Pappas Nick D, Watson Jeffry T, Erickson John M, Baldwin Keith D, Lee Donald H
Hand Surgeon at Greenville Health System/Steadman Hawkins Clinic of the Carolinas, Greenville, South Carolina.
Am J Orthop (Belle Mead NJ). 2013 Jul;42(7):321-3.
We conducted a study to examine intraobserver reliability, interobserver reliability, and accuracy of preoperative templating in approximating humeral and ulnar component sizes in total elbow arthroplasty (TEA). Twenty-two patients underwent cemented TEA with 1 of 2 commonly used implants. Four independent reviewers performed templating in 2 separate sessions spaced a minimum of 2 weeks apart. Reviewers were blinded to patient information and used appropriately magnified templates provided by the implant manufacturer. Preoperative and postoperative films were assessed for humeral and ulnar stem width and length. For both implants combined, there was substantial (κ > 0.7) intraobserver reliability for humeral width, humeral length, and ulnar length. Interobserver reliability was fair for humeral width (κ = 0.28), substantial for humeral length (κ = 0.64), and moderate for both ulnar width (κ = 0.44) and ulnar length (κ = 0.49). Preoperative templating accurately predicted exact stem size 72.7% of the time and within 1 size variation 96.9% of the time. Attending surgeons were slightly more accurate than fellows (75.5% vs 71.5%) in predicting stem sizes. Preoperative templating is moderately reliable and largely accurate in planning TEA.
我们开展了一项研究，以检验在全肘关节置换术（TEA）中，观察者内可靠性、观察者间可靠性以及术前模板在预估肱骨和尺骨假体组件尺寸方面的准确性。22例患者接受了使用2种常用植入物之一的骨水泥型TEA。4名独立的评估者在至少间隔2周的2个不同时间段进行模板测量。评估者对患者信息不知情，并使用了植入物制造商提供的适当放大的模板。对术前和术后的X线片评估肱骨和尺骨柄的宽度和长度。对于这两种植入物，观察者内对于肱骨宽度、肱骨长度和尺骨长度均具有较高的可靠性（κ>0.7）。观察者间对于肱骨宽度的可靠性一般（κ=0.28），对于肱骨长度的可靠性较高（κ=0.64），对于尺骨宽度（κ=0.44）和尺骨长度（κ=0.49）的可靠性中等。术前模板测量在72.7%的情况下能准确预测柄的精确尺寸，在96.9%的情况下能预测在1个尺寸变化范围内的尺寸。在预测柄的尺寸方面，主刀医生比住院医生略准确（75.5%对71.5%）。术前模板测量在TEA手术规划中具有中等可靠性且基本准确。
