双平面x线片三维舟月骨距离评估:临床实践的可行性研究。

IF 2.3 3区 医学 Q2 ORTHOPEDICS
François Loisel, Thomas Fradin, Laurent Gajny, Laurent Obert, Sébastien Laporte, Wafa Skalli
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引用次数: 0

摘要

腕部韧带损伤是骨科手术中的一个重大挑战。它们主要影响年轻和活跃的人群。如果不及时诊断,它们会导致慢性疼痛、关节炎退化和职业残疾。缺乏客观的术前和术后工具限制了有效的患者随访。本研究的目的是应用基于手和手腕双翼x线片的三维重建方法来诊断和监测这些韧带损伤。假设:从双翼x线片创建的个性化手和手腕重建可以客观诊断和随访腕韧带病变。材料与方法:健康志愿者30例,疑似韧带损伤患者12例。使用低剂量双翼x线摄影系统(EOS)进行数据采集。进行骨重建,通过测定骨质心计算中性和握拳位置之间的舟月骨距离。将患者术前和术后的SL距离变化与健康志愿者队列的值进行比较。结果:在健康志愿者中,中性拳位和握拳位之间的SL距离的变化因性别(男性为0.1 mm,女性为0.5 mm)和月骨形态而有显著差异。健康组与术前组比较差异无统计学意义(p = 0.165)。然而,术前和术后患者之间存在显著差异(p = 0.014)。讨论:本研究强调了个性化重建在客观评估腕部生物力学改变和监测患者中的作用。然而,该方法的常规临床应用需要在精度和自动化方面进行技术改进。证据等级:III;病例对照研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Three dimensional scapholunate distance assessment from biplanar radiographs: A feasibility study in clinical practice.

Introduction: Wrist ligament injuries present a significant challenge in orthopedic surgery. They primarily affect a young and active population. When left undiagnosed, they can lead to chronic pain, arthritic degeneration, and professional disabilities. The lack of objective pre- and postoperative tools limits effective patient follow-up. The aim of this study is to apply a 3D reconstruction method based on biplane radiographs of the hand and wrist to diagnose and monitor these ligament injuries.

Hypothesis: A personalized hand and wrist reconstruction created from biplane radiographs could enable the objective diagnosis and follow-up of carpal ligament pathologies.

Materials and methods: We included 30 healthy volunteers, and 12 patients suspected of having ligament injuries. Data acquisition was performed using a low-dose biplane radiography system (EOS). Bone reconstruction was conducted, and scapholunate (SL) distances were calculated between the neutral and clenched fist positions by determining bone centroids. The variations in SL distances in patients, both pre- and postoperatively, were compared to the values of the healthy volonteers cohort.

Results: In healthy volunteers, variations in SL distances between the neutral and clenched fist positions were significantly different depending on sex (0.1 mm in males, 0.5 mm in females) and lunate morphology. No statistically significant difference was observed between the healthy and preoperative groups (p = 0.165). However, a significant difference was found between preoperative and postoperative patients (p = 0.014).

Discussion: This study highlights the utility of personalized reconstruction in objectively assessing biomechanical alterations of the wrist and monitoring patients. However, the routine clinical application of this method requires technical improvements in terms of precision and automation.

Level of evidence: III; case-control study.

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来源期刊
CiteScore
5.10
自引率
26.10%
发文量
329
审稿时长
12.5 weeks
期刊介绍: Orthopaedics & Traumatology: Surgery & Research (OTSR) publishes original scientific work in English related to all domains of orthopaedics. Original articles, Reviews, Technical notes and Concise follow-up of a former OTSR study are published in English in electronic form only and indexed in the main international databases.
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