Cho Mickey S, Battista Vincent, Dubin Norman H, Pirela-Cruz Miguel
United States Army Medical Corps, William Beaumont Army Medical Center, El Paso, TX, USA.
Surg Radiol Anat. 2006 Mar;28(1):92-7. doi: 10.1007/s00276-005-0038-z. Epub 2005 Dec 9.
Several radiologic measurement methods have been described for determining static carpal alignment of the wrist. These include the scapholunate, radiolunate, and capitolunate angles. The triangulation method is an alternative radiologic measurement which we believe is easier to use and more reproducible and reliable than the above mentioned methods. The purpose of this study is to assess the intraobserver reproducibility and interobserver reliability of the triangulation method, scapholunate, radiolunate, and capitolunate angles. Twenty orthopaedic residents and staff at varying levels of training made four radiologic measurements including the scapholunate, radiolunate and capitolunate angles as well as the triangulation method on five different lateral, digitized radiographs of the wrist and forearm in neutral radioulnar deviation. Thirty days after the initial measurements, the participants repeated the four radiologic measurements using the same radiographs. The triangulation method had the best intra-and-interobserver agreement of the four methods tested. This agreement was significantly better than the capitolunate and radiolunate angles. The scapholunate angle had the next best intraobserver reproducibility and interobserver reliability. The triangulation method has the best overall observer agreement when compared to the scapholunate, radiolunate, and capitolunate angles in determining static midcarpal alignment. No comment can be made on the validity of the measurements since there is no radiographic gold standard in determining static carpal alignment.
已经描述了几种用于确定腕关节静态腕骨排列的放射学测量方法。这些方法包括舟月角、桡月角和头月角。三角测量法是另一种放射学测量方法，我们认为它比上述方法更易于使用，且具有更高的可重复性和可靠性。本研究的目的是评估三角测量法、舟月角、桡月角和头月角在观察者内的可重复性以及观察者间的可靠性。20名不同培训水平的骨科住院医师和工作人员对五张不同的腕关节和前臂中立位尺桡偏斜的数字化侧位X线片进行了四项放射学测量，包括舟月角、桡月角、头月角以及三角测量法。在首次测量30天后，参与者使用相同的X线片重复进行这四项放射学测量。在测试的四种方法中，三角测量法在观察者内和观察者间的一致性最佳。这种一致性显著优于头月角和桡月角。舟月角的观察者内可重复性和观察者间可靠性次之。与舟月角、桡月角和头月角相比，在确定腕中关节静态排列时，三角测量法具有最佳的总体观察者一致性。由于在确定静态腕骨排列方面没有放射学金标准，因此无法对测量的有效性作出评价。
