Rampal Virginie, Rohan Pierre-Yves, Saksik Rebekah, Wicart Philippe, Skalli Wafa
Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTech, 151, boulevard de l'hôpital, 75013 Paris, France; Service d'orthopédie pédiatrique, hôpitaux pédiatriques de Nice CHU Lenval, 57, avenue de la Californie, 06000 Nice, France.
Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTech, 151, boulevard de l'hôpital, 75013 Paris, France.
Orthop Traumatol Surg Res. 2018 Nov;104(7):1083-1089. doi: 10.1016/j.otsr.2018.07.023. Epub 2018 Sep 22.
The physical examination and weight-bearing radiography are the two main available methods for assessing the feet and lower limbs. The anatomy and function of these two structures interact with each other. These two assessment methods are affected by subjectivity and projection bias. Low-dose biplanar radiography (LDBR) is now a promising alternative for evaluating the lower limbs in children. At present, however, the foot cannot be assessed using LDBR. The objective of this study was to work towards developing a new method for 3D radiographic analysis of the paediatric foot during weight-bearing, first by determining the reproducibility of landmarks defined by LDBR then by reporting the values of the calculated radiographic parameters.
A new radiographic method based on LDBR can be used to obtain a 3D evaluation of the foot in paediatric patients.
Two biplanar radiographs in perpendicular planes were obtained simultaneously in a standardised position using the EOS system (EOS Imaging, Paris, France) in each of 10 healthy children. To assess measurement uncertainty, two observers performed 3D reconstructions of each of the 10 feet three times (60 reconstructions). The standard error of reproducibility of the anatomic landmarks and clinical parameters was computed. Measurement uncertainty was then estimated based on the 95% confidence interval (95%CI). To obtain reference values, the mean±SD of each variable was computed after checking that the data were normally distributed.
Reproducibility was high for the anatomical landmarks of interest, calcaneal pitch angle, tibio-calcaneal angle on the lateral view, and first metatarsal pitch angle (95%CI<5%). The values of these angles in the study population are reported.
The data reported here pave the way towards developing new parameters for describing 3D foot morphology and for simultaneously assessing the lower limb and foot in the standing position.
I.
体格检查和负重X线摄影是评估足部和下肢的两种主要可用方法。这两个结构的解剖学和功能相互影响。这两种评估方法受到主观性和投影偏差的影响。低剂量双平面X线摄影（LDBR）现在是评估儿童下肢的一种有前景的替代方法。然而，目前无法使用LDBR评估足部。本研究的目的是努力开发一种新的负重时小儿足部三维X线分析方法，首先确定LDBR定义的标志点的可重复性，然后报告计算出的X线参数值。
基于LDBR的一种新的X线摄影方法可用于获得小儿患者足部的三维评估。
使用EOS系统（法国巴黎EOS Imaging公司）在标准体位同时为10名健康儿童的每只脚获取两个相互垂直平面的双平面X线片。为评估测量不确定度，两名观察者对10只脚中的每只脚进行3次三维重建（共60次重建）。计算解剖标志点和临床参数的可重复性标准误差。然后根据95%置信区间（95%CI）估计测量不确定度。为获得参考值，在检查数据呈正态分布后计算每个变量的均值±标准差。
感兴趣的解剖标志点、跟骨倾斜角、侧位片上的胫跟角和第一跖骨倾斜角的可重复性较高（95%CI<5%）。报告了研究人群中这些角度的值。
此处报告的数据为开发描述三维足部形态以及同时评估站立位下肢和足部的新参数铺平了道路。
I级。
