Kirk M, Orlinsky M, Goldberg R, Brotman P
Department of Emergency Medicine, Los Angeles County-University of Southern California Medical Center.
Ann Emerg Med. 1990 Dec;19(12):1371-6. doi: 10.1016/s0196-0644(05)82600-9.
The purpose of this study was to determine if the navicular fat stripe (NFS) is a valid and reliable screening tool in assessing potential navicular fractures.
Retrospective analysis.
Minor trauma section of the Los Angeles County-University of Southern California Medical Center emergency department.
Study population included patients seen for wrist injury between January 1987 and December 1988. The individuals who interpreted the radiographs included eight observers with varying degrees of radiographic experience.
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The positive predictive value averaged 12% or 15% depending on how we counted a straight NFS, and the negative predictive value averaged 93% or 95%, again depending on how we counted a straight NFS. A straight NFS was ten times as likely to occur among normal wrists than among those with navicular fractures. Interobserver reliability was found to be high with a Hoyt reliability coefficient of .79.
An abnormal NFS is a poor predictor of a navicular fracture while both a straight and a normal NFS are good predictors of no navicular fracture. A normal NFS may allow less stringent treatment by the emergency physician. Extremes of radiographic experience were found to have no significant effect on NFS interpretation.
本研究旨在确定舟状骨脂肪条纹（NFS）在评估潜在舟状骨骨折时是否为一种有效且可靠的筛查工具。
回顾性分析。
洛杉矶县 - 南加州大学医学中心急诊科的轻伤科。
研究人群包括1987年1月至1988年12月期间因手腕受伤前来就诊的患者。解读X光片的人员包括八位具有不同程度放射学经验的观察者。
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根据我们对笔直NFS的计数方式，阳性预测值平均为12%或15%，阴性预测值平均为93%或95%，同样取决于我们对笔直NFS的计数方式。正常手腕出现笔直NFS的可能性是舟状骨骨折手腕的十倍。观察者间可靠性较高，霍伊特可靠性系数为0.79。
异常NFS对舟状骨骨折的预测性较差，而笔直和正常的NFS对无舟状骨骨折均有良好的预测性。正常的NFS可能使急诊医生采取不太严格的治疗措施。研究发现，放射学经验的极端差异对NFS的解读没有显著影响。
