桡骨远端骨折愈合时间的影像学评价:骨科与图像处理的定性评价

Maria Oulianski, Dana Avraham, O. Lubovsky
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引用次数: 1

摘要

桡骨远端骨折是人体中最常见的长骨骨折之一。骨折愈合评估是基于临床评估和放射学检查。关于骨折愈合的影像学标准缺乏共识。我们的工作检查了评估骨折愈合的常用标准。32例保守治疗桡骨远端骨折的患者参与了一项前瞻性研究。入组患者遵循方案26周。要求四名级别相似的骨科医生评估每组x线片的三个x线测量参数,包括70张x线片上的骨痂形成、骨折线的存在以及骨折部位或骨折边缘的桥接。10名患者符合研究条件。外科医生的一致程度为“良好”(Cronbach’s alpha):骨痂形成- 0.8,骨折部位桥接- 0.775,骨折线间隙模糊- 0.795。根据具体的周数和分级制度制定了时间表。第二次平片后,在6 - 9周之间,可以看到骨痂形成的x线检查,超过一半的患者的骨折间隙模糊,外科医生达成了一致。在6周和9周后可以检测到桡骨远端愈合的影像学进展,这三个参数在不同的外科医生之间有很好的一致性。该模型制作的时间轴图可用于随访患者骨折愈合情况或早期发现骨不连。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Radiographic Evaluation of Distal Radius Fracture Healing by Time: Orthopedist versus Qualitative Assessment of Image Processing
Distal radius fractures are among the most prevalent long-bone fractures in the body. Fracture healing assessment is based on clinical evaluation and radiological examinations. A lack of consensus exists regarding the radiographic criteria for fracture union. Our work examined the commonly used criteria for the assessment of fracture healing. Thirty-two patients, conservatively treated for distal radius fracture, participated in a prospective study. Enrolled patients followed protocol for 26 weeks. Four orthopedic surgeons with similar ranks were asked to evaluate three parameters of radiographic measurements for each set of radiographs, including callus formation, the presence of a fracture line, and bridging of fracture sites or sites of fracture edges in 70 radiographs. Ten patients were eligible for the study. The degree of agreement among surgeons was “good” (Cronbach’s alpha): callus formation—0.8, bridging of fracture sites—0.775, blurring of fracture line gap—0.795. A timeline based on the specific week and grading system was made. Radiographic detection of callus formation was seen after the second film, between 6 and 9 weeks, and an agreement among surgeons was achieved for more than half of the patients for the blurring of the fracture gap. The radiographic healing progression of the distal radius can be detected after 6 and 9 weeks in all three parameters with good agreement between different surgeons. A timeline graph such as the one that was made in this model can be used for the follow-up of patients’ fracture healing or early detection of non-union.
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