桡骨倾角对初次诊断时基恩博克病分期的影响

IF 1.8 Q2 ORTHOPEDICS
HAND Pub Date : 2025-05-01 Epub Date: 2024-01-02 DOI:10.1177/15589447231221246
Christina Wassef, Griffin R Rechter, Suhas Tatapudi, Varun Sambhariya, William F Pientka
{"title":"桡骨倾角对初次诊断时基恩博克病分期的影响","authors":"Christina Wassef, Griffin R Rechter, Suhas Tatapudi, Varun Sambhariya, William F Pientka","doi":"10.1177/15589447231221246","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Negative ulnar variance is a widely accepted risk factor for the development of Kienbock disease (KD). Variation in radial inclination has been proposed as a risk factor, but evidence thus far has been inconclusive. We aim to clarify the relationship between radial inclination and KD.</p><p><strong>Methods: </strong>A retrospective analysis of all KD patients from a single institution from 2007 to 2021 was conducted. Radiographs were reviewed to measure anatomic parameters and stage of disease. An exploratory multinomial regression model was created to examine the association of patient age, radial height, ulnar variance, radial inclination, volar tilt, scapholunate angle, duration of symptoms prior to evaluation, history of wrist trauma, and diagnosis of diabetes with stage of disease.</p><p><strong>Results: </strong>Fifty-seven cases of KD were identified, with a mean duration of disease of 33.3 months. A history of trauma to the wrist was common (53%) and significantly associated with stage of disease at initial presentation. Twenty-seven cases (47%) were stage IIIB or greater. The average initial radial inclination, radial height, and ulnar variance was 21.9°, 10.7 mm, and -1.23 mm, respectively. A multinominal logistic regression model revealed decreased initial radial inclination is associated with Lichtman stage IIIB or greater at the time of initial patient presentation.</p><p><strong>Conclusions: </strong>A correlation exists between decreased radial inclination and more advanced KD at presentation, suggesting this may be a risk factor for disease progression. This correlation is strengthened by our finding of decreased ulnar variance being associated with later stage at presentation, which is one of the most widely accepted proposed risk factors for development and progression of disease.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"365-370"},"PeriodicalIF":1.8000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571352/pdf/","citationCount":"0","resultStr":"{\"title\":\"The Effect of Radial Inclination on the Stage of Kienbock Disease at the Time of Initial Diagnosis.\",\"authors\":\"Christina Wassef, Griffin R Rechter, Suhas Tatapudi, Varun Sambhariya, William F Pientka\",\"doi\":\"10.1177/15589447231221246\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Negative ulnar variance is a widely accepted risk factor for the development of Kienbock disease (KD). Variation in radial inclination has been proposed as a risk factor, but evidence thus far has been inconclusive. We aim to clarify the relationship between radial inclination and KD.</p><p><strong>Methods: </strong>A retrospective analysis of all KD patients from a single institution from 2007 to 2021 was conducted. Radiographs were reviewed to measure anatomic parameters and stage of disease. An exploratory multinomial regression model was created to examine the association of patient age, radial height, ulnar variance, radial inclination, volar tilt, scapholunate angle, duration of symptoms prior to evaluation, history of wrist trauma, and diagnosis of diabetes with stage of disease.</p><p><strong>Results: </strong>Fifty-seven cases of KD were identified, with a mean duration of disease of 33.3 months. A history of trauma to the wrist was common (53%) and significantly associated with stage of disease at initial presentation. Twenty-seven cases (47%) were stage IIIB or greater. The average initial radial inclination, radial height, and ulnar variance was 21.9°, 10.7 mm, and -1.23 mm, respectively. A multinominal logistic regression model revealed decreased initial radial inclination is associated with Lichtman stage IIIB or greater at the time of initial patient presentation.</p><p><strong>Conclusions: </strong>A correlation exists between decreased radial inclination and more advanced KD at presentation, suggesting this may be a risk factor for disease progression. This correlation is strengthened by our finding of decreased ulnar variance being associated with later stage at presentation, which is one of the most widely accepted proposed risk factors for development and progression of disease.</p><p><strong>Level of evidence: </strong>IV.</p>\",\"PeriodicalId\":12902,\"journal\":{\"name\":\"HAND\",\"volume\":\" \",\"pages\":\"365-370\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2025-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571352/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"HAND\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/15589447231221246\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/2 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"HAND","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/15589447231221246","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/2 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0

摘要

背景:尺骨负偏差是公认的基恩博克病(KD)发病风险因素。桡骨倾斜度的变化也被认为是一个风险因素,但迄今为止还没有确切的证据。我们旨在阐明桡骨倾角与 KD 之间的关系:方法:我们对一家医疗机构 2007 年至 2021 年的所有 KD 患者进行了回顾性分析。我们回顾了X光片,以测量解剖参数和疾病分期。建立了一个探索性多项式回归模型,以研究患者年龄、桡骨高度、尺侧方差、桡骨倾斜度、外侧倾斜度、肩胛角、评估前症状持续时间、腕部外伤史和糖尿病诊断与疾病分期的关系:共发现57例KD病例,平均病程为33.3个月。腕部外伤史很常见(53%),且与初次发病时的疾病分期显著相关。27例(47%)为IIIB期或以上。初始桡骨倾斜度、桡骨高度和尺骨方差的平均值分别为21.9°、10.7毫米和-1.23毫米。多项式逻辑回归模型显示,初始桡骨倾斜度降低与患者初次就诊时Lichtman分期为IIIB期或以上有关:结论:桡骨倾角的减小与患者发病时KD的晚期程度相关,这可能是疾病进展的一个风险因素。我们发现尺侧倾角的减小与患者发病时的晚期相关,这进一步加强了这种相关性,而尺侧倾角的减小是最被广泛接受的导致疾病发展和恶化的风险因素之一:证据等级:IV。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Effect of Radial Inclination on the Stage of Kienbock Disease at the Time of Initial Diagnosis.

Background: Negative ulnar variance is a widely accepted risk factor for the development of Kienbock disease (KD). Variation in radial inclination has been proposed as a risk factor, but evidence thus far has been inconclusive. We aim to clarify the relationship between radial inclination and KD.

Methods: A retrospective analysis of all KD patients from a single institution from 2007 to 2021 was conducted. Radiographs were reviewed to measure anatomic parameters and stage of disease. An exploratory multinomial regression model was created to examine the association of patient age, radial height, ulnar variance, radial inclination, volar tilt, scapholunate angle, duration of symptoms prior to evaluation, history of wrist trauma, and diagnosis of diabetes with stage of disease.

Results: Fifty-seven cases of KD were identified, with a mean duration of disease of 33.3 months. A history of trauma to the wrist was common (53%) and significantly associated with stage of disease at initial presentation. Twenty-seven cases (47%) were stage IIIB or greater. The average initial radial inclination, radial height, and ulnar variance was 21.9°, 10.7 mm, and -1.23 mm, respectively. A multinominal logistic regression model revealed decreased initial radial inclination is associated with Lichtman stage IIIB or greater at the time of initial patient presentation.

Conclusions: A correlation exists between decreased radial inclination and more advanced KD at presentation, suggesting this may be a risk factor for disease progression. This correlation is strengthened by our finding of decreased ulnar variance being associated with later stage at presentation, which is one of the most widely accepted proposed risk factors for development and progression of disease.

Level of evidence: IV.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
HAND
HAND Medicine-Surgery
CiteScore
3.30
自引率
0.00%
发文量
209
期刊介绍: HAND is the official journal of the American Association for Hand Surgery and is a peer-reviewed journal featuring articles written by clinicians worldwide presenting current research and clinical work in the field of hand surgery. It features articles related to all aspects of hand and upper extremity surgery and the post operative care and rehabilitation of the hand.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信