两种平片和3d测量方法对三足醇踝关节骨折后外踝碎片大小的比较

G. Altun, H. Reis, B. Bayram, G. Saka
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引用次数: 1

摘要

目的:本研究的目的是比较踝关节外侧x线摄影测量和计算机辅助3D建模(CA3DM)方法对后踝碎片(PMF)大小的影响。方法:2015年1月至2018年11月,51例后踝骨折患者纳入本研究。两位外科医生通过两种不同的成像方法计算了胫骨远端关节面PMF的速率。根据后碎片大小将患者分为两组。第1组由于CA3DM的原因后碎片大小小于15%,第2组由于CA3DM的原因后碎片大小大于15%。结果:两名观察者与CA3DM的观察者间相关性(IOC)为44.3%。第一观察者与CA3DM的IOC为35.7% (p 0.05),第二观察者与CA3DM的IOC为51.6% (p 0.05),第一观察者与CA3DM的IOC为18.6% (p>0.05),第二观察者与CA3DM的IOC为7.1% (p>0.05),第二观察者与CA3DM的IOC为49% (p<0.05)。结论:我们的研究表明,对于较大的碎片,在x线平片上测量后外踝碎片大小并不是一种安全的方法,CA3DM方法可能更可靠地评估正确的碎片大小和分析骨折形态。但对于碎片≤15% CA3DM与x线平片测量无统计学差异。
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Comparison of two plain radiographic and 3D-based measurement methods for posterior malleolar fragment size in trimalleol ankle fractures
Aim: The aim of this study is, to compare the posterior malleolar fragment (PMF) sizing between lateral ankle radiography measurement and computer assistted 3D modelling (CA3DM) methods Methods: Fifty-one patients between january 2015 and november 2018 with posterior malleolar fractured were included in this study. The rate of PMF to the articular surface at the distal end of the tibia was calculated by two different imaging methods by two surgeons. According to posterior fragment size, patients were separated into two groups. Group 1 was consisted of posterior fragment size smaller than 15% and group 2 was bigger than 15% due to CA3DM. Results: The interobserver correlation (IOC) between two observers and CA3DM was 44.3%. Also the IOC between first observer and CA3DM was 35.7% (p 0.05), second observer and CA3DM was 51.6% (p 0.05), first and CA3DM was 18.6% (p>0.05), second observer and CA3DM was 7.1% (p>0.05) and two observers was 49% (p<0.05). Conclusion: Our study shows that posterior malleolar fragment size measuring on plain radiography is not a safe method for bigger fragments and CA3DM method may be a more reliable to assess correct fragment size and also to analyze fracture morphology. But for fragments ≤15% CA3DM and plain radiographic measures are not statistically different.
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