Normalización de medidas tomográficas (TAC) de longitud y rotación del peroné en el tobillo sano. Estudio observacional de concordancia ciego
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2021
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RESUMEN
Introducción: Las fracturas de tobillo son lesiones intra-articulares en las que se debe restaurar milimétricamente la anatomía. Se debe realizar una TAC como parte del planeamiento preoperatorio. El objetivo del estudio es normalizar un sistema de medición en cortes coronales de la TAC para determinar longitud y rotación del peroné.
Materiales & Métodos: Se realizó un estudio observacional de concordancia ciego con una muestra no probabilística y una técnica de muestreo por conveniencia. Cada participante realizó 4 mediciones en cortes coronales de 10 TAC de tobillos sanos. Se determinó: índice talar, índice de contacto talo-fibular, índice de longitud del peroné, índice fibulotalar, se realizó un análisis de varianza ANOVA de una vía y estudio de concordancia intra e inter observador.
Resultados: Se obtuvieron 400 registros de mediciones y 500 registros de índices, normalizamos cuatro medidas de longitud y rotación del peroné en cortes coronales de la TAC y establecimos cinco índices (Ancho del domo talar, longitud de la carilla articular fibular del talo, longitud del Peroné, longitud de la carilla talar del Peroné, Índice talar (1.1 ± 0.1 (SD) mm, P<0.05), Índice de contacto talo-fibular (1.0 ± 0.1 (SD) mm, P<0.05), Índice de longitud del peroné (0.9 ± 0.1 (SD) mm, P<0.05), Índice fibulotalar F/E (0.8 ± 0.1 (SD) mm, P<0.05), Índice fibulotalar G/E (0.8 ± 0.1 (SD) mm, P<0.05). Las medidas e índices propuestos fueron validadas con ICC (Índice de correlación) mayor del 95% interobservador e intragrupo.
Discusión: Se establecieron medidas normalizadas e índices reproducibles de longitud y rotación del peroné en la TAC. Los resultados mostraron alta correlación intra e interobservador y homocedasticidad lo que hace reproducible el sistema de mediciones propuesto.
ABSTRACT
Background: Ankle fractures are intra-articular injuries in which the anatomy must be perfectly restored. A CT scan should be performed as part of the pre-operative planning. The objective of the study is to standardize a measurement system in coronal CT slices to determine length and rotation of the fibula.
Methods: A blind observational concordance study was carried out with a non-probabilistic sample using a convenience sampling technique. Each participant performed 4 measurements on 10 CT coronal slices of healthy ankles. The following were determined: talar index, talar-fibular contact index, fibula length index, fibular-talar index. A one-way ANOVA analysis of variance and intra and inter-observer concordance analysis were performed.
Results: 400 measurement records and 500 index records were obtained, we normalized four measurements of length and rotation of the fibula in coronal CT slices and established five indexes (width of the talar dome, length of the fibular articular facet of the thallus, length of the Fibula, length of the fibula talar facet, Talar index (1.1 ± 0.1 (SD) mm, P <0.05), Talar-Fibular contact index (1.0 ± 0.1 (SD) mm, P <0.05), fibula (0.9 ± 0.1 (SD) mm, P <0.05), Fibular-Talar index F / E (0.8 ± 0.1 (SD) mm, P <0.05), Fibular-Talar index G / E (0.8 ± 0.1 (SD) mm, P < 0.05) The proposed measures and indexes were validated with an ICC (Correlation Index) greater than 95% interobserver and intragroup.
Discussion: Standardized measurements and reproducible indices of fibula length and rotation were established on CT. The results showed high intra- and interobserver correlation and homoscedasticity, which makes the proposed measurement system reproducible.
Descripción
Abstract
ABSTRACT
Introduction: Ankle fractures are intra-articular injuries in which the anatomy must be restored to the millimeter. A CT scan should be performed as part of the preoperative planning. The objective of the study is to standardize a measurement system in coronal CT scans to determine length and rotation of the fibula.
Materials & Methods: An observational blind concordance study was carried out with a non-probabilistic sample and a convenience sampling technique. Each participant made 4 measurements on coronal slices of 10 CT scans of healthy ankles. The following were determined: talar index, talo-fibular contact index, fibula length index, fibulotalar index, a one-way ANOVA analysis of variance and intra- and inter-observer agreement study were performed.
Results: 400 measurement records and 500 index records were obtained, we normalized four measures of length and rotation of the fibula in coronal CT slices and established five indices (width of the talar dome, length of the talus fibular facet joint, length of the Fibula, Fibula talar facet length, Talar index (1.1 ± 0.1 (SD) mm, P<0.05), Talo-fibular contact index (1.0 ± 0.1 (SD) mm, P<0.05), Talar length index fibula (0.9 ± 0.1 (SD) mm, P<0.05), fibulotalar index F/E (0.8 ± 0.1 (SD) mm, P<0.05), fibulotalar index G/E (0.8 ± 0.1 (SD) mm, P< 0.05) The proposed measures and indices were validated with ICC (Correlation Index) greater than 95% interobserver and intragroup.
Discussion: Standardized measurements and reproducible indices of fibular length and rotation on CT were established. The results showed high intra and interobserver correlation and homoscedasticity, which makes the proposed measurement system reproducible.
ABSTRACT
Background: Ankle fractures are intra-articular injuries in which the anatomy must be perfectly restored. A CT scan should be performed as part of the pre-operative planning. The objective of the study is to standardize a measurement system in coronal CT slices to determine length and rotation of the fibula.
Methods: A blind observational concordance study was carried out with a non-probabilistic sample using a convenience sampling technique. Each participant performed 4 measurements on 10 CT coronal slices of healthy ankles. The following were determined: talar index, talar-fibular contact index, fibula length index, fibular-talar index. A one-way ANOVA analysis of variance and intra and inter-observer concordance analysis were performed.
Results: 400 measurement records and 500 index records were obtained, we normalized four measurements of length and rotation of the fibula in coronal CT slices and established five indexes (width of the talar dome, length of the fibular articular facet of the thallus, length of the Fibula, length of the fibula talar facet, Talar index (1.1 ± 0.1 (SD) mm, P <0.05), Talar-Fibular contact index (1.0 ± 0.1 (SD) mm, P <0.05), fibula (0.9 ± 0.1 (SD) mm, P < 0.05), Fibular-Talar index F / E (0.8 ± 0.1 (SD) mm, P < 0.05), Fibular-Talar index G / E (0.8 ± 0.1 (SD) mm, P < 0.05 ) The proposed measures and indexes were validated with an ICC (Correlation Index) greater than 95% interobserver and intragroup.
Discussion: Standardized measurements and reproducible indices of fibula length and rotation were established on CT. The results showed high intra- and interobserver correlation and homoscedasticity, which makes the proposed measurement system reproducible.
Palabras clave
Tomografía computarizada por rayos x, Articulación del tobillo, Lesiones del tobillo, Usos terapéuticos, Medición de la longitud, Protocolos clínicos
Keywords
X-ray computed tomography, Ankle joint, Ankle injuries, Therapeutic uses, Length measurement, Clinical protocols