A total of 80 subjects were included in this study, including 45 males and 35 females, 44 left humerus and 36 right humerus. The mean age of the subjects was 38.03 ± 12.21 years. The data characteristics of the subjects' test parameters are shown in Table 1.
Table1. Morphological parameters.
|
|
Means±SD
|
1/4 quartile
|
3/4 quartile
|
Age
|
48.15±15.32
|
28
|
47
|
Morphological parameter of distal humerus
|
W (mm)
|
44.38±4.07
|
41.38
|
47.55
|
CW (mm)
|
17.60±2.06
|
16.14
|
18.98
|
CD (mm)
|
10.83±1.18
|
10.07
|
11.7
|
CH (mm)
|
21.10±2.03
|
20
|
22
|
HMW (mm)
|
58.95±4.86
|
54.18
|
62.53
|
EW (mm)
|
12.02±1.9
|
10.77
|
13.24
|
Morphological parameter of trochlea humeri
|
ODT (mm)
|
5.98±1.66
|
4.79
|
7.15
|
AMTD (mm)
|
12.01±1.40
|
10.95
|
12.84
|
PMTD (mm)
|
12.03±1.79
|
10.94
|
13.24
|
TD (mm)
|
16.28±1.95
|
14.78
|
17.41
|
ALTD (mm)
|
9.97±1.19
|
9.03
|
10.8
|
PLTD (mm)
|
14.94±1.57
|
13.78
|
15.95
|
AMTW (mm)
|
11.94±1.60
|
10.9
|
13.01
|
PMTW (mm)
|
8.98±1.35
|
7.91
|
9.9
|
ALTW (mm)
|
7.81±1.81
|
6.3
|
8.83
|
PLTW (mm)
|
11.92±1.92
|
10.76
|
13.23
|
LTH (mm)
|
18.79±2.07
|
17.12
|
20.23
|
TH (mm)
|
16.63±1.96
|
15.47
|
17.85
|
MTH (mm)
|
23.87±2.40
|
21.98
|
25.4
|
TW (mm)
|
26.78±2.96
|
24.75
|
28.8
|
Angle parameter of distal humerus
|
HAA (°)
|
86.22±3.27
|
83.76
|
88.71
|
MCCTA (°)
|
43.05±7.53
|
38.64
|
47.46
|
LCCTA (°)
|
16.03±7.32
|
10.26
|
20.08
|
MCSTA (°)
|
7.52±11.00
|
2.73
|
13.35
|
LCSTA (°)
|
37.31±9.10
|
31.73
|
42.81
|
Three-dimensional morphological parameters of distal humerus
|
MEV (mm3)
|
2334.49±591.95
|
1845.2
|
2688.38
|
OFV (mm3)
|
1613.52±401.63
|
1377.14
|
1813.9
|
CFV (mm3)
|
388.42±165.57
|
264.48
|
528.06
|
OFSA (mm2)
|
481.84±91.13
|
431.03
|
535.79
|
CFSA (mm2)
|
134.59±36.85
|
106.12
|
157.3
|
MESA (mm2)
|
751.61±134.77
|
660.64
|
828.83
|
Morphological parameters of distal humerus
The mean and standard deviation of CD, CW and CH measured at the flexion axis cross-section were 10.83 ± 1.18 mm, 17.60 ± 2.06 mm and 21.10 ± 2.03 mm, respectively. The W, EW and HMW were 44.38 ± 4.07 mm, 12.02 ± 1.90 mm and 58.95 ± 4.86 mm, respectively.
Humeral trochlea shape parameters
The humeral trochlea is an important anatomical structure for maintaining the normal motion of the elbow joint. It is the anatomical basis of the functional range of motion of the elbow joint. The mean TH, LTH and MTH were 16.63 ± 1.96 mm, 18.79 ± 2.07 mm and 23.87 ± 2.40 mm, respectively. The AMTD, PMTD, ALTD and PLTD were 12.01 ± 1.40 mm, 12.03 ± 1.79 mm, 9.97 ± 1.19 mm and 14.94 ± 1.57 mm, respectively. The TW, AMTW, PMTW, ALTW and PLTW were 26.78 ± 2.96 mm, 11.94 ± 1.60 mm, 8.98 ± 1.35 mm, 7.81 ± 1.81 mm and 11.92 ± 1.92 mm, respectively. The ODT and TD were 5.98 ± 1.66 mm and 16.28 ± 1.95 mm, respectively.
Angle parameters
The means of the HAA in 80 subjects was 86.22 ± 3.27°. The MCCTA and LCCTA were 43.05 ± 7.53° and 16.03 ± 7.32° respectively. The MCSTA and LCSTA were 7.52 ± 11.00° and 37.31 ± 9.10°, respectively.
3D shape parameters
The MEVB were 2334.49 ± 591.95mm3. The OFV and CFV were 1613.52 ± 401.63mm3 and 388.42 ± 165.57mm3, respectively. The OFSA, CFSA and MESA were 134.59 ± 36.85 mm2,134.59 ± 36.85 mm2 and 751.61 ± 134.77 mm2, respectively.
Gender differences and left- right side differences
As shown in Table 2, CD (P < 0.001*), CW (P < 0.001*), CH (P<0.001 *), W (P < 0.001 *), EW (P < 0.001 *), and HMW (P < 0.001 *) were significantly higher in males than in females. There was no significant difference between the sexes in the shape parameters of the humeral trochlea except for ODT (P = 0.098).AMTD (P < 0.001 *), PMTD (P < 0. 001 *), TD (P < 0.001 *), ALTD (P < 0.001 *), PLTD (P < 0.001 *), AMTW (P < 0.001 *), PMTW (P = 0.01 *), ALTW (P < 0.001 *), PLTW (P < 0.001 *), LTH (P < 0. 001 *), TH (P < 0.001 *), MTH (P < 0.001 *), TW (P < 0.001 *) of males were significantly higher than those of females, and MEV (P < 0.001 *), OFV (P < 0.001 *), CFV (P = 0.003 *), OFSA (P = 0.001 *), CFSA (P = 0.007 *), MESA (P < 0.001 *) were also significantly higher in men than in women. However, the gender differences in the angle parameters included in this study were insignificant. There was no significant difference in the distal humerus parameters between the left and right sides, except for the HAA (P= 0.045 *).
Table2.Gender differences and left-right side differences.
|
|
Total
|
Male
|
Female
|
P value
|
Left
|
Right
|
P value
|
Age
|
38.02±12.28
|
34.58±11.25
|
42.46±12.29
|
0.005*
|
37.02±12.54
|
39.25±12.03
|
0.333
|
Morphological parameter of distal humerus
|
CD (mm)
|
10.83±1.18
|
11.45±1.01
|
10.04±0.87
|
<0.001*
|
10.94±1.33
|
10.71±0.96
|
0.366
|
CW (mm)
|
17.60±2.06
|
18.64±1.78
|
16.25±1.57
|
<0.001*
|
17.84±2.21
|
17.31±1.85
|
0.252
|
CH (mm)
|
21.10±2.03
|
22.25±1.77
|
19.62±1.24
|
<0.001*
|
21.16±2.16
|
21.03±1.9
|
0.67
|
W (mm)
|
44.38±4.07
|
47.1±2.63
|
40.88±2.66
|
<0.001*
|
44.06±4.28
|
44.77±3.81
|
0.439
|
EW (mm)
|
12.02±1.90
|
12.95±1.6
|
10.83±1.57
|
<0.001*
|
11.97±2.07
|
12.08±1.68
|
0.803
|
HMW (mm)
|
58.95±4.86
|
62.43±2.93
|
54.47±2.7
|
<0.001*
|
58.37±5.28
|
59.65±4.27
|
0.164
|
Morphological parameter of the trochlea
|
ODT (mm)
|
5.98±1.66
|
6.25±1.63
|
5.63±1.65
|
0.098
|
5.67±1.42
|
6.35±1.86
|
0.067
|
AMTD (mm)
|
12.01±1.40
|
12.79±1.26
|
11±0.78
|
<0.001*
|
11.99±1.38
|
12.03±1.43
|
0.89
|
PMTD (mm)
|
12.03±1.79
|
12.69±1.6
|
11.18±1.68
|
<0.001*
|
11.77±1.73
|
12.34±1.83
|
0.153
|
TD (mm)
|
16.28±1.95
|
17.22±1.68
|
15.08±1.58
|
<0.001*
|
16.18±1.94
|
16.4±1.97
|
0.622
|
ALTD (mm)
|
9.97±1.19
|
10.67±1.03
|
9.08±0.64
|
<0.001*
|
9.92±1.12
|
10.04±1.28
|
0.671
|
PLTD (mm)
|
14.94±1.57
|
15.8±1.22
|
13.85±1.26
|
<0.001*
|
14.93±1.49
|
14.95±1.67
|
0.653
|
AMTW (mm)
|
11.94±1.60
|
12.6±1.59
|
11.08±1.14
|
<0.001*
|
11.78±1.51
|
12.12±1.71
|
0.342
|
PMTW (mm)
|
8.98±1.35
|
9.32±1.5
|
8.54±0.97
|
0.01*
|
8.87±1.2
|
9.12±1.51
|
0.505
|
ALTW (mm)
|
7.81±1.81
|
8.39±1.78
|
7.07±1.57
|
<0.001*
|
7.79±1.62
|
7.84±2.04
|
0.839
|
PLTW (mm)
|
11.92±1.92
|
12.77±1.62
|
10.82±1.73
|
<0.001*
|
11.47±1.98
|
12.47±1.72
|
0.02*
|
LTH (mm)
|
18.79±2.07
|
19.72±1.97
|
17.6±1.52
|
<0.001*
|
19±1.86
|
18.53±2.29
|
0.309
|
TH (mm)
|
16.63±1.96
|
17.57±1.7
|
15.43±1.6
|
<0.001*
|
16.44±1.94
|
16.87±1.99
|
0.336
|
MTH (mm)
|
23.87±2.40
|
25.23±1.79
|
22.12±1.91
|
<0.001*
|
23.7±2.53
|
24.09±2.25
|
0.475
|
TW (mm)
|
26.78±2.96
|
28.46±2.23
|
24.63±2.32
|
<0.001*
|
26.22±3.12
|
27.47±2.63
|
0.06
|
Angle parameter
|
|
|
|
|
|
|
|
HAA (°)
|
86.22±3.27
|
85.73±3.27
|
86.85±3.2
|
0.128
|
86.88±3.31
|
85.41±3.07
|
0.045*
|
MCCTA (°)
|
43.05±7.53
|
43.51±6.91
|
42.46±8.33
|
0.538
|
42.3±7.37
|
43.97±7.74
|
0.326
|
LCCTA (°)
|
16.03±7.32
|
14.91±7.93
|
17.47±6.29
|
0.122
|
16.84±6.95
|
15.05±7.75
|
0.281
|
MCSTA (°)
|
7.52±11.00
|
5.97±11.58
|
9.51±10.01
|
0.116
|
7.32±10.05
|
7.77±12.2
|
0.95
|
LCSTA (°)
|
37.31±9.10
|
36.38±9.32
|
38.51±8.8
|
0.302
|
37.32±9.19
|
37.3±9.12
|
0.995
|
Three-dimensional parameter
|
|
|
|
|
|
|
|
MEV (mm3)
|
2334.49±591.95
|
2657.68±522.29
|
1918.97±381.04
|
<0.001*
|
2330.39±623.27
|
2339.51±560.02
|
0.946
|
OFV (mm3)
|
1613.52±401.63
|
1759±410.67
|
1426.47±304.19
|
<0.001*
|
1663.04±432.39
|
1552.99±357.14
|
0.225
|
CFV (mm3)
|
388.42±165.57
|
429.16±154.59
|
336.05±166.58
|
0.003*
|
402.78±169.47
|
370.88±161.3
|
0.459
|
OFSA (mm2)
|
481.84±91.13
|
511.38±80.14
|
443.85±91.35
|
0.001*
|
495.19±103.28
|
465.52±71.7
|
0.135
|
CFSA (mm2)
|
134.59±36.85
|
144.28±39.03
|
122.13±29.99
|
0.007*
|
139.65±37.39
|
128.4±35.73
|
0.176
|
MESA (mm2)
|
751.61±134.77
|
815.83±129.74
|
669.04±89.12
|
<0.001*
|
752.98±137.93
|
749.93±132.73
|
0.921
|
Correlation analysis of parameters of distal humerus
The results of the correlation analysis are shown in Tables 3,4,5,6. Among them, CW (r = -0.300, P< 0.01), ALTD (r = -0.227, P < 0.05), MCCTA (r = 0.307, P < 0.01), OFV (r = -0.408, P < 0.01), OFSA (r = -0.345, P < 0.01) and CFSA (r = -0.279, P < 0.05) were significantly correlated with the age of the subjects. There was no correlation between the angle parameters of the distal humerus. However, the correlation analysis results between the distal humerus morphological parameters were positively correlated. In summary, there is a broad and complex correlation between the measured parameters.
Table3.Shape parameters of the humerus schematic diagram of the correlation between morphological parameters of the distal humerus.
|
|
Age
|
CD
|
CW
|
CH
|
W
|
EW
|
HMW
|
Age
|
1
|
|
|
|
|
|
|
CD
|
-0.05
|
1
|
|
|
|
|
|
CW
|
-.300**
|
0.545**
|
1
|
|
|
|
|
CH
|
-0.067
|
.801**
|
.591**
|
1
|
|
|
|
W
|
-0.149
|
.789**
|
.719**
|
.786**
|
1
|
|
|
EW
|
-0.199
|
.350**
|
.341**
|
.305**
|
.409**
|
1
|
|
HMW
|
-0.126
|
.684**
|
.664**
|
.679**
|
.885**
|
.588**
|
1
|
**Correlation is significant at the 0.01 level (two-tailed). *Correlation is significant at the 0.05 level (two-tailed).
Table4.Correlation analysis between humeral trochlea shape parameters. **Correlation is significant at the 0.01 level (two-tailed).
|
|
Age
|
ODT
|
AMTD
|
PMTD
|
TD
|
ALTD
|
PLTD
|
AMTW
|
PMTW
|
ALTW
|
PLTW
|
LTH
|
TH
|
MTH
|
TW
|
Age
|
1
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
ODT
|
0.063
|
1
|
|
|
|
|
|
|
|
|
|
|
|
|
|
AMTD
|
-0.184
|
0.057
|
1
|
|
|
|
|
|
|
|
|
|
|
|
|
PMTD
|
0.139
|
0.172
|
.426**
|
1
|
|
|
|
|
|
|
|
|
|
|
|
TD
|
-0.118
|
0.043
|
.626**
|
.590**
|
1
|
|
|
|
|
|
|
|
|
|
|
ALTD
|
-.227*
|
0.092
|
.747**
|
.598**
|
.697**
|
1
|
|
|
|
|
|
|
|
|
|
PLTD
|
-0.172
|
0.202
|
.692**
|
.609**
|
.675**
|
.720**
|
1
|
|
|
|
|
|
|
|
|
AMTW
|
0.143
|
0.108
|
.280*
|
.590**
|
.351**
|
.411**
|
.361**
|
1
|
|
|
|
|
|
|
|
PMTW
|
0.133
|
0.013
|
.346**
|
.450**
|
.463**
|
.289**
|
.373**
|
.592**
|
1
|
|
|
|
|
|
|
ALTW
|
-0.188
|
0.027
|
.386**
|
-0.009
|
0.175
|
0.154
|
0.134
|
0.026
|
0.037
|
1
|
|
|
|
|
|
PLTW
|
-0.108
|
0.138
|
.382**
|
.537**
|
.264*
|
.516**
|
.357**
|
.346**
|
-0.026
|
.260*
|
1
|
|
|
|
|
LTH
|
-0.183
|
0.071
|
.561**
|
.455**
|
.585**
|
.601**
|
.610**
|
.339**
|
.331**
|
.289**
|
.302**
|
1
|
|
|
|
TH
|
-0.133
|
0.069
|
.622**
|
.561**
|
.929**
|
.700**
|
.691**
|
.306**
|
.378**
|
0.122
|
.262*
|
.519**
|
1
|
|
|
MTH
|
0.003
|
0.144
|
.724**
|
.718**
|
.674**
|
.647**
|
.740**
|
.493**
|
.426**
|
.276*
|
.443**
|
.619**
|
.660**
|
1
|
|
TW
|
0.005
|
0.19
|
.541**
|
.614**
|
.399**
|
.560**
|
.521**
|
.644**
|
.308**
|
.356**
|
.790**
|
.367**
|
.363**
|
.648**
|
1
|
**Correlation is significant at the 0.01 level (two-tailed).*Correlation is significant at the 0.05 level (two-tailed).
Table5.Correlation analysis of angle parameters.
|
|
Age
|
HAA
|
MCCTA
|
LCCTA
|
MCSTA
|
LCSTA
|
Age
|
1
|
|
|
|
|
|
HAA
|
0.037
|
1
|
|
|
|
|
MCCTA
|
.307**
|
0.052
|
1
|
|
|
|
LCCTA
|
0.134
|
-0.022
|
-0.078
|
1
|
|
|
MCSTA
|
0.084
|
-0.091
|
-0.059
|
0.089
|
1
|
|
LCSTA
|
0.015
|
0.032
|
-0.044
|
0.07
|
0.19
|
1
|
**Correlation is significant at the 0.01 level (two-tailed) . *Correlation is significant at the 0.05 level (two-tailed).
Table6.Correlation analysis of 3D morphological parameters.
|
|
Age
|
MEV
|
OFV
|
CFV
|
OFSA
|
CFSA
|
MESA
|
Age
|
1
|
|
|
|
|
|
|
MEV
|
-0.174
|
1
|
|
|
|
|
|
OFV
|
-.408**
|
.561**
|
1
|
|
|
|
|
CFV
|
-0.108
|
.426**
|
.452**
|
1
|
|
|
|
OFSA
|
-.345**
|
.296**
|
.531**
|
.304**
|
1
|
|
|
CFSA
|
-.279*
|
.300**
|
.399**
|
.509**
|
.388**
|
1
|
|
MESA
|
-0.105
|
.959**
|
.508**
|
.386**
|
.222*
|
.247*
|
1
|
**Correlation is significant at the 0.01 level (two-tailed). *Correlation is significant at the 0.05 level (two-tailed
Comparative analysis with other populations
As shown in Table 7, the mean values of CH(P < 0.001 *), CD (P < 0.001 *), LTH (P < 0.001 *), TH (P < 0.001 *) and TD (P < 0.001 *) were smaller in the Chinese population compared with the Western people, while CW (P < 0.001 *) and CD (P < 0.001 *) were more prominent. There was no significant difference in W (P = 0.263) and TW (P = 0.08) between the two groups.
Table7.Comparison of morphological parameters of some distal humerus between Eastern and Western populations.
|
|
Western cohort
|
Chinese cohort
|
|
Anatomical parameter
|
Sample size
|
Mean±SD
|
Sample size
|
Mean±SD
|
P Value
|
CH
|
100
|
23.25±2.56
|
270
|
20.26±1.89
|
<0.001*
|
CW
|
100
|
15.55±2.68
|
309
|
17.31±2.33
|
<0.001*
|
LTH
|
50
|
21.6±2.20
|
270
|
19.02±1.76
|
<0.001*
|
TH
|
50
|
17.8±2.00
|
270
|
16.43±1.93
|
<0.001*
|
MTH
|
50
|
29.9±4.10
|
270
|
23.66±2.41
|
<0.001*
|
W
|
50
|
42.5±4.60
|
201
|
41.72±4.35
|
0.263
|
TW
|
50
|
25.3±3.20
|
270
|
24.48±3.00
|
0.08
|
CD
|
50
|
9.00±1.00
|
201
|
10.44±1.13
|
<0.001*
|
TD
|
50
|
17.80±2.00
|
201
|
16.48±1.83
|
<0.001*
|
*p<0.05, the distinction is statistically significant.