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桡骨远端乙状切迹形态与三角纤维软骨复合体中央凹撕裂风险的相关性。

The correlation between shape of the sigmoid notch of the distal radius and the risk of triangular fibrocartilage complex foveal tear.

机构信息

Department of Orthopaedic Surgery, Medical Center of Chung-Ang University School of Medicine, Seoul, South Korea.

Department of Orthopedic Surgery, Samsung Medical Center, SunKyuKwan University School of Medicine, Seoul, South Korea.

出版信息

Bone Joint J. 2020 Jun;102-B(6):749-754. doi: 10.1302/0301-620X.102B6.BJJ-2019-1284.R1.

Abstract

AIMS

The aim of this study was to analyze the association between the shape of the distal radius sigmoid notch and triangular fibrocartilage complex (TFCC) foveal tear.

METHODS

Between 2013 and 2018, patients were retrospectively recruited in two different groups. The patient group comprised individuals who underwent arthroscopic transosseous TFCC foveal repair for foveal tear of the wrist. The control group comprised individuals presenting with various diseases around wrist not affecting the TFCC. The study recruited 176 patients (58 patients, 118 controls). The sigmoid notch shape was classified into four types (flat-face, C-, S-, and ski-slope types) and three radiological parameters related to the sigmoid notch (namely, the radius curvature, depth, and version angle) were measured. The association of radiological parameters and sigmoid notch types with the TFCC foveal tear was investigated in univariate and multivariate analyses. Receiver operating characteristic curves were used to estimate a cut-off for any statistically significant variables.

RESULTS

Univariate analysis showed that the flat-face type was more prevalent in the patients than in the control group (43% vs 21%; p = 0.002), while the C-type was lower in the patients than in the control group (3% vs 17%; p = 0.011). The depth and version angle of sigmoid notch showed a negative association with the TFCC foveal tear in the multivariate analysis (depth: odds ratio (OR) 0.380; p = 0.037; version angle: OR 0.896; p = 0.033). Estimated cut-off values were 1.34 mm for the depth (area under the curve (AUC) = 0.725) and 10.45° for the version angle (AUC = 0.726).

CONCLUSION

The proportion of flat-face sigmoid notch type was greater in the patient group than in the control group. The depth and version angle of sigmoid notch were negatively associated with TFCC foveal injury. Cite this article: 2020;102-B(6):749-754.

摘要

目的

本研究旨在分析桡骨远端乙状切迹形态与三角纤维软骨复合体(TFCC)窝状撕裂的关系。

方法

在 2013 年至 2018 年间,回顾性地招募了两组患者。患者组包括接受关节镜下经骨 TFCC 窝状修复治疗腕部窝状撕裂的患者。对照组包括患有各种腕部疾病但不影响 TFCC 的患者。研究共招募了 176 名患者(58 名患者,118 名对照组)。将乙状切迹形状分为四种类型(平面型、C 型、S 型和滑雪坡型),并测量与乙状切迹相关的三个影像学参数(即桡骨曲率、深度和版本角)。在单变量和多变量分析中,研究了影像学参数和乙状切迹类型与 TFCC 窝状撕裂的关系。使用受试者工作特征曲线来估计任何具有统计学意义的变量的截止值。

结果

单变量分析显示,平面型乙状切迹在患者组中比对照组更为常见(43%比 21%;p=0.002),而 C 型乙状切迹在患者组中比对照组更为少见(3%比 17%;p=0.011)。多变量分析显示,乙状切迹的深度和版本角与 TFCC 窝状撕裂呈负相关(深度:比值比(OR)0.380;p=0.037;版本角:OR 0.896;p=0.033)。估计的截止值为 1.34mm 用于深度(曲线下面积(AUC)=0.725)和 10.45°用于版本角(AUC=0.726)。

结论

患者组中平面型乙状切迹的比例大于对照组。乙状切迹的深度和版本角与 TFCC 窝状损伤呈负相关。

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