Trauma Department, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany.
Trauma Department, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany.
Hand Surg Rehabil. 2021 Sep;40(4):472-476. doi: 10.1016/j.hansur.2021.01.008. Epub 2021 Mar 17.
Traditionally, the angle between the intersecting central axes (lateral projection intersecting central axes - LCA) of the proximal and distal fragments of metacarpal fractures is measured on radiographs. We recommend using the angle between the intersecting dorsal tangent lines instead (lateral projection intersecting dorsal tangent lines - LDT). We analyzed radiographs of 25 fractures of the fifth metacarpal bone shaft in three planes. Intraclass correlation coefficients (ICC) were used to estimate inter-rater and intra-rater reliability. Mean palmar tilt was 35.6° ± 12.5° according to LCA and 27.6° ± 12.0° according to LDT. There were no differences during repeated measurements. Intra-rater reliability was high: ICC (95% CI) for LDT was 0.82 (0.74-0.88) and for LCA it was 0.71 (0.51-0.83). Mean values of palmar tilt using LCA exceeded those using LDT by 8.0° ± 7.7° (p < 0.001). Only LDT measurements provided comparable results between all raters. In conclusion, we demonstrated the feasibility and reliability of intersecting dorsal tangent lines for measuring palmar tilt in fifth metacarpal fractures as an alternative to the commonly used angle between the intersecting central axes.
传统上，掌骨近端和远端骨折碎片的相交中央轴（侧位投影相交中央轴-LCA）之间的角度是在 X 光片上测量的。我们建议使用相交背切线之间的角度（侧位投影相交背切线-LDT）。我们在三个平面上分析了 25 例第五掌骨干骨折的 X 光片。使用组内相关系数（ICC）来评估评分者间和评分者内的可靠性。根据 LCA，掌侧倾斜的平均值为 35.6°±12.5°，根据 LDT 为 27.6°±12.0°。重复测量时无差异。评分者内可靠性较高：LDT 的 ICC（95%CI）为 0.82（0.74-0.88），LCA 的 ICC 为 0.71（0.51-0.83）。使用 LCA 的掌侧倾斜平均值比使用 LDT 的平均值高 8.0°±7.7°（p<0.001）。只有 LDT 测量值在所有评分者之间提供了可比的结果。总之，我们证明了在第五掌骨骨折中，使用相交背切线测量掌侧倾斜的可行性和可靠性，可以替代常用的相交中央轴之间的角度。
