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[复发性肩关节前脱位患者关节盂轨迹三维CT测量的可靠性]

[Reliability of three dimensional CT measurement of glenoid track in patients with recurrent anterior dislocation of shoulder].

作者信息

Dai Fei, Yang Jin-Song, Zhang Qing, Chen Jun-Rong, Xiang Ming

机构信息

Department of Upper Limb, Sichuan Provincial Orthopaedic Hospital, Chengdu 610041, Sichuan, China.

出版信息

Zhongguo Gu Shang. 2021 Jun 25;34(6):492-6. doi: 10.12200/j.issn.1003-0034.2021.06.002.

Abstract

OBJECTIVE

To evaluate the reliability and repeatability of three-dimensional (3D)-CT measurement of glenoid track.

METHODS

Glenoid and Hill-Sachs bone defects in 60 patients with recurrent anterior dislocation of the unilateral shoulder were evaluated by 3D-CT and analyzed by three independent observers(shoulder orthopedists) according to the Di Giacomo method. These injuries were classified to formulate a surgical protocol. All the patients were repeatedly measured 1 week later. Intraclass correlation coefficient (ICC) and coefficient of variation (COV) were used for reliability analysis.

RESULTS

Interobserver reliability was "very good" for both measurements of glenoid diameter and glenoid bone defects, and "good" for measurements of Hill-Sachs interval. Interobserver agreement was high on the assessment of the extent of the glenoid defect, and poor on track/off track assessment of the Hill-Sachs lesion. Intraobserver reliability for measurements of glenoid diameter, glenoid defect, and Hill-Sachs interval was "very good". The COV was 4.1% for glenoid diameter, 4.4% for glenoid defect, and 21.1% for Hill-Sachs interval.

CONCLUSION

The reliability and reproducibility of 3D-CT measurements of glenoid bone defects are good, but the assessment of humeral head bone defects shows large variability with poor reliability.

摘要

目的

评估三维(3D)-CT测量肩胛盂轨迹的可靠性和可重复性。

方法

对60例单侧复发性肩关节前脱位患者的肩胛盂和希尔-萨克斯骨缺损进行3D-CT评估,并由三名独立的观察者(肩部骨科医生)根据迪贾科莫方法进行分析。对这些损伤进行分类以制定手术方案。所有患者在1周后进行重复测量。采用组内相关系数(ICC)和变异系数(COV)进行可靠性分析。

结果

观察者间对于肩胛盂直径和肩胛盂骨缺损测量的可靠性为“非常好”,对于希尔-萨克斯间距测量的可靠性为“好”。观察者间在肩胛盂缺损范围评估上一致性高,而在希尔-萨克斯损伤的轨迹/非轨迹评估上一致性差。观察者内对于肩胛盂直径、肩胛盂缺损和希尔-萨克斯间距测量的可靠性为“非常好”。肩胛盂直径的COV为4.1%,肩胛盂缺损的COV为4.4%,希尔-萨克斯间距的COV为21.1%。

结论

3D-CT测量肩胛盂骨缺损的可靠性和可重复性良好,但肱骨头骨缺损的评估显示出较大变异性且可靠性较差。

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