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Glenoid morphology in obstetrical brachial plexus lesion: a three-dimensional computed tomography study
Lars H Frich1, Pernille H Schmidt2, Trine Torfing3
1Department of Orthopaedics, Odense University Hospital, Odense, Denmark; Orthopaedic Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
Journal of Shoulder and Elbow Surgery
|April 17, 2017
Summary
Obstetric brachial plexus lesion (OBPL) causes 3-D glenoid deformities, including excessive retroversion and altered inclination. Three-dimensional CT imaging provides superior accuracy for assessing these OBPL-related shoulder abnormalities compared to 2-D methods.
Area of Science:
- Orthopedics
- Pediatric Imaging
- Skeletal Dysplasia
Background:
- Obstetric brachial plexus lesion (OBPL) is linked to glenohumeral dysplasia.
- Excessive glenoid retroversion is a known consequence of OBPL.
- Current 2D imaging limits assessment of glenoid inclination and sagittal plane morphology.
Purpose of the Study:
- To characterize the three-dimensional (3-D) glenoid deformity in children with OBPL.
- To compare 3-D CT measurements with 2-D imaging for assessing glenoid morphology.
Main Methods:
- Analysis of preoperative CT scans from 24 children (5-12 years) with OBPL.
- 3-D visualization and measurement of scapula and glenoid dimensions and deformities.
- Comparison of affected and nonaffected shoulders.
Main Results:
- Affected shoulders showed greater glenoid retroversion, which was overestimated by 2-D measurements.
- Glenoid inclination was altered, with distal bony edge loss observed in the sagittal plane.
- Affected scapulae were significantly smaller, and 3-D CT measurements demonstrated high reliability.
Conclusions:
- OBPL represents a complex 3-D disorder affecting glenoid morphology.
- 3-D CT imaging offers superior accuracy and comprehensive assessment of glenoid deformities in OBPL.
- 3-D CT provides critical insights into glenoid morphology in the coronal and sagittal planes for OBPL patients.