Luceri Francesco, Cucchi Davide, Rosagrata Enrico, Zaolino Carlo Eugenio, Menon Alessandra, Radici Mattia, Zagarella Andrea, Catapano Michele, Gallazzi Mauro Battista, Arrigoni Paolo Angelo, Randelli Pietro Simone
U.O.C. Clinica Ortopedica e Traumatologica Universitaria CTO, Azienda Socio Sanitaria Territoriale Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Piazza Cardinal Ferrari 1, 20122 Milan, Italy.
Department of Orthopaedics and Trauma Surgery, Universitätsklinikum Bonn, Venurberg-Campus 1, 53127 Bonn, Germany.
Indian J Orthop. 2021 Apr 28;55(Suppl 2):347-358. doi: 10.1007/s43465-021-00399-1. eCollection 2021 Jul.
The coronoid process plays a key-role in preserving elbow stability. Currently, there are no radiographic indexes conceived to assess the intrinsic elbow stability and the joint congruency. The aim of this study is to present new radiological parameters, which will help assess the intrinsic stability of the ulnohumeral joint and to define normal values of these indexes in a normal, healthy population.
Four independent observers (two orthopaedic surgeons and two radiologists) selected lateral view X-rays of subjects with no history of upper limb disease or surgery. The following radiographic indexes were defined: trochlear depth index (TDI); anterior coverage index (ACI); posterior coverage index (PCI); olecranon-coronoid angle (OCA); radiographic coverage angle (RCA). Inter-observer and intra-observer reproducibility were assessed for each index.
126 subjects were included. Standardized lateral elbow radiographs (62 left and 64 right elbows) were obtained and analysed. The mean TDI was 0.46 ± 0.06 (0.3-1.6), the mean ACI was 2.0 ± 0.2 (1.6-3.1) and the mean PCI was 1.3 ± 0.1 (1.0-1.9). The mean RCA was 179.6 ± 8.3° (normalized RCA: 49.9 ± 2.3%) and the mean OCA was 24.6 ± 3.7°. The indexes had a high-grade of inter-observer and intra-observer reliability for each of the four observers. Significantly higher values were found for males for TDI, ACI, PCI and RCA.
The novel radiological parameters described are simple, reliable and easily reproducible. These features make them a promising tool for radiographic evaluation both for orthopaedic surgeons and for radiologists in the emergency department setting or during outpatient services.
Basic Science Study (Case Series).
The novel radiological parameters described are reliable, easily reproducible and become handy for orthopaedic surgeons as well as radiologists in daily clinical practice.
冠突在维持肘关节稳定性中起关键作用。目前，尚无用于评估肘关节内在稳定性和关节一致性的影像学指标。本研究的目的是提出新的放射学参数，以帮助评估尺肱关节的内在稳定性，并确定这些指标在正常健康人群中的正常值。
四名独立观察者（两名骨科医生和两名放射科医生）选择了无上肢疾病或手术史受试者的肘关节侧位X线片。定义了以下放射学指标：滑车深度指数（TDI）；前覆盖指数（ACI）；后覆盖指数（PCI）；鹰嘴-冠突角（OCA）；放射学覆盖角（RCA）。评估了每个指标的观察者间和观察者内的可重复性。
纳入126名受试者。获得并分析了标准化的肘关节侧位X线片（左侧62例，右侧64例）。平均TDI为0.46±0.06（0.3 - 1.6），平均ACI为2.0±0.2（1.6 - 3.1），平均PCI为1.3±0.1（1.0 - 1.9）。平均RCA为179.6±8.3°（标准化RCA：49.9±2.3%），平均OCA为24.6±3.7°。对于四名观察者中的每一位，这些指标在观察者间和观察者内均具有高度可靠性。男性的TDI、ACI、PCI和RCA值明显更高。
所描述的新放射学参数简单、可靠且易于重复。这些特点使其成为骨科医生和急诊科或门诊放射科医生进行影像学评估的有前景的工具。
基础科学研究（病例系列）。
所描述的新放射学参数可靠、易于重复，在日常临床实践中对骨科医生和放射科医生都很方便。
