Anterior glenoid rim fracture: the value of helical CT with threedimensional reconstruction and electronic humeral disarticulation

• Main Authors: Heverton César de Oliveira, Luís Cesar Paiva, Lúcio Cesar Silva Righi
• Format: Article
• Language: English
• Published: Instituto Israelita de Ensino e Pesquisa Albert Einstein 2003-06-01
• Series: Einstein (São Paulo)
• Subjects: Fractures; Shoulder/injury; Humerus; Tomography; spiral computed; Imaging; three dimensional
• Online Access: http://www.einstein.br/biblioteca/artigos/Anterior%20glenoid%20original.pdf

Objectives: To show a new three-dimensional reconstructiontechnique based on helical computed tomography images withelectronic humeral disarticulation in anterior glenoid rim fractures,correlating the anatomic specimen with simulation of an anteriorglenoid rim fracture, as well as evaluating the extension of thefracture, the bone fragment position and distance in relation to theglenoid cavity in six patients. Methods: One scapula and onehumerus with no signs of fracture or congenital malformationswere placed in anatomical position using an adhesive tape aftersimulating an anterior glenoid rim fracture made by an osteotome.Helical CT imaging was acquired and three-dimensionalreconstructions were made based on these images, with andwithout electronic humeral disarticulation. The bone fragment waslocated, measured and its position in relation to the glenoid cavitywas assessed. Six patients with anterior glenoid rim fracture weresubmitted to CT of the shoulder using the same parameters asthose applied to the anatomic specimen. Results: In the anatomicspecimen and in all six patients the bone fragment was clearlydemonstrated; bone fragment measurements in the anatomicspecimen and in three-dimensional reconstructions wereequivalent. The fragment was better demonstrated in the imagestaken with electronic humeral disarticulation, particularly in thefrontal view of the glenoid cavity as observed in all six patients.Conclusion: We concluded that our experiment with the anatomicspecimen and the study of six patients allow us to state that thistechnique is safe and accurate to demonstrate the extension, sizeand location of the bone fragment in anterior glenoid rim fractures,and it provides essential elements for therapeutic planning.