摘要
目的 评价泪滴角(Teardrop Angle, TDA)测量时的组间一致性与组内一致性,及其作为桡骨远端关节内骨折关节面复位指标的可靠程度。方法 在标准腕部侧位片及尺偏10°侧位片,由3名医生对24例正常腕部和24例桡骨关节内骨折病例,测量泪滴角、掌倾角等评价指标。采用相关系数(ICC)评价TDA测量的组内一致性与组间一致性。结果 在标准侧位片上,骨折组泪滴角值,有良好的组间一致性(ICC=0.95)和组内一致性(ICC=0.93)。正常组测量泪滴角一致性较低(组间ICC=0.28,组内ICC=0.76)。在尺偏10°的侧位片上,骨折组组间一致性(ICC=0.91)和组内一致性(ICC=0.95)与标准X线片相近;正常组组内一致性提高(ICC=0.76),组间一致性无明显变化(ICC=0.61)。TDA值与CT测量所得关节面分离值的线性回归分析示,它们之间有显著的相关性(r=0.44,P <0.005)。结论 在标准侧位片上,泪滴角在骨折组测量比正常组有较高的组间、组内一致性。尺偏10°的侧位片上,骨折组与正常组泪滴角与标准X线片测量一致性相近;正常腕关节组测量的TDA值的组间一致性会有提高。在X线片上测量的泪滴角是良好的判断关节平整性的指标。
Objective To investigate intra-observer and interobserver reliability of the measurements of the teardrop angle(TDA). Methods We studied radiographs of 24 uninjured wrists and 24 wrists with intraarticular distal radius fractures. On standard and ulnar side10° tilt views of lateral wrist radiographs. We examined interobserver and intra-observer reliability for 3 observers using the intraclass correlation coefficient(ICC) for measurements of the uninjured and fractured wrists. Results On the standard lateral film, the measurement of TDA in the fracture group had good inter group consistency(ICC = 0.93) and intra group consistency(ICC =0.93). The consistency of measurement of TDA in the nonfracture group was poor(inter group ICC = 0.28, intra group ICC = 0.76). In the fracture group, when the TDA was measured on the lateral film with 10° ulnar tilt, the inter group consistency(ICC = 0.91) and intra group consistency(ICC = 0.95) were like those measured on the standard X-ray film. The intra-group consistency in the normal group was improved(ICC = 0.76), while there was no significant change in inter group consistency(ICC = 0.61). Linear regression analysis of TDA and degree of intra-articular step measured by CT showed a significant linear correlation(r = 0.44, P < 0.005). Conclusion The measurement of TDA on the standard wrist lateral radiograph exhibits higher intra and inter observer reliability in fractured compared with uninjured wrists. On the 10° ulnar tilt lateral views, the reliability increased in the uninjured wrists. Measurement of the TDA in plain radiographs is an effective method to directly estimate the articular incongruity just as computed tomography images.
作者
余青华
史本海
白雪冬
李积杰
余清文
YU Qinghua;SHI Benhai;BAI Xuedong(Air Force Military Medical University Academy of Basic Medicine,Xian,Shanxi,710032,China)
出处
《实用手外科杂志》
2022年第2期239-241,共3页
Journal of Practical Hand Surgery
关键词
桡骨远端骨折
泪滴角
关节内骨折
测量一致性
Distal radial fracture
Teardrop angle(TDA)
Intraarticular fracture
Consistency of measurement
