Davids Jon R, Gibson T Whitney, Pugh Linda I
Motion Analysis Laboratory, Shriners Hospital for Children, Greenville, SC 29605, USA.
J Pediatr Orthop. 2005 Nov-Dec;25(6):769-76. doi: 10.1097/01.bpo.0000173244.74065.e4.
Clinical decision-making for the management of foot deformities in children is primarily based upon the analysis of weight-bearing radiographs of the foot and ankle. However, a comprehensive quantitative technique for the analysis of such radiographs has not been described. Ten radiographic measurements were developed and applied to the foot and ankle radiographs of a normal foot and ankle in 60 children (mean age 10 years, range 5-17 years). Intraobserver variability and interobserver variability were determined for 10 cases. Mean values for the 10 measurements were calculated from the entire study group. Intraobserver variability was excellent, with correlation coefficients for the 10 measurements ranging from 0.89 to 0.99. The absolute value of the mean differences in angular measurements ranged from 0.8 to 2.5 degrees. Interobserver variability was also excellent, with correlation coefficients ranging from 0.86 to 0.99. The absolute value of the mean differences in angular measurements ranged from 0.5 to 3.2 degrees. The mean values, standard deviations, and ranges for the 10 radiographic parameters from the 60 normal feet have been determined. Clinically acceptable variability of 10 selected radiographic measurements of the foot and ankle was achieved, and normal values and ranges for these measurements were determined. Quantitative segmental analysis of foot and ankle alignment, using these 10 radiographic measurements, can be used to describe common malalignment patterns, and this may assist in clinical decision-making and assessment of outcome.
儿童足部畸形管理的临床决策主要基于对足踝负重X线片的分析。然而，尚未有用于此类X线片分析的综合定量技术被描述。开发了10项X线测量指标，并将其应用于60名儿童（平均年龄10岁，范围5 - 17岁）正常足踝的X线片上。对10例病例测定了观察者内变异性和观察者间变异性。从整个研究组计算出10项测量指标的平均值。观察者内变异性极佳，10项测量指标的相关系数范围为0.89至0.99。角度测量中平均差异的绝对值范围为0.8至2.5度。观察者间变异性也极佳，相关系数范围为0.86至0.99。角度测量中平均差异的绝对值范围为0.5至3.2度。已确定60只正常足的10项X线参数的平均值、标准差和范围。实现了足部和踝部10项选定X线测量的临床可接受变异性，并确定了这些测量的正常值和范围。使用这10项X线测量对足踝对线进行定量节段分析，可用于描述常见的对线不良模式，这可能有助于临床决策和结果评估。
