Graham David, Suzuki Arnold, Reitz Christopher, Saxena Akshat, Kuo Judy, Tetsworth Kevin
Department of Orthopaedics, Wollongong Hospital, Wollongong, New South Wales, Australia.
ANZ J Surg. 2013 Dec;83(12):937-41. doi: 10.1111/ans.12371. Epub 2013 Aug 30.
We assessed the accuracy of three different methods measuring the angle between two fixed Kirschner wires for the potential purpose of determining correction during rotational osteotomy of long bones.
Thirty-one orthopaedic consultants and registrars were prospectively asked to measure the angle between two fixed Kirschner wires in four saw bones models using three different techniques: visual estimation (VE), osteotomy templates (OT), and a contemporary smartphone (iPhone4; SP) with its gyroscopic function. These three methods were compared with the value obtained by computed tomography (CTV), which we considered the preferred value.
For the pooled data for all four bone models, the mean difference of the VE compared with the CTV was 5.4° ± 5.3°; the mean difference of the OT compared with the CTV was 2.9 ± 3.8°; and the mean difference of the SP compared with the CTV was 0.8 ± 0.9°. Using the pooled data, the difference between using each of these methods was highly significant, as demonstrated by the one-way analysis of variance across groups (P ≤ 0.001). In addition, for the pooled data the independent t-test between each pair of the three methods (VE and OT, VE and SP, and OT and SP) also demonstrated these differences were highly significant (P ≤ 0.001) for all three comparisons. In this study, the number of years of orthopaedic experience did not significantly influence the ability of individual test subjects.
Measurement of a rotational deformity using a SP app was significantly more accurate and consistent than both VE and OT. We believe the currently available SP technology provides orthopaedic surgeons with a significantly better alternative method of determining the magnitude of rotational deformity when performing corrective osteotomies.
我们评估了三种不同方法测量两根固定克氏针之间角度的准确性，其潜在目的是在长骨旋转截骨术中确定矫正情况。
前瞻性地邀请31名骨科顾问和住院医师，使用三种不同技术在四个锯骨模型中测量两根固定克氏针之间的角度：视觉估计（VE）、截骨模板（OT）和具有陀螺仪功能的当代智能手机（iPhone4；SP）。将这三种方法与计算机断层扫描（CTV）获得的值进行比较，我们将其视为首选值。
对于所有四个骨模型的汇总数据，VE与CTV相比的平均差值为5.4°±5.3°；OT与CTV相比的平均差值为2.9±3.8°；SP与CTV相比的平均差值为0.8±0.9°。使用汇总数据，这些方法之间的差异非常显著，如通过组间单因素方差分析所示（P≤0.001）。此外，对于汇总数据，三种方法中每对之间的独立t检验（VE和OT、VE和SP以及OT和SP）也表明，所有三项比较的这些差异都非常显著（P≤0.001）。在本研究中，骨科经验年限并未显著影响个体测试对象的能力。
使用SP应用程序测量旋转畸形明显比VE和OT更准确、更一致。我们认为，当前可用的SP技术为骨科医生在进行矫正截骨术时确定旋转畸形程度提供了一种明显更好的替代方法。
