Vauclair Frédéric, Aljurayyan Abdulaziz, Abduljabbar Fahad H, Barimani Bardia, Goetti Patrick, Houghton Fiona, Harvey Edward J, Rouleau Dominique M
Department of Orthopedic and Trauma Surgery, Lausanne University Hospital, Lausanne, Switzerland.
Department of Orthopedic Surgery, King Saud University, Riyadh, Saudi Arabia.
Eur J Orthop Surg Traumatol. 2018 Apr;28(3):415-421. doi: 10.1007/s00590-017-2058-x. Epub 2017 Oct 19.
There are easily accessible tools on smartphones (APP) for measuring elbow range of motion (ROM). The purpose of this study is to evaluate the validity of a particular APP in determining elbow ROM in comparison with the commonly used goniometer (GON), surgeon estimation of range (EST) and measurement on X-ray (XR).
The study included 20 patients (40 elbows). Flexion, extension, pronation and supination were measured using three different methods: EST, GON and APP. Radiographic measurements were taken using the average humeral diaphysis axis and dorsal midthird of ulna in flexion and extension.
The accuracy of the three different methods has been compared to GON using statistical analysis (ANOVA and paired samples test). There was no statistically significant difference for XR flexion measurement (mean of 2.8° ± 1.5°). The APP overestimated flexion (mean of 6.4° ± 1.0°), and EST underestimated it (mean of - 7.9° ± 1.1°). For extension, the mean difference was 2.8° ± 0.7° for EST and - 26.8° ± 3.1° for XR. The APP method did not significantly differ from GON. Supination accuracy was greater with EST (2.7° ± 1.7°) than with APP (5.9° ± 1.9°). There was no difference for pronation measurement with both EST and APP.
This study is the first comparing four measurement techniques of elbow ROM. Our results showed that EST was only accurate for forearm rotation. The XR scored the best for flexion but is less reliable for extension. Surprisingly, compared to GON, APP did not correlate as we expected for flexion and supination, but the other methods were also inaccurate. We found APP to be very useful to measure complete arc of motion (difference between maximal flexion and maximal extension).
III, Retrospective review of a prospective cohort of elbow fracture patients: Diagnostic Study.
智能手机上有易于获取的工具（应用程序）可用于测量肘部活动范围（ROM）。本研究的目的是评估一款特定应用程序与常用的角度计（GON）、外科医生估计范围（EST）以及X线测量（XR）相比，在确定肘部ROM方面的有效性。
该研究纳入了20名患者（40个肘部）。使用三种不同方法测量屈曲、伸展、旋前和旋后：EST、GON和应用程序。通过肱骨骨干平均轴以及尺骨背侧中三分之一在屈曲和伸展位进行X线测量。
使用统计分析（方差分析和配对样本检验）将三种不同方法的准确性与GON进行了比较。X线屈曲测量无统计学显著差异（平均值为2.8°±1.5°）。应用程序高估了屈曲（平均值为6.4°±1.0°），而EST低估了屈曲（平均值为-7.9°±1.1°）。对于伸展，EST的平均差异为2.8°±0.7°，XR的平均差异为-26.8°±3.1°。应用程序方法与GON无显著差异。EST的旋后准确性（2.7°±1.7°）高于应用程序（5.9°±1.9°）。EST和应用程序在旋前测量上无差异。
本研究是首次比较四种肘部ROM测量技术。我们的结果表明，EST仅在前臂旋转方面准确。X线在屈曲方面得分最佳，但在伸展方面可靠性较低。令人惊讶的是，与GON相比，应用程序在屈曲和旋后方面与我们预期的相关性不一致，但其他方法也不准确。我们发现应用程序对于测量完整的运动弧度（最大屈曲与最大伸展之间的差异）非常有用。
III，对肘部骨折患者前瞻性队列的回顾性研究：诊断性研究。
