Prévost R, Arsenault A B, Dutil E, Drouin G
Research Centre, Institut de réadaptation de Montréal, Québec, Canada.
Arch Phys Med Rehabil. 1987 Nov;68(11):782-5.
A tridimensional (3-D) x-ray method of evaluation of the shoulder was contrasted with six clinical and radiologic techniques used to evaluate shoulder subluxation, in 50 hemiplegic subjects. The 3-D evaluation is obtained through a mathematical computation associating two x-rays of the same shoulder, one taken at 0 degree (anteroposterior) and the other at a 45 degrees oblique view. A vector is thus obtained quantifying the separation from the apex of the humeral head to the inferior border of the glenoid fossa. The Y component (cephalocaudal) of this vector is used to represent the inferior displacement of the humeral head. The six other techniques of evaluation were: a) palpation, or the number of finger breadths inserted between the acromial process and the head of the humerus; b) anthropometry, or the distance between the acromial process and the lateral epicondyle of the humerus; c) templates, or the use of four schemas representing different degrees of separation of the humeral head from the glenoid fossa; d) a measure of the relation of the center of the humeral head to the center of the glenoid fossa; e) the vertical distance between the center of the humeral head and the center of the glenoid fossa; and f) the vertical distance between the apex of the humeral head and the inferior border of the glenoid fossa. Correlation coefficients contrasting the 3-D x-ray technique and the six other measures ranged from .738 to .995. The high level of precision and reliability of the 3-D measure indirectly validated the other measurement techniques.
在50名偏瘫患者中，将一种用于评估肩部的三维（3-D）X线方法与六种用于评估肩关节半脱位的临床和放射学技术进行了对比。三维评估是通过对同一肩部的两张X线片进行数学计算获得的，一张在0度（前后位）拍摄，另一张在45度斜位拍摄。由此获得一个向量，量化从肱骨头顶点到关节盂下边缘的间距。该向量的Y分量（头足方向）用于表示肱骨头的向下移位。其他六种评估技术分别为：a）触诊，即测量肩峰与肱骨头之间插入的手指宽度数量；b）人体测量学，即测量肩峰与肱骨外侧髁之间的距离；c）模板法，即使用四种表示肱骨头与关节盂不同分离程度的示意图；d）测量肱骨头中心与关节盂中心的关系；e）测量肱骨头中心与关节盂中心之间的垂直距离；f）测量肱骨头顶点与关节盂下边缘之间的垂直距离。对比三维X线技术与其他六种测量方法的相关系数在0.738至0.995之间。三维测量的高精度和可靠性间接验证了其他测量技术。
