Luke Sang, Steven M Garcia, Alex Youn, Katherine Bach, Ishaan Swarup
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引用次数: 0
Abstract
Purpose: The purpose of this study was to assess the ability of radiographic measures to predict displacement on computed tomography (CT) for transitional ankle fractures.
Methods: This study is a retrospective review of pediatric patients who presented with Tillaux (Salter-Harris III) and triplane (Salter-Harris IV) fractures at a single institution. Radiographs and CT measurements were performed by three independent evaluators. Intraclass correlation coefficients (ICCs) were calculated to determine interrater reliability. Spearman correlations were performed to assess the correlations between each radiographic parameter and CT measurements.
Results: A total of 61 patients were included in this study. The average age of patients was 12.3, and 65.6% of patients were male. There was an almost even split of triplane (55.7%) and Tillaux (44.3%) fractures. Overall, measurements showed at least good interobserver agreement (ICC >0.6). Radiographic anteroposterior view showed the least reliable measurements compared to the mortise and lateral views. There was significant correlation between CT displacement and the following measures on radiographs: tibiofibular clear space on the mortise view (ρ = 0.27, p < 0.05), articular displacement on the mortise view (ρ = 0.35, p < 0.01), articular displacement on the lateral view (ρ = 0.28, p < 0.05), and epiphyseal displacement on the lateral view (ρ = 0.55, p < 0.001).
Conclusions: There are several radiographic parameters that significantly correlate with increased displacement of transitional ankle fractures on CT. Increased articular displacement on the mortise and lateral view, as well as increased tibiofibular clear space on the mortise view, correlates with increased displacement. These radiographic parameters may be good indicators for the selective use of CT scans for transitional ankle fractures.
Level of evidence: Level III, retrospective comparative study.
目的：本研究的目的是评估放射测量在计算机断层扫描（CT）上预测过渡性踝关节骨折移位的能力。方法：本研究是对在同一医院就诊的Tillaux （Salter-Harris III）和三平面（Salter-Harris IV）骨折患儿的回顾性分析。x线片和CT测量由三名独立评估人员进行。计算分类内相关系数（ICCs）以确定分类间的信度。采用Spearman相关性来评估各影像学参数与CT测量值之间的相关性。结果：本研究共纳入61例患者。患者平均年龄12.3岁，男性占65.6%。三面骨折（55.7%）和Tillaux骨折（44.3%）几乎均匀。总体而言，测量结果显示观察者之间至少有良好的一致性（ICC >0.6）。与榫眼和侧位片相比，正位片显示的测量结果最不可靠。CT位移与以下x线片上的测量值有显著相关性：关节槽位上的胫腓骨间隙（ρ = 0.27, p p p p）。结论：有几个影像学参数与CT上过渡性踝关节骨折位移增加有显著相关。在榫槽位和侧位上关节位移增加，以及在榫槽位上胫腓骨间隙增加，均与位移增加相关。这些影像学参数可能是选择性使用CT扫描诊断过渡性踝关节骨折的良好指标。证据等级：III级，回顾性比较研究。
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Aims & Scope
The Journal of Children’s Orthopaedics is the official journal of the European Paediatric Orthopaedic Society (EPOS) and is published by The British Editorial Society of Bone & Joint Surgery.
It provides a forum for the advancement of the knowledge and education in paediatric orthopaedics and traumatology across geographical borders. It advocates an increased worldwide involvement in preventing and treating musculoskeletal diseases in children and adolescents.
The journal publishes high quality, peer-reviewed articles that focus on clinical practice, diagnosis and treatment of disorders unique to paediatric orthopaedics, as well as on basic and applied research. It aims to help physicians stay abreast of the latest and ever-changing developments in the field of paediatric orthopaedics and traumatology.
The journal welcomes original contributions submitted exclusively for review to the journal. This continuously published online journal is fully open access and will publish one print issue each year to coincide with the EPOS Annual Congress, featuring the meeting’s abstracts.
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