小儿胫骨棘骨折患者X线片上胫骨坡度的评估：一项年龄和性别匹配的研究。
Evaluation of Tibial Slope on Radiographs in Pediatric Patients With Tibial Spine Fractures: An Age- and Sex-Matched Study.
作者信息
Shin Chang Ho, Syed Akbar N, Swanson Morgan E, Kushare Indranil V, Shea Kevin G, Ganley Theodore J, Baghdadi Soroush, Cruz Aristides I, Ellis Henry B, Fabricant Peter D, Ganley Theodore J, Green Daniel W, Kerrigan Alicia, Kirby Julia, Kocher Mininder, Kushare Indranil V, Jay Lee R, MacDonald James P, McKay Scott D, Parikh Shital N, Patel Neeraj M, Yen Yi-Meng, Schmale Gregory A, Shea Kevin G, Justin Mistovich R
机构信息
Division of Pediatric Orthopaedics, Seoul National University Children's Hospital, Seoul, Republic of Korea; Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.
Investigation performed at the Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
出版信息
Orthop J Sports Med. 2024 Jul 31;12(7):23259671241256445. doi: 10.1177/23259671241256445. eCollection 2024 Jul.
BACKGROUND
A recent study has reported that the radiographic measurement of posterior tibial slope (PTS) is larger in male pediatric patients with tibial spine fractures (TSF) than in controls. However, they found no difference in PTS between female patients and controls.
PURPOSE
(1) To identify whether PTS is larger in female pediatric patients with TSF than in female controls and (2) to validate the relationship between PTS and pediatric TSF in male patients.
STUDY DESIGN
Cross-sectional study; Level of evidence, 3.
METHODS
After an a priori power analysis, 84 pediatric patients with TSF (50 female patients and 34 male patients) and 84 age- and sex-matched controls were enrolled in this study. Demographic information, including sex, age, and race, was recorded. Skeletal maturity was determined based on the stage of epiphyseal union on knee radiographs. PTS was defined as the angle between a line perpendicular to the longitudinal axis of the tibia and the posterior inclination of the medial tibial plateau on standard knee lateral radiographs.
RESULTS
The mean age when the TSF occurred was 11.2 ± 2.7 years for female patients and 12.9 ± 2.5 years for male patients. There was no significant difference in skeletal maturity between female patients and female controls or between male patients and male controls. The mean PTS was not significantly different between female patients (8.8°± 2.8°) and female controls (8.3°± 3.1°) ( = .366) or between male patients (9.0°± 2.8°) and male controls (9.3°± 2.6°) ( = .675). Those with a PTS >1 SD (2.9°) above the mean (8.8°) had no greater odds (1.0 [95% CI, 0.4-2.5]; ≥ .999) of having a TSF than others.
CONCLUSION
PTS was not found to be a risk factor for pediatric TSF in female or male patients in this study.
背景
最近一项研究报告称，患有胫骨棘骨折（TSF）的男性儿科患者的胫骨后倾坡度（PTS）的影像学测量值大于对照组。然而，他们发现女性患者与对照组之间的PTS没有差异。
目的
（1）确定患有TSF的女性儿科患者的PTS是否大于女性对照组；（2）验证男性患者中PTS与儿科TSF之间的关系。
研究设计
横断面研究；证据等级，3级。
方法
经过预先的功效分析，本研究纳入了84例患有TSF的儿科患者（50例女性患者和34例男性患者）以及84例年龄和性别匹配的对照组。记录了人口统计学信息，包括性别、年龄和种族。根据膝关节X线片上骨骺联合的阶段确定骨骼成熟度。PTS定义为在标准膝关节侧位X线片上，垂直于胫骨纵轴的线与胫骨内侧平台后倾角之间的角度。
结果
女性患者TSF发生时的平均年龄为11.2±2.7岁，男性患者为12.9±2.5岁。女性患者与女性对照组之间或男性患者与男性对照组之间的骨骼成熟度没有显著差异。女性患者（8.8°±2.8°）与女性对照组（8.3°±3.1°）之间（P = 0.366）或男性患者（9.0°±2.8°）与男性对照组（9.3°±2.6°）之间（P = 0.675）的平均PTS没有显著差异。PTS高于平均值（8.8°）1个标准差（2.9°）的患者发生TSF的几率并不比其他人高（1.0[95%CI，0.4 - 2.5]；P≥0.999）。
结论
在本研究中，未发现PTS是女性或男性儿科患者TSF的危险因素。
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