了解距骨颈的三维解剖结构对于评估距骨颈骨折复位的准确性以及计划距骨畸形的手术矫正至关重要。然而,描述这种解剖结构的几何参数在骨科文献中很少报道。我们的目的是从现有的文献中找出,描述距骨颈部解剖结构的几何参数,确定这些是如何测量的,和他们的规范价值观。根据系统审查和荟萃分析(PRISMA)扩展范围审查(PRISMA-ScR)指南的首选报告项目进行范围审查。主要搜索是在PubMed上进行的,Embase,和Scopus数据库。包括观察人类距骨颈部几何形状的任何原始研究研究。确定了描述距骨颈解剖结构的参数,和汇总估计值由随机效应荟萃分析模型确定。异质性通过I2检验和留一法荟萃分析进行评估。进行亚组分析以比较亚洲和非亚洲人群之间的参数值。偏见的风险由美国国立卫生研究院(NIH)病例系列工具评估。组合搜索产生了6326个结果,其中21项研究被纳入综述,15项被纳入六组不同的元分析。大多数研究(n=19,90.5%)评估了成人塔利,只有两个(9.5%)评估了小儿距骨。在大多数研究中(n=13,61.9%),在干骨或解剖标本上评估距骨颈几何形状;通过成像技术评估(X光片,CT,MRI,和放射立体测量分析)被用于八项研究,(39.1%)。总共八个不同的几何参数(颈部长度,高度,宽度,偏角,倾角,扭转角,周长,和横截面积)被识别。除了距骨扭转,所有其他参数的测量方法均存在差异.亚组分析显示,与非亚洲人相比,亚洲人的颈部高度更高;其他参数没有显着差异。尽管文献报道了评估距骨几何形状的几何参数,这些参数的测量方法是可变的。大多数现有文献描述了尸体上的测量技术,并且没有关于如何在常规CT或MRI切片上测量这些参数的文献。进一步的研究需要集中在常规CT和/或MRI扫描上这些参数的测量技术的标准化上。
Understanding the three-dimensional anatomy of the talar neck is essential in assessing the accuracy of reduction in talar neck fractures as well as for planning surgical correction for talar malunions. However, the geometrical parameters that describe this anatomy are sparsely reported in the orthopedics literature. We aimed to identify from the existing literature, geometrical parameters that describe the anatomy of the talar neck, determine how these are measured, and their normative values. A scoping literature review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews (PRISMA-ScR) guidelines. The primary searches were conducted on the PubMed, Embase, and Scopus databases. Any original research study looking at the human talus neck
geometry was included. Parameters that described the anatomy of the talar neck were identified, and pooled estimates were determined by the random-effects meta-analysis model. Heterogeneity was assessed by the I2 test and leave-one-out meta-analysis. Subgroup analysis was done to compare the values of parameters between the Asian and Non-Asian populations. The risk of bias was assessed by the National Institutes of Health (NIH) Case Series Tool. The combined searches yielded 6326 results, of which 21 studies were included in the review and 15 in six different sets of metanalysis. The majority of the studies (n=19, 90.5%) evaluated adult tali, and only two (9.5%) evaluated pediatric tali. In most of the studies (n=13, 61.9%), talus neck
geometry was evaluated on dry bones or anatomical specimens; evaluation by imaging techniques (radiographs, CT, MRI, and radiostereometric analysis) was used in eight studies, (39.1%). A total of eight different geometrical parameters (neck length, height, width, declination angle, inclination angle, torsion angle, circumference, and cross-sectional area) were identified. Except for talar torsion, variability was noted in methods of measurement of all other parameters. Subgroup analysis revealed that Asians had a higher neck height as compared to non-Asians; other parameters were not significantly different. Although the literature reports geometrical parameters to assess the talar
geometry, the methods of measurement of these parameters are variable. Most of the available literature describes measurement techniques on cadaveric tali, and there is no literature on how these parameters should be measured on conventional CT or MRI slices. Further research needs to focus on the standardization of measurement techniques for these parameters on conventional CT and/or MRI scans.