摘要
目的探讨髋臼后方包容角值这一新指标对髋臼后壁骨折稳定性评估的临床应用。方法对34例单侧髋臼后壁骨折健侧的CT影像资料进行测量，估算出髋臼后壁完整和骨折20％、50％时髋臼后方包容角的大小，并利用该值对髋臼后壁骨折进行稳定性判定。通过组内相关系数（ICC）对髋臼后方包容角测量的稳定性进行评估，并将利用该方法进行髋臼后壁骨折稳定性判定的结果与传统Keith法进行比较。结果髋臼后壁完整和骨折20％、50％时髋臼后方包容角分别为（92．47±10．96）°、（74．30±9．5）°、（52．57±6．27）°不同测量者之间的ICC值为0．977～0．996，不同时间的ICC值为0．977～0．996,利用髋臼后方包容角法对髋臼后壁骨折稳定进行判定的结果与利用Keith法的结果之间的Kappa值为0．816。经髋臼后方稳定性试验判定，两者的准确率分别为84．2％和76．5％，差异无统计学意义（x^2=0．343，P=0．558〉0．05）。结论髋臼后方包容角测量时具有较高的稳定性，利用该方法对髋臼后壁骨折稳定性进行判定的结果与传统的Keith法一致性好，并且该方法简便、临床应用性强。
Objective To discuss the clinical use of the posterior acetabular arc angle in evaluation of the stability in posterior wall acetabulum fracture. Methods The posterior acetabular arc angle in intact, 20% and 50% defects of posterior acetabular walls was measured and used for the evaluation of the stability in 34 cases of unilateral posterior wall acetabulum fracture. The constancy of the measurements was assesed by inter-and intraobserver error with an intraelass correlation coefficient （ICC）. Agreement of result between the new method and the Keith method （Kappa value） was calculated and the accuracy rates were compared. Results The posterior acetabtdar arc angle in intact, 20% and 50% defects of posterior acetabular walls were （92.47±10.96）°, （74.30±9.5）° and （52.57±.27）° respectively. The ICCs among two observers were 0.977-0.996 and the ICCs of the ame observer in different times were 0.977-0.998. The Kappa value was 0.816 between the two methods. The accuracy rates of the new method and the Keith method was 84.2% and 76.5% acco,＇ding to the dynamic stress examination under anesthesia （X^2 =0.343,P =0.558 〉0.05）. Conclusion The measurement of posterior acetabular arc angle is easy to practice and has a good constancy. The judge in the stability in posterior wall acetabulum fracture of the two methods coincides with each other with a Kappa value of 0.816. Although the accuracy rate of the new method is higher than the Keith method but it is not supported by statistical analysis results. It should be recommended for its practicability.
出处
《中国骨与关节损伤杂志》
2014年第2期105-107,共3页
Chinese Journal of Bone and Joint Injury
关键词
髋臼骨折
稳定性
CT
髋臼后方包容角
Acetabulum fracture
Stability
Computed tomography
Posterior acetabular arc angle
