Van Royen K, Gevers M, Vanmierlo B, Scheerlinck T, Goubau J
Dept. Orthopedics and Traumatology, UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium; Dept. Orthopedics and Traumatology, AZ Damiaan, Gouwelozestraat 100, 8400 Oostende, Belgium.
Dept. Orthopedics and Traumatology, UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium.
Hand Surg Rehabil. 2021 Feb;40(1):44-50. doi: 10.1016/j.hansur.2020.10.010. Epub 2020 Nov 4.
Trapeziometacarpal instability is a well-known condition that could lead to trapeziometacarpal osteoarthritis. With the focus in the literature being on ligament insufficiency, bony deformity has received much less attention. Although trapezial tilt is currently used to measure trapezial dysplasia, we believe trapezial inclination is a more reliable measurement. The purpose of this study is to compare these two methods for evaluating trapezial dysplasia and to define the most reproducible measurement. Fifty patients were identified who had three consecutive radiographs of the trapeziometacarpal joint. Eaton views with little to no signs of osteoarthritis (Eaton stage I or II) were used. Both trapezial tilt and trapezial inclination were measured by two independent observers on three radiographs for every patient. Intra-observer variation, absolute agreement and consistency, and intra-observer variation and consistency were assessed for both measurements. Mean trapezial tilt was 135° and mean trapezial inclination was 10°. For both observers, intra-observer variation of trapezial inclination was significantly less than for trapezial tilt. Our study shows that mean trapezial inclination in a middle-aged adult population is approximately 10°. This measurement is more reproducible than the more frequently used trapezial tilt and may be a better parameter to define trapezial dysplasia and to guide its treatment.
大多角骨-掌骨不稳定是一种众所周知的病症，可导致大多角骨-掌骨骨关节炎。鉴于文献主要关注韧带不足，骨畸形受到的关注要少得多。尽管目前使用大多角骨倾斜度来测量大多角骨发育异常，但我们认为大多角骨倾斜角是一种更可靠的测量方法。本研究的目的是比较这两种评估大多角骨发育异常的方法，并确定最可重复的测量方法。确定了50例患者，他们有三张连续的大多角骨-掌骨关节X线片。使用几乎没有或没有骨关节炎迹象的伊顿位片（伊顿I期或II期）。两名独立观察者对每位患者的三张X线片测量大多角骨倾斜度和大多角骨倾斜角。评估两种测量方法的观察者内变异、绝对一致性和一致性，以及观察者间变异和一致性。大多角骨倾斜度的平均值为135°，大多角骨倾斜角的平均值为10°。对于两位观察者来说，大多角骨倾斜角的观察者内变异明显小于大多角骨倾斜度。我们的研究表明，中年成人人群中大多角骨倾斜角的平均值约为10°。该测量方法比更常用的大多角骨倾斜度更具可重复性，可能是定义大多角骨发育异常和指导其治疗的更好参数。
