Smees Camiel J, van Es Eline M, Tuijthof Gabriëlle J M, Colaris Joost W, de Graaff Feike, Vochteloo Anne J H
Centre for Orthopaedic Surgery and Sports Medicine, OCON, Hengelo, The Netherlands.
Biomedical Device Design and Production Technology, University of Twente, Enschede, The Netherlands.
J Hand Surg Eur Vol. 2024 May;49(5):546-553. doi: 10.1177/17531934231213790. Epub 2023 Nov 21.
Two-dimensional (2-D) plain radiographs may be insufficient for the evaluation of distal radial malunion, as it is a three-dimensional (3-D) deformity. This study introduced a 3-D measuring method that outputs radial inclination, ulnar variance, palmar tilt and axial rotation. To this end, a standardized and clearly defined coordinate system was constructed that allowed 3-D measurements closely resembling the conventional 2-D method in 35 patients. Mean differences between 3-D and 2-D measurements in affected wrists were 1.8° for radial inclination, 0.8 mm for ulnar variance and 3.7° for palmar tilt. In addition, inter- and intra-observer reproducibility of all 3-D and 2-D measurements were good or excellent (intraclass correlation coefficient >0.75), with 3-D reproducibility always better than 2-D. Axial rotation was present in all patients with a mean of 7.9° (SD 6.9). Although the differences between 2-D and 3-D measurements were small, 3-D evaluation enables the assessment of axial rotation and brings us closer to a routine 3-D evaluation of malunion. III.
二维（2-D）X线平片对于评估桡骨远端畸形愈合可能并不充分，因为这是一种三维（3-D）畸形。本研究引入了一种三维测量方法，可得出桡骨倾斜度、尺骨变异、掌倾角和轴向旋转。为此，构建了一个标准化且定义明确的坐标系，对35例患者进行了与传统二维方法极为相似的三维测量。患侧腕关节三维测量与二维测量之间的平均差异为：桡骨倾斜度1.8°、尺骨变异0.8毫米、掌倾角3.7°。此外，所有三维和二维测量的观察者间及观察者内重复性均为良好或优秀（组内相关系数>0.75），三维测量的重复性始终优于二维测量。所有患者均存在轴向旋转，平均为7.9°（标准差6.9）。尽管二维和三维测量之间的差异较小，但三维评估能够评估轴向旋转，使我们更接近畸形愈合的常规三维评估。III.
