基于三维计算机断层扫描获得的高长比来量化舟状骨排列不齐。

Quantifying scaphoid malalignment based upon height-to-length ratios obtained by 3-dimensional computed tomography.

作者信息

ten Berg Paul W L, Dobbe Johannes G G, Strackee Simon D, Streekstra Geert J

机构信息

Department of Plastic, Reconstructive, and Hand Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Department of Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

出版信息

J Hand Surg Am. 2015 Jan;40(1):67-73. doi: 10.1016/j.jhsa.2014.10.037.

DOI:10.1016/j.jhsa.2014.10.037

PMID:25534836

Abstract

PURPOSE

To determine if 3-dimensional height-to-length (H/L) measurements including coronal plane assessment will improve malalignment detection of scaphoid fractures and to determine if more waist than proximal pole nonunions are malaligned.

METHODS

Computed tomography scans of uninjured wrists (n = 74) were used to obtain 3-dimensional models of healthy scaphoids. These models were used to determine 95% normal ranges of the H/L ratio in standard sagittal and coronal planes in an automated fashion. Subsequently, the H/L ratios of fibrous nonunions (n = 26) were compared with these normal ranges and were classified as either aligned or malaligned.

RESULTS

The mean normal H/L ratio in the sagittal plane was 0.61 (range, 0.54-0.69) and in the coronal plane 0.42 (range, 0.36-0.48). The mean H/L ratios of the nonunions differed from those of the healthy scaphoids in these planes: 0.65 and 0.48, respectively. Based on sagittal plane evaluation of all nonunions, 46% exceeded the normal H/L range versus 54% based on combining sagittal and coronal plane measurements. More waist nonunions (71%) than proximal pole nonunions (22%) exceed the normal H/L range.

CONCLUSIONS

Evaluation of the H/L ratio in the coronal plane provided valuable additional information for the detection of scaphoid deformities. More malaligned cases were found for waist nonunions than for proximal pole nonunions.

CLINICAL RELEVANCE

This method may be a helpful diagnostic tool to detect malalignment and to choose between in situ fixation or reconstruction.

摘要

目的

确定包括冠状面评估在内的三维高度与长度（H/L）测量是否能改善舟骨骨折对线不良的检测，并确定腰部不愈合比近端极不愈合出现对线不良的情况是否更多。

方法

使用未受伤手腕的计算机断层扫描（n = 74）来获取健康舟骨的三维模型。这些模型以自动化方式用于确定标准矢状面和冠状面中H/L比值的95%正常范围。随后，将纤维性不愈合（n = 26）的H/L比值与这些正常范围进行比较，并分为对线良好或对线不良。

结果

矢状面的平均正常H/L比值为0.61（范围0.54 - 0.69），冠状面为0.42（范围0.36 - 0.48）。在这些平面中，不愈合的平均H/L比值与健康舟骨不同：分别为0.65和0.48。基于所有不愈合的矢状面评估，46%超过正常H/L范围，而基于矢状面和冠状面测量相结合则为54%。腰部不愈合（71%）超过正常H/L范围的情况比近端极不愈合（22%）更多。