应力位影像评估拇指腕掌关节松弛性的研究及意义
The study of stress radiograph in the evaluation of trapeziometacarpal joint laxity
目的 应用应力位影像技术评估拇指腕掌关节松弛性，并评价其一致性。 方法 选择66例无拇指腕掌关节外伤史、骨关节炎史和手术史的患者进行应力位投照，由两名手外科医生对每张图片分别测量两个参数：第1掌骨基底桡偏宽度（RS），第1掌骨基底关节面的宽度（AW），并计算两者之间比值（R），用独立样本t检验评估男性、女性之间的关系，用配对t检验评估测量者之间数据的一致性。 结果 RS的平均测量值为（4.27±1.83）mm（1~8 mm），AW的平均测量值为（13.52±1.89）mm（10~17.3 mm），平均比率（R）为（0.32±0.11）,性别之间有显著差异（P=0.026），女性桡偏率比男性显著高，测量者之间数据无明显差异（P=0.23）。 结论 应力位拇指腕掌关节影像可以评估关节松弛性，一致性比较高。
Objective Modified stress-positioned radiograph technique was used to measure carpometacarpal joint laxity with its consistence evaluated. Method Stress -positioned radiographs were obtained from 66 patients whose carpometacarpal joint had no trauma, arthritis and surgeric history. Two measurements were performed by two hand surgeons: the width of radial subluxation of the first metacarpal base and the width of the first metacarpal articular surface; the ratio between them was calculated. T-test were performed to assess the reliability and difference between male and female. Result The average of the RS measurement is (4.27±1.83) mm (range 1~8mm)and the AW measurement is (13.52±1.89)mm (range 10~17.3 mm). The average RS/AW subluxation ratio is (0.32±0.11). Women showed greater value of the ratio than men（P=0.026）. The measurements of two hand surgeon showed high consistence (P=0.23). Conclusion The stress-positioned radiograph could evaluate joint laxity of the trapeziometacarpal articulation with high consistence.
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