摘要
目的探讨GardenⅢ型股骨颈骨折移位特点和正位Garden指数评价GardenⅢ型股骨颈骨折移位程度的信度、效度及其价值。方法收集2010年10月至2018年10月河南省洛阳正骨医院(河南省骨科医院)收治的98例GardenⅢ型股骨颈骨折患者骨盆X线片,其中男47例,女51例;年龄19~89岁[(64.9±16.2)岁]。患者中包括21例髋关节64排三维CT资料。由3名高年资医师先后重复2次,对每例患侧股骨颈正位Garden指数各测量3次。统计描述正位Garden指数的分布特点。采用Spearman相关系数和Kappa系数评价股骨颈正位Garden指数信度,包括重测信度和测量者间的一致性。依据21例髋关节三维CT,测量并计算骨折断端接触面积和股骨颈上移距离,与正位Garden指数行多元相关分析,评价正位Garden指数的效度。结果98例GardenⅢ型股骨颈骨折的正位Garden指数为(136±15)°,最小值为90°,最大值为159°,指数呈正态分布(P>0.05)。3名测量者重测信度的Spearman相关系数分别为0.93、0.97和0.95(P均<0.01),3名测量者间一致性的Kappa值分别为0.87、0.91和0.86(P均<0.01)。正位Garden指数与骨折断端接触面积呈正相关(r=0.80,P<0.01),与股骨颈上移距离呈负相关(r=-0.77,P<0.01)。结论GardenⅢ型股骨颈骨折移位程度具有多样性且呈正态分布。正位Garden指数能够可信、有效地定量评价Ⅲ型骨折移位程度,并可为治疗方案的选择提供参考依据。
Objective To discuss the displacement characteristics of Garden type III femoral neck fracture and investigate the reliability,validity and clinical value of the frontal Garden index in assessing the displacement degree of Garden type III femoral neck fracture.Methods The pelvis X‑ray films of 98 patients with Garden type III femoral neck fracture treated at Luoyang Orthopedic‑Traumatological Hospital of Henan Province(Henan Provincial Orthopedic Hospital)from October 2010 to October 2018 were collected,including 47 males and 51 females;aged 19‑89 years[(64.9±16.2)years].Three‑dimensional data of the hip with 64‑slice CT were available in 21 patients.Each patient′s frontal Garden index was measured three times by three senior doctors,which was repeated twice in turn.The distribution characteristics of the frontal Garden index were statistically described.The reliability of the frontal Garden index was tested by Spearman correlation coefficient and Kappa coefficient,including test‑retest reliability and intra‑rater consistency.The contact area of fracture ends and upper‑shift distance of the femoral neck were calculated based on three‑dimensional CT data of the hip in 21 patients.Correlation analysis of the contact area of fracture ends and upper‑shift distance of the femoral neck with the frontal Garden index was performed by multiple correlation analysis to assess the validity of the frontal Garden index.Results The Frontal Garden index of 98 patients with Garden type III femoral neck fracture was(136±15)°,with the minimum value of 90°and maximum value of 159°,and was found to be normally distributed(P>0.05).Spearman correlation coefficient of the test‑retest reliability was 0.93,0.97 and 0.95,respectively(all P<0.01).Kappa coefficient of the intra‑rater consistency was 0.87,0.91 and 0.86,respectively(all P<0.01).The frontal Garden index was positively correlated with the contact area of fracture ends(r=0.80,P<0.01),and was negatively with the upper‑shift distance of the femoral neck(r=-0.77,P<0.01).Conclusions The displacement degree of Garden type III femoral neck fracture shows diversity and normal distribution.The frontal Garden index can credibly and effectively measure the displacement degree of Garden type III femoral neck fracture,which may help to choose the treatment plan.
作者
侯洪涛
刘立平
李无阴
陈柯
孙群周
刘又文
张伟
Hou Hongtao;Liu Liping;Li Wuyin;Chen Ke;Sun Qunzhou;Liu Youwen;Zhang Wei(Department of Hip Surgery,Luoyang Orthopedic‑Traumatological Hospital of Henan Province(Henan Provincial Orthopedic Hospital),Luoyang 471002,China)
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2022年第10期904-908,共5页
Chinese Journal of Trauma
基金
河南省科技攻关计划项目(182102310448)。
