Multiplier method for predicting limb-length discrepancy
Multiplier method for predicting limb-length discrepancy
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DOI：
10.2106/00004623-200010000-00010
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发表时间：
2000-10-01
影响因子：
5.3
通讯作者：
Bowen, JR
中科院分区：
文献类型：
--
作者：
Paley, D;Bhave, A;Bowen, JR
背景：在先天性或发育性肢体长度差异的患者中，短肢的生长速度与正常长肢的生长速度成正比。这是现有方法预测肢体长度差异的基础，这些方法复杂且需要多个数据点。我们研究的目的是推导一个简单的算术公式，可以轻松准确地预测骨骼成熟时的肢体长度差异。方法：利用现有的数据库，我们将骨骼成熟时的股骨和胫骨长度除以每个年龄的股骨和胫骨长度，为每个百分位数组。由此得到的数称为乘数。利用乘数，我们推导出了预测枝长差异和剩余生长量的公式。我们通过评估两组患有先天性短缩的患者，并对其进行表皮成形术或肢体延长术来验证这些公式的准确性。我们还根据放射学、临床和人类学下肢测量计算并比较了其他数据库的乘数。结果：股骨和胫骨的乘数在所有百分位组中是相等的，仅随年龄和性别而变化。由于先天肢体长度差异与生长成正比，因此成熟时的差异可以用当前差异乘以当前年龄和性别的乘数来计算。这种计算可以通过对肢体长度差异的单一测量来完成。对于进行性发育（非先天性）差异，骨骼成熟时的差异可以计算为当前差异加上生长抑制乘以剩余生长量。也可以用倍增器来计算表观变色的颜色。使用乘数法所做的预测与使用莫斯利法所做的预测以及肢体延长组和内旋成形术组的实际肢体长度差异有很好的相关性。尽管种族、民族和世代不同，但从股骨和胫骨的x线、临床和人类学测量中得出的乘数都是相似的。结论：乘数法可以快速计算出骨骼成熟时预测的四肢长度差异，而不需要绘制图表，并且只需要一两次测量。该方法独立于百分位数组，对股骨、胫骨和全肢长度的预测是相同的。乘数值也与世代、身高、社会经济阶层、民族和种族无关。我们通过对肢体延长或表皮成形症患者进行临床评估，验证了该方法的准确性。该方法也可与Moseley方法相媲美或更准确地预测肢体长度。
Background: In patients with a congenital or developmental limb-length discrepancy, the short limb grows at a rate proportional to that of the normal, long limb. This is the basis of predicting limb-length discrepancy with existing methods, which are complicated and require multiple data points. The purpose of our study was to derive a simple arithmetic formula that can easily and accurately predict limb-length discrepancy at skeletal maturity.Methods: Using available databases, we divided the femoral and tibial lengths at skeletal maturity by the femoral and tibial lengths at each age for each percentile group. The resultant number was called the multiplier, Using the multiplier, we derived formulae to predict the limb-length discrepancy and the amount of growth remaining. We verified the accuracy of these formulae by evaluating two groups of patients with congenital shortening who were managed with epiphysiodesis or limb-lengthening. We also calculated and compared the multipliers for other databases according to radiographic, clinical, and anthropological lower-limb measurements.Results: The multipliers for the femur and tibia were equivalent in all percentile groups, varying only by age and gender. Because congenital limb-length discrepancy increases at a rate proportional to growth, the discrepancy at maturity can be calculated as the current discrepancy times the multiplier for the current age and the gender. This calculation can be performed,vith use of a single measurement of limb-length discrepancy. For progressive developmental (noncongenital) discrepancies, the discrepancy at skeletal maturity can be calculated as the current discrepancy plus the growth inhibition times the amount of growth remaining. The tinting of the epiphysiodesis can also be calculated with the multiplier. The predictions made,vith use of the multiplier method correlated well with those made,vith use of the Moseley method as well as with the actual limb-length discrepancy in both the limb-lengthening and epiphgsiodesis groups. The multipliers derived from the radiographic, clinical, and anthropological measurements of femora and tibiae were all similar to each other despite differences in race, ethnicity, and generation.Conclusions: The multiplier method allows for a quick calculation of the predicted limb-length discrepancy at skeletal maturity, without the need to plot graphs, and is based on as few as one or two measurements. This method is independent of percentile groups and is the same for the prediction of femoral, tibial, and total-limb lengths. The multiplier values are also independent of generation, height, socioeconomic class, ethnicity and race. We verified the accuracy of this method clinically by evaluating patients who had been managed with limb-lengthening or epiphysiodesis. The method was also comparable with or more accurate than the Moseley method of limb-length prediction.