计算机断层扫描诊断舟状骨腰部骨折部分愈合的可靠性
Reliability of Diagnosis of Partial Union of Scaphoid Waist Fractures on Computed Tomography.
作者信息
Drijkoningen Tessa, Ten Berg Paul Willem Louis, Guitton Thierry G, Ring David, Mudgal Chaitanya S
机构信息
Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, United States.
Department of Plastic Reconstructive and Hand Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
出版信息
J Hand Microsurg. 2018 Dec;10(3):130-133. doi: 10.1055/s-0038-1636831. Epub 2018 Mar 20.
Computed tomography (CT) is increasingly used not just to diagnose union but also to estimate the percentage of the fracture gap that is bridged by healing bone. This study tested the primary null hypothesis that there is no agreement between observers on the extent of union of a scaphoid waist fracture on CT. CT scans of 13 nondisplaced scaphoid waist fractures treated nonoperatively were rated by 145 observers. CT scans were done 10 to 12 weeks after injury. Observers were asked to "eyeball" measure percentage of union. We found that there was a moderate agreement on the categorical degree of partial union of a scaphoid waist fracture on CT (k = 0.34). Agreement on the location of bony bridging was slight (k = 0.31). We concluded that there is limited reliability of diagnosis of partial union of a scaphoid waist fracture on CT and that this should be taken into account in both patient care and research. This is a Level III, diagnostic study.
计算机断层扫描（CT）不仅越来越多地用于诊断骨折愈合，还用于估计愈合骨桥接骨折间隙的百分比。本研究检验了主要无效假设，即观察者之间对于CT上舟状骨腰部骨折的愈合程度没有一致性意见。145名观察者对13例非手术治疗的无移位舟状骨腰部骨折的CT扫描进行了评级。CT扫描在受伤后10至12周进行。要求观察者“目测”测量愈合百分比。我们发现，对于CT上舟状骨腰部骨折部分愈合的分类程度存在中度一致性（k = 0.34）。在骨桥接位置上的一致性很轻微（k = 0.31）。我们得出结论，CT上舟状骨腰部骨折部分愈合的诊断可靠性有限，在患者护理和研究中均应考虑到这一点。这是一项III级诊断性研究。
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