Kenney S, Schlechter J
Riverside University Health System Medical Center, Moreno Valley, California, USA and Children's Hospital of Orange County, Orange, California, USA.
J Child Orthop. 2019 Feb 1;13(1):57-61. doi: 10.1302/1863-2548.13.180173.
Fluoroscopy is commonly used to confirm acceptable position of percutaneously placed pins when treating paediatric fractures. There is a paucity of literature investigating the accuracy of fluoroscopic imaging when determining pin position relative to the far cortex of the fixated bone. The purpose of this study was to evaluate the accuracy of fluoroscopic and radiographic imaging in measuring smooth pin protrusion from the far cortex of a bone model.
Eight bone models were implanted with smooth pins and anteroposterior fluoroscopic and radiographic studies were obtained. All images were evaluated by orthopaedic attending physicians, residents and medical students. The length of pin protrusion from the model surface was estimated on fluoroscopic imaging and measured on radiographs and compared with actual lengths measured on the bone models.
20 evaluators took a total of 320 pin measurements on images of 8 models. There was a significant difference between fluoroscopic measurements compared to radiographic measurements and actual pin lengths. There was no significant difference between radiographic measurements and actual pin lengths. Level of training of examiner was not statistically significant. On average, fluoroscopic estimations of pin protrusion were 1.53 mm shorter than the actual measured length.
Fluoroscopic images underestimate the length of smooth pins protruding from a bone model surface when compared with radiographs and actual measurements. Orthopaedic surgeons using fluoroscopy should be aware of this discrepancy when assessing intraoperative fluoroscopic images to decide on acceptable implant position.
Level V.
在治疗儿童骨折时，荧光透视检查常用于确认经皮置入钢针的位置是否合适。关于荧光透视成像在确定钢针相对于固定骨远侧皮质的位置时的准确性，相关文献较少。本研究的目的是评估荧光透视和X线摄影成像在测量光滑钢针从骨模型远侧皮质突出长度方面的准确性。
将光滑钢针植入8个骨模型中，并获得前后位荧光透视和X线摄影图像。所有图像均由骨科主治医师、住院医师和医学生进行评估。在荧光透视成像上估计钢针从模型表面突出的长度，并在X线片上测量，然后与在骨模型上测量的实际长度进行比较。
20名评估者对8个模型的图像共进行了320次钢针测量。荧光透视测量结果与X线摄影测量结果及钢针实际长度之间存在显著差异。X线摄影测量结果与钢针实际长度之间无显著差异。检查者的培训水平无统计学意义。平均而言，荧光透视对钢针突出长度的估计比实际测量长度短1.53毫米。
与X线片和实际测量相比，荧光透视图像低估了光滑钢针从骨模型表面突出的长度。使用荧光透视的骨科医生在评估术中荧光透视图像以确定植入物位置是否合适时应注意这种差异。
V级。
