0. 6) cm was significantly smaller than other types (P 0. 05). Conclusion In this experiment, there are five variations in the articular surface of calcaneal talus, mainly type I, and its anatomical morphological classification has certain guiding significance for clinical diagnosis and treatment.
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Objective: To explore the morphological classification and clinical significance of scapular spine based on CT three dimensional reconstruction. Methods: The scapular spines of 280 adults in the Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University were classified by CT plain scan and three-dimensional reconstruction, and its guiding significance for clinical work was discussed. Measurement content the distance between the seven structures of the scapular region and the thickness of the nine points. Results: Under the CT 3D reconstruction, the scapular spines were divided into five types: thin shape, wood rod shape, thick shape, fusiform shape and S shape. There were 14 cases of thin shape, accounting for 14.64%; and 63 cases of wood rod shape, accounting for 22.50%; and 78 cases of wood rod shape, accounting for 27.86%; and 89 cases of thick shape, accounting for 27.86%; and 89 cases of fusiform shape, accounting for 31.7p%, and 9 cases of S shape, accounting for 3.21%. In the thin shape, the thickness of B (9.36±3.61) mm was obviously thinner than the other four types (P<0.05); In thick shape, the length of AC (84.36± 6.00) mm and AD (84.36±6.00) mm was longer than the other four types, and the thickness of F, H, I, K was the thickest (P<0.05); In the fusiform shape, the length of BC was the shortest, and the thickness of K was the thinnest except for the thin shape (P<0.05). Conclusion: Under the CT 3D reconstruction, the scapular spines are divided into five types; thin shape, wood rod shape, thick shape, fusiform shape and S shape. Among them, fusiform shape is the most, and S shape is the least; The scapular spine of thick shape is the most abundant bone, which is the high quality source of autologous bone graft, and can also be used as a better fixed position for internal implants. On the contrary, the scapular spine of thin shape has the least amount of bone, and the internal fixation strength is relatively poor. Different types of scapular spines have certain effects on their operative method.
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Objective To measure and investigate the anatomical characteristics of the proximal femur canal curves in patients with developmental dysplasia of the hip (DDH), and to provide references for the design of femoral stem of DDH patients. Methods Three-dimensional reconstructions of the proximal femur were conducted from the CT data, and the anatomical morphology characteristics were obtained from 64 patients with DDH (74 hips, 12 males, 52 females, average age of 45.3 years) and 30 healthy controls (30 hips, 21 males, 9 females, average age of 29.4 years). Multiple anteroposterior diameter and mediolateral diameter around the lesser trochanter at different heights and the fitting curves of different groups were obtained. Results The femoral neck anteversion angle, neck-shaft angle, height of the isthmus, canal flare index (CFI), femoral head diameter and femoral offset of DDH patients and healthy controls were 26.39°±14.74° and 15.68°±7.95°, 125.65°±5.73° and 129.19°±5.80°, (99.14±14.62) mm and (110.13±11.73) mm, 3.63±0.77 and 4.45±0.79, (44.01±5.75) mm and (47.26±3.94) mm, (31.80±3.82) mm and (36.42±4.84) mm, respectively. DDH group had the significantly greater femoral neck anteversion angle, and other anatomical morphology characteristics were significantly smaller than the control group. The obtained anteroposterior diameter, mediolateral diameter and the fitting curves showed that DDH group had narrow medullary cavity and forward shifting anteroposterior diameter. In addition, there was a statistical significance between the Crowe Ⅳ DDH and other types of DDH, and deformation degree of the femur increased with the increase of DDH type. Conclusions The proximal femur of DDH patients was significantly different from the healthy controls. Moreover, there were significantly morphological differences between different types of DDH. The research findings can be used as quantitative references for understanding the morphological feature of DDH patients and the corresponding design of femoral stem for DDH patients.
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Objective To measure and investigate the anatomical characteristics of the proximal femur canal curves in patients with developmental dysplasia of the hip (DDH), and to provide references for the design of femoral stem of DDH patients. Methods Three-dimensional reconstructions of the proximal femur were conducted from the CT data, and the anatomical morphology characteristics were obtained from 64 patients with DDH (74 hips, 12 males, 52 females, average age of 45.3 years) and 30 healthy controls (30 hips, 21 males, 9 females, average age of 29.4 years). Multiple anteroposterior diameter and mediolateral diameter around the lesser trochanter at different heights and the fitting curves of different groups were obtained. Results The femoral neck anteversion angle, neck-shaft angle, height of the isthmus, canal flare index (CFI), femoral head diameter and femoral offset of DDH patients and healthy controls were 26.39°±14.74° and 15.68°±7.95°, 125.65°±5.73° and 129.19°±5.80°, (99.14±14.62) mm and (110.13±11.73) mm, 3.63±0.77 and 4.45±0.79, (44.01±5.75) mm and (47.26±3.94) mm, (31.80±3.82) mm and (36.42±4.84) mm, respectively. DDH group had the significantly greater femoral neck anteversion angle, and other anatomical morphology characteristics were significantly smaller than the control group. The obtained anteroposterior diameter, mediolateral diameter and the fitting curves showed that DDH group had narrow medullary cavity and forward shifting anteroposterior diameter. In addition, there was a statistical significance between the Crowe Ⅳ DDH and other types of DDH, and deformation degree of the femur increased with the increase of DDH type. Conclusions The proximal femur of DDH patients was significantly different from the healthy controls. Moreover, there were significantly morphological differences between different types of DDH. The research findings can be used as quantitative references for understanding the morphological feature of DDH patients and the corresponding design of femoral stem for DDH patients.
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SUMMARY: Model analysis was performed to identify palatal rugae anatomical morphology patterns, evaluate their individual-specific properties and stability before and after orthodontic treatments, and investigate their reliability in the use for individual identification from the perspective of forensic dentistry. Maxillary models of 70 patients were collected before and after orthodontic treatments, palatine images were taken under standard conditions. Pattern-based individual identification was performed through measuring some indices including changes in number, orientation, shape, and length of palatal rugae, as well as mesial and distal endpoint displacement of palatal rugae in the anteroposterior (AP) and mesiodistal (MD) direction. At the same time, maxillary models of 10 patients were randomly selected for individuality confirmation and the average rate of correct matches was calculated. palatal rugae anatomical morphology patterns were highly individual-specific. Palatine of the same pattern were not found before or after orthodontic treatment. Model-based analysis confirmed the high individual-specificity properties of the palatal rugae anatomical morphology patterns, and also showed that the incidence of any morphological change in the patterns after orthodontic treatment was 45.7 % for anteroposterior displacement of the distal endpoint of palatal rugae, 40 % for mesiodistal displacement of the distal endpoint of palatine, 32.9 % for anteroposterior displacement of the mesial endpoint of palatal rugae, and 17.1 % for mesiodistal displacement of the mesial endpoint of palatal rugae. The incidence of change in length, orientation and shape of palatine after orthodontic treatment was 28.6 %, 1.4 % and 1.4 % respectively; and the incidence of palatal segmentation and unification after orthodontic treatment was 4.3 % and 2.9 % respectively. The mean percentage of correct matches of the palatine patterns after orthodontic treatment to their duplicates was 99.05 % and the mean percentage of correct matches of the palatine patterns between before and after orthodontic treatment was 92.19 %. Palatal rugae anatomical morphology patterns are unique to each individual. After orthodontic treatment, palatal rugae have diverse presentation patterns. Although the diverse palatine patterns to a certain degree, influence individual identification in the field of forensic identification, palatal rugae patterns can be used as a novel method for individual identification in forensic dentistry.
RESUMEN: Se realizó un análisis de modelo para identificar los patrones de morfología anatómica de las rugosidades palatinas, evaluar sus propiedades individuales y estabilidad antes y después de los tratamientos ortodónticos e investigar su fiabilidad en el uso para la identificación individual desde la perspectiva de la odontología forense. Se recogieron modelos maxilares de 70 pacientes, antes y después de tratamientos ortodónticos, y se tomaron imágenes palatinas bajo condiciones estándar. La identificación individual basada en patrones se realizó a través de la medición de algunos índices incluyendo cambios en el número, orientación, forma y longitud de las rugas palatinas, así como el desplazamiento mesial y distal del punto final de las rugas palatinas en dirección antero-posterior (AP) y mesiodistal (MD). Al mismo tiempo, los modelos maxilares de 10 pacientes fueron seleccionados aleatoriamente para la confirmación de la individualidad y se calculó la tasa promedio de coincidencias correctas. Los patrones de morfología anatómica de las rugas palatinas eran altamente específicos de cada individuo. Una ruga palatina del mismo patrón no se encontró antes o después del tratamiento ortodóncico. El análisis basado en modelos confirmó las altas propiedades individuales de los patrones de morfología anatómica de las rugas palatinas y también mostró que la incidencia de cualquier cambio morfológico en los patrones después del tratamiento ortodóncico fue del 45,7 % en el desplazamiento anteroposterior de la porción distal de las rugas palatinas. Los porcentajes para el desplazamiento mesiodistal de la porción distal de la ruga palatina fue del 40 %, el desplazamiento anteroposterior del extremo mesial de las rugas palatinas presentó un porcentaje del 32,9 %, y 17,1 % para el desplazamiento mesiodistal del extremo mesial de las rugas palatinas. La incidencia de cambio de longitud, orientación y forma de la ruga palatina después del tratamiento ortodóncico fue de 28,6 %, 1,4 % y 1,4 %, respectivamente; la incidencia de segmentación y unificación de rugas palatinas después del tratamiento ortodóncico fue de 4,3 % y 2,9 % respectivamente. El porcentaje medio de coincidencias de los patrones de rugas palatinas después del tratamiento ortodóncico con sus duplicados fue del 99,05 % y el porcentaje medio de coincidencias correctas de los patrones de las rugas palatinas antes y después del tratamiento ortodóncico fue del 92,19 %. Los patrones de morfología anatómica de las rugas palatinas son únicos para cada individuo. Después de un tratamiento ortodóncico, las rugas palatinas presentan diversos patrones. No obstante, los diversos patrones de rugas palatinas influyen en cierto grado en la identificación individual forense; los patrones de las rugas palatinas pueden ser usados como un nuevo método para la identificación individual en odontología forense.
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Humans , Male , Female , Adult , Orthodontics , Palate, Hard/anatomy & histology , Forensic DentistryABSTRACT
Objective To explore the application value of 64-slice spiral CT cardiac enhancement scanning in the morphological as-sessment of left atrial appendage(LAA).Methods Patients were selected retrospectively between April 16,2013 and May 1,2013, including 142 patients with sinus rhythms underwent MDCT coronary angiography,25 patients with atrial fibrillation underwent MDCT pulmonary vein-left atrial angiography.All images were post-processed,datas were measured and the morphology of left at-rial appendage were classified into different types.Results 167 patients were enrolled,including 88 males and 79 femals,age 53.7± 8.9 years.Anatomical relationship of the orifice of left atrial appendage to left superior pulmonary vein(LSPV)were classified as high type (superior to LSPV,2.4%),middle type(parallel to LSPV,86.2%),low type(inferior to LSPV,11.4%).LAA orifice could be classified into three types including oval(162,97%),round-like(3,1.8%)and drop-like(2,1.2%).LAA morphology could be classified in four types including Cauliflower(35,21%),Windsock(41,24.6%),Cactus(7,4.2%),Chicken-wing(84, 50.3%).Patients with atrial fibrillation have a larger LAA volume than who with sinus rhythm.Conclusion 64-slice spiral CT car-diac enhancement scanning can provide a vivid and intuitive reference to the anatomy of LAA and its adjacent structures,and it can also provide quantitative evaluation of LAA anatomical parameters,so it may have a nice significance in the direction of LAA occlu-sion.
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Objective To investigate the influence of acetabular morphology on contact mechanics of the human hip joint. Methods One anatomical finite element (FE) model of natural hip joint and three simplified FE models with different acetabular geometry were established to study the contact mechanics of hip joint under gait loads. Results (1) Contact predicted by the anatomical model was mainly distributed in the acetabular medial-superior area, from anterior to posterior, with the peak contact pressure occurred in the anterior-superior area; (2) Compared with the anatomical model, the rotational ellipsoid produced similar contact behavior, while the sphere and the rotational conchoids predicted that contact was distributed in the medial-lateral direction; (3) The rotational ellipsoid predicted the largest contact area and the lowest peak contact pressure and Von-Mises stress; (4) The sphere and rotational conchoids had similar contact mechanical behavior. Conclusions Compared with the sphere and rotational conchoids, the rotational ellipsoid could be more preferable to represent the anatomical morphology of the acetabulum and its contact mechanics.
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Objective:To obtain 29 anatomic parameters of normal Chinese proximal femur through CT 3D reconstruction so as to provide anatomical references for hip prosthesis selection and design. Methods:Bilateral proximal femurs of 82 normal Chinese were scanned by CT and visualized by CT 3D reconstruction. The parameters of proximal femur were measured by medical imaging analysis software and compared with the existing references. Results: The shape and size of proximal femoral medullary cavity had obvious individual diversities. All morphologic parameters of the proximal femur was close to a normal distribution with no marked difference between left and right side. Neck shaft angle was negatively correlated with offset; the femoral head diameter had a strong correlation with femoral neck diameter, femoral head height, distance between femoral head tip to great trochanter, and distance between apex of femur anterior arch to less trochanter section. The offset and neck-shaft angle were significantly different between Chinese and Caucasian(P