Dhinsa Baljinder S, Saini Aaron, Dick Alastair G, Nash William J, Nzeako Obinna, Shah Zameer
William Harvey Hospital, Kennington Road, Willesborough, Ashford, TN24 0LZ, UK.
Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London, SE1 9RT, UK.
J Clin Orthop Trauma. 2019 Jul-Aug;10(4):674-679. doi: 10.1016/j.jcot.2018.08.020. Epub 2018 Aug 24.
There have been many techniques described to measure limb length discrepancy and methods to correct this during total hip arthroplasty; preoperative and intraoperative. These techniques have been either inconsistent, cumbersome or not readily available due to expense. There is a lack of evidence to support one particular approach. The aim of this study is to assess the accuracy of the relationship between the centre of the femoral head and tip of the greater trochanter.
A prospective observational cross-sectional study, with patients undergoing Positron emission tomography-CT (PET-CT) scan between 20th January 2016 to 31st December 2016. Exclusion criteria were patients undergoing PET-CT scan for musculoskeletal condition, those found to have existing pathology of the hip (including previous trauma) and those aged younger than 18 years and over 50 years.
There was a total of 116 participants, giving 232 hips for assessment and 184 hips were measured by two observers. The mean age of the sample was 40.51 years. The mean distance of the centre of the femoral head from the tip of the greater trochanter was 8.53 mm distal (with a standard deviation of 4.97). Analysis of the right and left hip measurements gave a Pearson correlation coefficient of 0.87, suggesting a good correlation. Interobserver analysis demonstrated fair agreement with intraclass correlation coefficient of 0.52.
The evidence of this study and that in literature suggests that this landmark is unreliable and should no longer be used.
已有多种测量肢体长度差异的技术以及在全髋关节置换术中术前和术中纠正该差异的方法。这些技术要么不一致、操作繁琐，要么因费用问题难以获得。缺乏支持某一特定方法的证据。本研究的目的是评估股骨头中心与大转子尖之间关系的准确性。
一项前瞻性观察性横断面研究，研究对象为2016年1月20日至2016年12月31日期间接受正电子发射断层扫描-计算机断层扫描（PET-CT）的患者。排除标准为因肌肉骨骼疾病接受PET-CT扫描的患者、已发现存在髋关节病变（包括既往创伤）的患者以及年龄小于18岁和大于50岁的患者。
共有116名参与者，共232个髋关节可供评估，两名观察者测量了184个髋关节。样本的平均年龄为40.51岁。股骨头中心距大转子尖的平均距离为向远端8.53毫米（标准差为4.97）。对左右髋关节测量值的分析得出皮尔逊相关系数为0.87，表明相关性良好。观察者间分析显示一致性一般，组内相关系数为0.52。
本研究及文献中的证据表明，该标志不可靠，不应再使用。
