摘要
[目的]对髋臼骨折Letournel分型系统进行评价并分析此种分型系统的临床应用价值。[方法]于已行手术治疗的265例髋臼骨折患者的病例资料库中按Letournel分型系统10个亚型中每种亚型随机抽取6例,再分为2组:平片组30例(提供骨盆正位、髂骨斜位、闭孔斜位X线片)及CT组30例(提供X线片、二维CT),抽取9位骨科创伤专业医生对两组进行读片并根据Letournel分型系统做出诊断;每位观察者只读片而不给予其他临床资料。第二阶段即3个月后再次对相同资料进行分析,将结果统计Kappa值用来评估观察者间的可信度和可重复性进行一致性检验。[结果]不同观察者间在前后2个阶段的可信度为平片组0.65(0.70)、CT组0.66(0.71);同一观察者前后2次读片可重复性分别为平片组0.74、CT组0.77。[结论]以Letournel分型系统对髋臼骨折进行分类诊断时,可以获得一致度较高的诊断结果,CT虽然对于髋臼骨折的治疗具有重大的指导意义,但并不能明显提高对髋臼骨折Letournel分型诊断的可信度。
[ Objective ] To evaluate the Letournel and Judet classification for acetatbular fractures. [ Method ] Sixty cases with plain radiographs （AP, iliac and obturator oblique views） ,2D-CT were randomly chosen from database of 265 cases of acetabular fractures. Sixty cases were divided into two groups： A （plain radiographs without CT） and B （plain radiographs with 2D- CT）. Each observer read the radiographs twice with 3-month interval without knowledge of the treatment. The serial numbers of the radiographs were changed before the second review. The purposed classification was tested for inter- and intra-observer reliability and reproducibility using Kappa test by 9 surgeons （3 with 1 to 5-year experience ,3 with 5 to 10 year experience and the other 3 had an experience of more than 10 years）. [ Result] The inter-observer reliability testing without and with computed CT during the two sessions were 0.65 （0.70） and 0.66 （0.71）. Intra-observer reproducibility of group A,B and C were almost the same （0. 74 and 0.77）. [ Conclusion] Different experienced surgeons were chosen for reading radiographs without and with 2D-CT. Tere was substantial reliability for the Letournel. The value of computed tomography scans in the evaluation of acetabular fractures has been well established for the identification of loosened bodies and articular impaction. However, CT scans were not helpful for increasing the reliability of Letournel classification.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2009年第10期731-733,共3页
Orthopedic Journal of China
关键词
髋臼骨折
分类法
三维CT
可信度
acetabular fracture
classification
3D CT
reliability
