Schieder Sophie, Nemecek Elena, Schuh Reinhard, Kolb Alexander, Windhager Reinhard, Willegger Madeleine
Department of Orthopedics and Trauma Surgery, Division of Orthopedics, Medical University of Vienna, 1090 Vienna, Austria.
Department of Trauma Surgery, Kepler University Hospital Linz, 4021 Linz, Austria.
J Clin Med. 2020 Mar 16;9(3):801. doi: 10.3390/jcm9030801.
Radiographic outcome assessment of ankle arthrodesis (AA) requires accurate measurement techniques. This study aimed to identify the most reliable methods for sagittal tibio-talar alignment measurements with regard to the tibio-talar offset after AA. Lateral weight-bearing radiographs of 38 fused ankles were selected for retrospective review. The sagittal tibio-talar angle (STTA), the modified tibio-talar ratio (mT-T ratio) and the sagittal tibio-talar offset (tibCOR, procLAT) were measured by three independent observers. Intra- and interobserver correlation coefficients (ICC) and mean measurement differences were calculated to assess measurement reliability and accuracy. By defining the talar longitudinal axis as a line from the inferior aspect of the posterior tubercle of the talus to the most inferior aspect of the talar neck, STTA showed excellent (ICC 0.924; CI 95% 0.862-0.959) and mTT-ratio provided high (ICC 0.836; CI 95% 0.721-0.909) interobserver reliability, respectively. For tibio-talar offset measurement the tibCOR method showed superior reliability and better interobserver agreement compared to the procLAT technique. The STTA and a modified T-T ratio are recommended for future scientific radiographic measurements in AA.
踝关节融合术（AA）的影像学结果评估需要精确的测量技术。本研究旨在确定在AA术后胫距偏移方面，矢状面胫距对线测量最可靠的方法。选择38例融合踝关节的负重侧位X线片进行回顾性分析。由三名独立观察者测量矢状面胫距角（STTA）、改良胫距比（mT-T比）和矢状面胫距偏移（tibCOR，procLAT）。计算观察者内和观察者间相关系数（ICC）以及平均测量差异，以评估测量的可靠性和准确性。通过将距骨纵轴定义为从距骨后结节下表面到距骨颈最下表面的连线，STTA显示出极好的观察者间可靠性（ICC 0.924；95%置信区间0.862 - 0.959），mTT比也具有较高的观察者间可靠性（ICC 0.836；95%置信区间0.721 - 0.909）。对于胫距偏移测量，与procLAT技术相比，tibCOR方法显示出更高的可靠性和更好 的观察者间一致性。推荐将STTA和改良T-T比用于未来AA的科学影像学测量。
