Precision of foot alignment measures in Charcot arthropathy.
Precision of foot alignment measures in Charcot arthropathy.
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DOI：
10.3113/fai.2011.0867
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发表时间：
2011-09
影响因子：
2.7
通讯作者：
Johnson JE
中科院分区：
文献类型：
--
作者：
Hastings MK;Sinacore DR;Mercer-Bolton N;McCormick JJ;Hildebolt CF;Prior FW;Johnson JE
糖尿病（DM）和周围神经病变（PN）引起的足部畸形可导致关节不稳定、溃疡和截肢。本研究报告了患有DM、PN和足部相关并发症的受试者中足部畸形放射学测量的评估者内和评估者间测量精度和最小显著变化（LSC）。对15名患有DM、PN和足部相关并发症的受试者的X线平片测量骰骨高度、Meary角、跟骨间距和后足-前足角。一名接受过足和踝关节研究金培训、具有23年经验的骨科医生（1级评分者）测量了两次X线片。一名接受过足踝奖学金培训并具有2年经验的骨科医生（2级评分者）和一名接受住院医师培训的放射科医生（3级评分者）测量了一次X线片。计算均方根标准差和LSC，以确定测量精密度，并将最小变化视为生物学上的真实的变化，而不是偶然的结果。测量精度为：骰骨高度0.9mm，Meary角3 °，跟骨俯仰角和后足-前足角2 °。评分者1与2和1与3的评分者间测量精度分别为：骰骨高度为1.7和1.6 mm，Meary角为4度，跟骨俯仰为2度，后足-前足角为3度。LSC小于或等于：骰骨4.7 mm，Meary角12度，跟骨俯仰8度，后足-前足角9度。骰骨高度、跟骨间距和后足-前足角度的测量可以以相对较好的测量精度完成。
Foot deformity associated with diabetes mellitus (DM) and peripheral neuropathy (PN) contributes to joint instability, ulceration and amputation. This study reports the intrarater and inter-rater measurement precision and least significant change (LSC) of radiological measures of foot deformity in subjects with DM, PN, and foot related complications. Cuboid height, Meary’s angle, calcaneal pitch and hindfoot-forefoot angle were measured from plain-film radiographs on fifteen subjects with DM, PN and foot related complications. A foot and ankle fellowship trained orthopedic surgeon with 23 years of experience (rater 1) measured radiographs twice. A foot and ankle fellowship trained orthopedic surgeon with 2 years of experience (rater 2) and a radiologist in residency training (rater 3) measured radiographs once. Root mean square standard deviation and LSC were calculated to determine measurement precision and the smallest change considered biologically real, not the result of chance. Intrarater measurement precision was: 0.9 mm for cuboid height, 3 degrees for Meary’s angle, and 2 degrees for calcaneal pitch and hindfoot-forefoot angle. Inter-rater measurement precision for rater 1 vs 2 and 1 vs 3 were: 1.7 and 1.6 mm for cuboid height, 4 degrees for Meary’s angle, 2 degrees for calcaneal pitch, and 3 degrees for the hindfoot-forefoot angle. The LSC was less than or equal to: 4.7 mm for cuboid, 12 degrees for Meary’s angle, 8 degrees for calcaneal pitch, and 9 degrees for hindfoot-forefoot angle. Cuboid height, calcaneal pitch, and hindfoot-forefoot angle measures can be completed with relatively good measurement precision.