Orthopaedics Unit, Department of Basic Medical Science, Neuroscience and Sensory Organs, Faculty of Medicine and Surgery, University of Bari, General Hospital, Bari, Italy.
Department of Biomedical Sciences and Human Oncology, Faculty of Medicine and Surgery, University of Bari, General Hospital, Italy.
Biomed Res Int. 2018 Jul 12;2018:5930106. doi: 10.1155/2018/5930106. eCollection 2018.
The aim of this study is to evaluate the predictive efficacy of the radiographic parameters and the relationship between the radiographic results and the clinical data. We carried out a retrospective study analyzing the data of 225 pediatric patients with forearm fractures treated conservatively. Two orthopaedists examined 4 different radiographic parameters. They compared CI and radial translation parameters at T0, in terms of indication of type of treatment and predictive efficacy. Afterwards, the two orthopaedists analyzed X-rays performed at T1, evaluating radiographic results according to radial shortening and angle parameters. From the analysis of the CI measured by Observer 1, 135 patients out of 225 had retrospective indication to conservative treatment; the frequency of failure was 18/135 (13.3%). Observer 2 indicated conservative treatment in 144 patients out of 225 and the proportion of failure was 21/144 (14.6%). As regards the radial translation, Observer 1 reported a frequency of failure of 78/225 (34.7%) and Observer 2 reported 75/222 (33.8%). Furthermore the authors detected a deficit of pronosupination for the patients considered to have failure according to radiographic results. The authors defined the greater reliability of CI with respect to the radial translation parameter and the direct relationship between radiographic failure and clinical-functional data.
本研究旨在评估影像学参数的预测效果，以及影像学结果与临床数据之间的关系。我们对 225 例接受保守治疗的儿童前臂骨折患者的数据进行了回顾性研究。两名骨科医生检查了 4 个不同的影像学参数。他们比较了 T0 时的 CI 和桡骨移位参数，以评估治疗指征和预测效果。之后，两名骨科医生分析了 T1 时的 X 射线，根据桡骨缩短和角度参数评估影像学结果。从观察者 1 测量的 CI 分析中，225 例患者中有 135 例有保守治疗的回顾性指征；失败的频率为 18/135（13.3%）。观察者 2 在 225 例患者中有 144 例指示保守治疗，失败的比例为 21/144（14.6%）。至于桡骨移位，观察者 1 报告的失败频率为 78/225（34.7%），观察者 2 报告的失败频率为 75/222（33.8%）。此外，作者发现根据影像学结果判断为失败的患者存在旋前旋后功能不足。作者定义了 CI 参数比桡骨移位参数具有更高的可靠性，以及影像学失败与临床功能数据之间的直接关系。
