Turan Adil, Kose Ozkan, Aktan Cemil, Unal Melih, Acar Baver, Sindel Muzaffer
University of Health Sciences, Antalya Training and Research Hospital, Department of Orthopedics and Traumatology, 07100 Antalya, Turkey.
University of Health Sciences, Antalya Training and Research Hospital, Department of Orthopedics and Traumatology, 07100 Antalya, Turkey.
Clin Imaging. 2018 Sep-Oct;51:341-346. doi: 10.1016/j.clinimag.2018.06.014. Epub 2018 Jun 30.
The purpose of this study was to investigate the role of anatomic variations in distal radius radiographic indices in patients with or without scaphoid fractures.
Radial inclination (RI), volar tilt (VT), radial height (RH) and ulnar variance (UV) were measured on wrist radiographs of 320 patients with (Group I, n = 167) or without (Group II, n = 153) scaphoid fracture, fall on outstretched hand (FOOSH). Receiver operating characteristics (ROC) curve analysis was used to assess the diagnostic performance for each variable. Sensitivity (Sn), specificity (Sp), cutoff value, and area under the ROC curve were analyzed. Odds ratio was calculated for defined cutoff values.
The mean age of the groups was similar (29.3 ± 10.2 vs 31.1 ± 9.9 years, p = 0.060). RI (30.0 ± 2.9 vs 26.8 ± 2.3°) VT (11.4 ± 2.4 vs 10.5 ± 2.2°), RH (14.8 ± 2.1 vs 13.2 ± 1.9 mm), UV (-0.46 ± 1.7 vs 0.00 ± 1.5 mm) were higher in scaphoid fracture group (Gr I vs Gr II, p = 0.000, p = 0.000, p = 0.001, p = 0.012 respectively). Ulna minus variant was more prevalent in fracture group (p = 0.001). Optimal cutoff points for RI, VT, RH and UV in differentiating fractured and intact scaphoid were 28.6° (Sn = 81.0%, Sp = 26.3%), 12.2° (Sn = 80.4%, Sp = 67.1%), 14.85 mm (Sn = 80.4%, Sp = 52.1%) and 0 mm (Sn = 88.6%, Sp = 75.8%), respectively. Odds ratios for defined cutoff points for RI, VT, RH and UV were 10.4 (95% CI, 6.2-17.4), 1.8 (95% CI, 1.1-3.0), 3.7 (95% CI, 2.3-6.2) and 2.2 (95% CI, 1.3-3.7) respectively.
Increased RI, VT, RH and negative UV were found to be predisposing anatomical risk factors for scaphoid fracture when FOOSH.
本研究旨在探讨桡骨远端影像学指标的解剖变异在有无舟骨骨折患者中的作用。
对320例因伸直型桡骨远端骨折（FOOSH）导致舟骨骨折的患者（I组，n = 167）和未发生舟骨骨折的患者（II组，n = 153）的腕部X线片测量桡骨倾斜度（RI）、掌倾角（VT）、桡骨高度（RH）和尺骨变异（UV）。采用受试者操作特征（ROC）曲线分析评估各变量的诊断性能。分析敏感性（Sn）、特异性（Sp）、截断值和ROC曲线下面积。计算定义截断值的比值比。
两组的平均年龄相似（29.3±10.2岁 vs 31.1±9.9岁，p = 0.060）。舟骨骨折组的RI（30.0±2.9° vs 26.8±2.3°）、VT（11.4±2.4° vs 10.5±2.2°）、RH（14.8±2.1 mm vs 13.2±1.9 mm）、UV（-0.46±1.7 mm vs 0.00±1.5 mm）更高（I组 vs II组，p分别为0.000、0.000、0.001、0.012）。尺骨负变异在骨折组更常见（p = 0.001）。区分骨折和完整舟骨时RI、VT、RH和UV的最佳截断点分别为28.6°（Sn = 81.0%，Sp = 26.3%）、12.2°（Sn = 80.4%，Sp = 67.1%）、14.85 mm（Sn = 80.4%，Sp = 52.1%）和0 mm（Sn = 88.6%，Sp = 75.8%）。RI、VT、RH和UV定义截断值的比值比分别为10.4（95%CI，6.2 - 17.4）、1.8（95%CI，1.1 - 3.0）、3.7（95%CI，2.3 - 6.2）和2.2（95%CI，1.3 - 3.7）。
发现当发生伸直型桡骨远端骨折时，RI、VT、RH增加和UV为负是舟骨骨折的解剖学易感危险因素。
