Brunner R, Baumann J U
University of Basel, Division of Pediatric Orthopedics, Children's Hospital, Switzerland.
Arch Orthop Trauma Surg. 1998;117(6-7):351-6. doi: 10.1007/s004020050264.
A tool is presented to assess the lower extremities using linear and angular measurements under full weight-bearing in three dimensions. While the patient is standing on both legs in a frame representing a calibrated three-dimensional (3D) space, standard radiographs of the hips (anteroposterior view, AP) as well as of the knees (AP and lateral views) are taken. The coordinates for localisation of the malleoli are determined clinically in respect to the coordinate system of the 3D space. Characteristic landmarks are digitized on the calibrated radiographic films, and the so determined coordinates of the malleoli are fed into the computer together with the femoral anteversion, which is ascertained from an additional Dunn-Rippstein II view. All angles of the lower extremities in the frontal or sagittal planes as well as torsions are measured with an error of less than +/- 5 degrees and the lengths, with an error of less than 5 mm. The data are presented in a stick figure diagram and listed in a table. With this device, it is possible to determine simultaneously the angular values and bone lengths under full weight-bearing. The method has proved its value for planning corrective surgery of complex bony deformities of the lower extremities. An accuracy evaluation is reported which includes intra- and interobserver reliability of results.
本文介绍了一种用于在三维全负重状态下通过线性和角度测量来评估下肢的工具。当患者双脚站立在代表校准三维（3D）空间的框架中时，拍摄髋关节的标准X线片（前后位，AP）以及膝关节的标准X线片（AP位和侧位）。根据3D空间的坐标系在临床上确定踝关节定位的坐标。在已校准的X线片上对特征性标志点进行数字化处理，并将如此确定的踝关节坐标与通过额外的Dunn-Rippstein II位片确定的股骨前倾角度一起输入计算机。下肢在额状面或矢状面的所有角度以及扭转角度的测量误差小于±5度，长度测量误差小于5毫米。数据以简笔画图的形式呈现并列表。使用该设备，可以在全负重状态下同时确定角度值和骨长度。该方法已证明其在规划下肢复杂骨畸形矫正手术方面的价值。报告了一项准确性评估，其中包括结果在观察者内和观察者间的可靠性。
