Analisis Morfometrik Tiga DImensi Tulang Humerus Proksimal pada Studi Kadaver di Laboratorium Anatomi FK-KMK UGM

Benny Yusri Tanjung, dr. Nur Arfian, Ph.D.; dr. Junaedy Yunus, M.Sc., Ph.D.

2025 | Tesis | S2 Ilmu Kedokteran Dasar dan Biomedis

Latar Belakang: Tingginya angka kejadian fraktur tulang humerus proksimal membuat tatalaksana akan kasus tersebut menjadi perhatian khusus. Ternyata, implan dan prostesis yang selama ini digunakan di Indonesia untuk terapi masih mengacu pada ukuran morfometri populasi negara Barat. Ukuran implan dan prostesis yang tidak sesuai dengan morfometri populasi Indonesia terkadang dapat menimbulkan berbagai masalah pascaoperasi.

Tujuan Penelitian: Penelitian ini bertujuan untuk mendeskripsikan ukuran morfometri tulang humerus proksimal pada populasi Indonesia, menganalisis perbedaan antara jenis kelamin dan sisi tulang dari populasi yang sama dan menganalisis korelasi antara parameter dimensi caput humeri.

Bahan dan Metode: Menggunakan 112 tulang humerus kering yang diperoleh dari kadaver di Laboratorium Anatomi FK-KMK UGM, kemudian dipindai menggunakan computed tomography scan (CT scan) dan hasilnya diukur menggunakan perangkat lunak reverse engineering computer-aided design (CAD). Analisis statistik dilakukan menggunakan uji t independen dan korelasi Pearson. Nilai p < 0>

Hasil Penelitian: Rata-rata ukuran morfometri tulang humerus proksimal populasi Indonesia menunjukkan diameter caput humeri 40,25 mm, diameter permukaan persendian caput humeri 37,17 mm, tebal permukaan persendian caput humeri 14,63 mm, sudut inklinasi 123,55°, sudut retroversi yang melalui aksis transepikondilar 31,73° dan sudut retroversi yang melalui aksis tangent elbow 34,44°. Rata-rata diameter caput humeri, diameter permukaan persendian dan tebal permukaan persendian pada tulang humerus berjenis kelamin laki-laki lebih besar secara signifikan bila dibandingkan tulang humerus berjenis kelamin perempuan. Rata-rata sudut inklinasi tulang humerus kanan lebih besar secara signifikan dibandingkan tulang humerus kiri.

Kesimpulan: Ukuran morfometri tulang humerus proksimal populasi Indonesia terutama diameter caput humeri, diameter permukaan persendian caput humeri dan tebal permukaan persendian caput humeri cenderung lebih kecil bila dibandingkan dengan populasi lainnya, terutama Kaukasia. Selain populasi, ternyata jenis kelamin dan sisi tulang juga berpengaruh terhadap ukuran morfometri tulang humerus proksimal.

Background: The high incidence of proximal humerus fractures has made the management of these cases a special concern. It turns out that the implants and prostheses currently used for therapy in Indonesia still refer to the morphometric sizes of Western populations. Implants and prostheses that do not match the morphometry of the Indonesian population can sometimes lead to various post-operative problems.

Objective: This study aims to describe the morphometric measurements of the proximal humerus bone in the Indonesian population, to analyze the differences between sexes and bone sides within the same population, and to analyze the correlation between the dimensional parameters of the humeral head.

Materials and Methods: We utilized 112 dry humerus bones obtained from cadavers at the Anatomy Laboratory, Faculty of Medicine, Public Health and Nursing, Gadjah Mada University (FK-KMK UGM). These bones were scanned using computed tomography (CT) scan, and the resulting images were measured using reverse engineering computer-aided design (CAD) software. Statistical analysis was performed using independent t-tests and Pearson correlation. A p-value of < 0>

Results: The average morphometric dimensions of the proximal humerus in the Indonesian population showed a humeral head diameter of 40.25 mm, an articular surface diameter of the humeral head of 37.17 mm, an articular surface thickness of the humeral head of 14.63 mm, an inclination angle of 123.55°, a retroversion angle through the transepicondylar axis of 31.73°, and a retroversion angle through the tangent elbow axis of 34.44°. The average diameter of the humeral head, articular surface diameter, and articular surface thickness of the humerus were significantly larger in males compared to females. The inclination angle of the right humerus is greater than that of the left.

Conclusion: The morphometric dimensions of the proximal humerus in the Indonesian population, especially the humeral head diameter, articular surface diameter, and articular surface thickness of the humeral head, tend to be smaller compared to other populations, particularly Caucasians. Besides population, sex and bone sides also influences the morphometric dimensions of the proximal humerus.

Kata Kunci : Humerus proksimal, morfometrik tiga dimensi, populasi Indonesia, implan dan prostesis.