Department of Orthopaedics and Traumatology, Paracelsus Medical University, Müllner Hauptstraße 48, 5020 Salzburg, Austria; Research Unit for Orthopaedic Sports Medicine and Injury Prevention (OSMI), ISAG, UMIT Tirol, 6060 Hall in Tirol, Austria.
Department of Orthopaedics and Traumatology, Paracelsus Medical University, Müllner Hauptstraße 48, 5020 Salzburg, Austria; Center for Musculoskeletal Surgery, Campus Virchow, Charité - Universitaetsmedizin, Augustenburger Platz 1, 13353 Berlin, Germany.
Orthop Traumatol Surg Res. 2020 Dec;106(8):1653-1658. doi: 10.1016/j.otsr.2020.06.018. Epub 2020 Oct 22.
Subcapital fractures of the 5th metacarpal bone (MCV) represent a common injury. Volar angulation measurement is essential for treatment decision-making and therefore needs a reliable and valid method. The purpose of the present study was to investigate a new technique for volar angulation measurement, called the "Trigonometric Technique" (TT), and to compare the TT with the reference standard based on computed tomography (CT).
Quantifying volar angulation in MCV neck fractures with the TT shows no difference compared to the angle measured on CT scans.
Fifteen patients (14 men and 1 woman) with a mean age of 37±16years (range, from 16 to 72 years) who suffered MCV neck fracture and met the inclusion and exclusion criteria were selected for this prospective cohort study. Radiologic investigation included simple dorsopalmar (DP) radiographs and CT scans from the injured hand. Volar angulation measurements were performed by three observers at two time points comparing the TT to measurements obtained on CT scans. Intraclass correlation coefficients (ICC) were determined to assess inter- and intra-observer reliability.
The TT showed a mean volar angulation of 39±5 degrees (range, from 26 to 46 degrees) compared to 41±7 degrees (range, from 28 to 54 degrees) on CT measurement, which revealed a significant correlation between the two measurement techniques (R=0.922, p<0.001). Overall, the inter-rater (R=0.977; 95% CI 0.945-0.992) as well as intra-rater (R=0.857; 95% CI 0.739-0.941) reliability for the volar angulation using the TT was excellent.
The TT presented in this study uses plain radiography and trigonometric identities to precisely determine volar angulation in MCV neck fractures. The TT correlates excellently with the obtained volar angulation angles measured on CT scans. We recommend the TT for volar angulation measurement in boxer's fracture as a reliable alternative to the conventional techniques. However, rotational abnormalities may remain undetected and should therefore be ruled out during clinical examination.
II, study of diagnostic test.
第五掌骨颈骨折是一种常见的损伤。掌侧成角测量对于治疗决策至关重要，因此需要一种可靠且有效的方法。本研究的目的是探讨一种新的掌侧成角测量技术，称为“三角测量技术”（TT），并将 TT 与基于计算机断层扫描（CT）的参考标准进行比较。
使用 TT 量化第五掌骨颈骨折的掌侧成角与 CT 扫描测量的角度无差异。
本前瞻性队列研究纳入了 15 名（14 名男性和 1 名女性）符合纳入和排除标准的患者，平均年龄为 37±16 岁（年龄范围为 16 岁至 72 岁）。影像学检查包括受伤手部的简单背侧掌侧（DP）射线照片和 CT 扫描。通过 TT 对三位观察者在两个时间点进行掌侧成角测量，并与 CT 扫描测量值进行比较。采用组内相关系数（ICC）评估观察者间和观察者内的可靠性。
TT 测量的掌侧成角平均为 39±5 度（范围为 26 度至 46 度），而 CT 测量的掌侧成角平均为 41±7 度（范围为 28 度至 54 度），两种测量技术之间存在显著相关性（R=0.922，p<0.001）。总体而言，使用 TT 进行掌侧成角的测量的组内信度（R=0.977；95%CI 0.945-0.992）和组内信度（R=0.857；95%CI 0.739-0.941）均为优秀。
本研究中提出的 TT 利用普通 X 射线摄影和三角恒等式精确确定第五掌骨颈骨折的掌侧成角。TT 与 CT 扫描测量的掌侧成角角度具有极好的相关性。我们推荐 TT 作为常规技术的可靠替代方法，用于测量拳击手骨折的掌侧成角。然而，旋转异常可能无法被检测到，因此应在临床检查中排除。
II，诊断测试研究。
