Glenoid kenar kırığı (kemik Bankart dışı) BT bulguları

Özet

Glenoid kenar kırıklarının morfolojisini hassas biçimde değerlendirmede BT önemlidir. Bony Bankart lezyonu, glenoid kenarının anteroinferior bölümündeki kırık veya kemik defektiyle ilişkilidir. BT, glenoid kenar kırıklarının morfolojisini hassas biçimde değerlendirmeye yardımcı olur. Glenoid ve humerus başındaki kemik defektleri birlikte değerlendirilmelidir; bunlardan birinin gözden kaçması birleşik kemik hasarı değerlendirmesini eksik bırakabilir.

Okuma sırası

Glenoid kenarı. Glenoid kenar kırığının morfolojisini BT'de değerlendirin.
Fragman ve yatak. Fragmanı ardışık kesitlerde izleyin ve ana çanakla arasındaki açıklığı, deplasman yönünü ve fragman yatağındaki kontur kaybını belirleyin.
Glenohumeral karşılıklı yüzler. Humerus başının eklem içindeki pozisyonu ve karşılıklı humerus başı yüzeyindeki impaksiyon defektleri, glenoid kırık morfolojisiyle birlikte değerlendirilmelidir.
Humerus başı ve eklem. Humerus başı defektini glenoid kemik kaybıyla birlikte değerlendirin; Hill-Sachs lezyonunun klinik önemi glenoid morfolojisine bağlıdır.

Faz ve pencere

Kontrastsız tanısal: Glenoid kenar kırığında fragman deplasmanı koronal ve sagittal düzlemlerde değerlendirilir. Glenoid kenar kırığının morfolojisini değerlendirmede BT kullanılır.
Kemik algoritmalı rekonstrüksiyon tanısal: Aksiyel kemik algoritmalı rekonstrüksiyonlar posterior/anterior kenarı, koronal ve sagittal düzlemler üst-alt uzanımı ve eklem yüzü basamağını gösterir; glenoide hizalı oblik seri fragman boyutu ve kalan eklem yüzünü birlikte değerlendirmeye yardım eder.

Önerilen pencereler: Kemik (G 1800 / M 400).

BT bulguları

Posterior glenoid kemik defektleri posteroinferior kadranda öngörülebilir bir patern gösterebilir.
Glenoid kenar kırığında fragman deplasmanı koronal ve sagittal düzlemlerde değerlendirilir.
Glenoid kenar kırığında fragman deplasmanı koronal ve sagittal düzlemlerde, eklem yüzü basamağı ise kırık morfolojisi içinde değerlendirilir.
Glenoid kemik kaybı değerlendirilirken etkilenmiş ve etkilenmemiş tarafın glenoid ölçümleri karşılaştırılabilir.
Humerus başı subluksasyonu — başın kalan glenoid yüzüne göre eksantrik konumu, kemik kenar desteğinin azaldığını gösterebilir.
Glenoid ve humerus başındaki kemik defektleri birlikte bulunduğunda bipolar kemik kaybı olarak değerlendirilir.
Klasik bony Bankart dışlama kontrolü — anterior-inferior küçük fragman ve yakın tarihli anterior dislokasyon paterni varsa lezyon bu başlık yerine kemik Bankart olarak adlandırılır.
Glenoid kemik kaybı ölçümünde 3D BT üzerinde best-fit circle yöntemi kullanılabilir.

Ölçütler ve sınıflamalar

Ideberg (Goss modifikasyonu), tip I: Bu kaynakta anterior glenoid kenar avulsiyonları Ideberg 1A, 5 mm ve üzerindeki anterior glenoid kırıkları ise Ideberg 1B olarak tanımlanır. Bu içerikte tip Ia kemik Bankart lezyonları yalnızca ayırıcı sınıflama bilgisi olarak anılır; ana konu kapsamına alınmaz.
AO/OTA skapula sınıflaması: AO/OTA sınıflaması, glenoid tutulumu olan eklem içi skapula kırıklarını sınıflandırmak için uygundur. Glenoid tutulumu olan eklem içi skapula kırıklarını sınıflandırmak için AO/OTA sınıflaması uygundur.

Normalde

Eşlik eden çok parçalı proksimal humerus kırığında humerus başı sentrisitesini değerlendirmek güç olabilir. Glenoid kemik kaybını değerlendirirken travmalı tarafın BT görüntülerini etkilenmemiş tarafın görüntüleriyle karşılaştırabilirsiniz.

Ayırıcı tanı

Klasik bony Bankart: anterior-inferior kenar fragmanı ve anterior omuz dislokasyonu ilişkisi tipiktir; bu konu başlığında dışlanır.
Glenoid fossa kırıkları eklem içi skapula kırıklarıdır; BT kırık paternini ve özelliklerini tanımlamak için kullanılır.
Glenoid boyun kırığı: eklem yüzünü dışlayan anatomik boyun bölgesinde kırık hattı görülür; glenoid kenarından daha medial uzanır.
Humerus başı Hill-Sachs impaksiyonu: çökme glenoid yerine humerus başının posterolateral yüzündedir; eşlik eden karşı glenoid kenar defekti ayrıca aranır.

Tuzaklar

Anterior-inferior kenar kırıkları büyük olasılıkla bony Bankart lezyonudur; olgu öyküsü, fragman boyutu ve deplasmanı raporlanmalıdır.
5 mm'den küçük anterior kenar kırıkları genellikle konservatif yönetilir ve çalışmaların dahil edilme kriterlerinde dışlanmışlardır.
Fragman boyutunu üç boyutlu yüzey görüntüsünden tahmin etmeyin; ince kesit ortogonal düzlemlerde eklem yüzü ve kalan kemik yatağını izleyin.
Humerus başı defekti ile glenoid kemik kaybını ayrı lezyonlar olarak adlandırıp birlikte değerlendirin.

Kendini dene

Glenoid kenar kırığının morfolojisini hassas biçimde değerlendirmek için hangi görüntüleme yöntemi kaynakta özellikle vurgulanmıştır?
Cevabı göster
Bilgisayarlı tomografi. Kaynak, kırık morfolojisinin hassas değerlendirilmesi için BT'nin önemli olduğunu belirtir.
Glenoid ve humerus başında birlikte kemik defekti bulunması hangi kavramla ifade edilir?
Cevabı göster
Bipolar kemik kaybı. Bipolar kemik kaybı glenoid ve humerus başı defektlerinin birlikte bulunmasını ifade eder; iki lezyon birlikte değerlendirilmelidir.

İlgili konular

Kemik Bankart lezyonu

Kaynaklar

Bu sayfadaki 40 cümle ve 2 quiz sorusu aşağıdaki kaynaklardan alıntılarla otomatik olarak karşılaştırıldı; 27 cümle bu karşılaştırmada düzeltildi (2026-10-09).

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Eğitim amaçlıdır; hasta başında tanı ve tedavi kararının yerine geçmez, tıbbi tavsiye değildir. Metinler yapay zekâ desteğiyle yazıldı ve otomatik bir adımda kaynak alıntılarıyla karşılaştırıldı; bu bir tıbbi doğrulama değildir ve içerik uzman radyolog incelemesinden geçmedi. Klinik kararlarda güncel kılavuzları, kurum protokollerini ve radyoloji raporunu esas alın.