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首页> 外文期刊>Journal of Hand Surgery. American Volume >Reliability and clinical importance of teardrop angle measurement in intra-articular distal radius fracture
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Reliability and clinical importance of teardrop angle measurement in intra-articular distal radius fracture

机译：泪滴角度测量在关节内distal骨远端骨折中的可靠性和临床重要性

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Purpose: The teardrop angle (TDA) is a newly characterized radiographic parameter that some authors propose as an indicator of articular incongruity of the lunate facet. The purposes of this study were to investigate intra-observer and interobserver reliability of the measurements of the TDA and to determine whether the TDA is a reliable indicator of articular step and gap formation after distal radius fracture. Methods: We studied radiographs of 24 uninjured wrists and 24 wrists with intra-articular distal radius fractures. On standard and 10° tilt views of lateral wrist radiographs, the teardrop represents the volar rim of the lunate facet, and the TDA is defined as the angle between the central axis of the teardrop and the radial shaft. We examined interobserver and intra-observer reliability for 3 observers using the intraclass correlation coefficient (ICC) for measurements of the uninjured and fractured wrists. For subjects with fractures, we determined correlation of the TDA-volar tilt with the articular step and gap measured by computed tomography using simple linear regression. Results: There was almost perfect intra-observer (ICC = 0.95) and interobserver (ICC = 0.93) reliability in the fractured wrists. We observed substantial intra-observer (ICC = 0.64) and fair interobserver (ICC = 0.28) reliability in the uninjured wrists on the standard lateral radiographs. On the 10° tilt views, intra-observer and interobserver reliability in the uninjured wrists increased to substantial levels (ICC = 0.76 and 0.61, respectively). The TDA-volar tilt was significantly associated with articular step and gap on computed tomography. Conclusions: The TDA, measured on the lateral radiograph of the wrist, exhibits higher intra-observer and interobserver reliability in fractured wrists compared with uninjured wrists. On the 10° tilt views, the reliability increased in the uninjured wrists. Measurement of the TDA in plain radiographs may allow direct estimation of articular incongruity as seen on sagittal computed tomography reconstruction images.
机译：目的：泪滴角（TDA）是一种新近表征的射线照相参数，一些作者提议将其作为月牙面关节不协调的指标。这项研究的目的是调查观察者内部和观察者之间对TDA测量的可靠性，并确定TDA是否是distal骨远端骨折后关节台阶和间隙形成的可靠指标。方法：我们研究了24例未受伤的手腕和24例关节内distal骨远端骨折的手腕的X光片。在腕部侧位片的标准和10°倾斜视图上，泪滴代表月牙面的掌侧边缘，而TDA定义为泪滴的中心轴和radial骨轴之间的角度。我们使用组内相关系数（ICC）来测量3名观察者的观察者之间和观察者内部可靠性，以测量未受伤和骨折的手腕。对于患有骨折的受试者，我们确定了TDA球体倾斜度与通过简单的线性回归通过计算机断层摄影术测量的关节台阶和间隙的相关性。结果：腕部骨折的观察者内（ICC = 0.95）和观察者间（ICC = 0.93）可靠性几乎完美。我们在标准的侧位X光片上观察到未受伤的手腕有相当多的观察者内部观察者（ICC = 0.64）和公平的观察者相互观察者（ICC = 0.28）。在10°倾斜视图上，未受伤手腕的观察者内和观察者间可靠性提高到了实质水平（分别为ICC = 0.76和0.61）。 TDA骨倾斜与计算机断层扫描上的关节台阶和间隙显着相关。结论：在腕部侧位X线片上测量的TDA与未受伤的腕部相比，在骨折腕部中观察者内和观察者间的可靠性更高。在10°倾斜视图上，未受伤手腕的可靠性提高了。在X线平片上测量TDA可以直接估算在矢状计算机断层扫描重建图像上看到的关节不协调度。

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