介绍我们介绍了一种新的数值指标,称为后突测量(PPM),从横向平面射线照片图像中得出,这有效地用于区分稳定和不稳定的股骨转子骨折。本研究旨在仔细检查两种分类断裂模式中的PPM值,稳定和不稳定,在三维(3D)CT分类系统中,建立PPM的数字阈值以区分这些组;探索PPM指数与未分类类别之间的潜在关系;研究按PPM阈值划分的组如何基于3DCT预测骨折稳定性。材料和方法在这项研究中,三名观察员的任务是一次性测量PPM。卡方检验评估了分类量表上每个人口统计学参数与稳定/不稳定组之间的关联。连续变量也要接受检查。采用接收器工作特性(ROC)分析来确定PPM的最佳截止点,以预测稳定组与不稳定组的存在。此外,卡方检验基于定义的阈值PPM值检查了分离组与稳定/不稳定组之间的线性关系。结果在3DCT分类系统中使用CT扫描图像和X线平片共识别出106例经股骨转子骨折,揭示了稳定组的35例患者和不稳定组的71例患者。稳定/不稳定骨折的PPM值是,平均值(±标准偏差),观察员1为0.34±0.25/0.50±0.29,观察员2为0.31±0.23/0.57±0.31,观察员3为0.41±0.29/0.57±0.26(p<0.01)。我们建立了0.3作为PPM的截止值。三个观察者之间的平均PPM值代表每个患者评估骨折稳定性。PPM<0.3组包括27例患者(稳定16例,不稳定11例),PPM≥0.3组包括79例患者(稳定19例,不稳定60例;p<0.005)。结论本研究显示,在稳定和不稳定的3DCT分类组中,PPM值存在显着差异。此外,0.3的阈值PPM值表明了区分骨折稳定性的关键点。这种创新的方法为临床工作做出了重大贡献,潜在地规避了3DCT扫描的必要性。
Introduction We introduced a novel numerical index known as posterior protrusion measures (PPM), derived from lateral plain radiograph images, which effectively serves to distinguish
stable from unstable pertrochanteric fractures. The present study aims to scrutinize PPM values among two classified fracture patterns,
stable and unstable, within the three-dimensional (3D) CT classification system, establishing a numeric threshold for PPM to differentiate between these groups; explore the potential relationship between the PPM index and unclassified categories; investigate how groups divided by the PPM threshold value can predict fracture stability based on 3D CT. Materials and methods In this study, three observers were tasked with measuring PPM on a single occasion. The chi-square test assessed the association between each demographic parameter on a categorical scale and stable/unstable groups. Continuous variables were also subject to examination. Receiver operating characteristic (ROC) analysis was employed to determine optimal cut-off points of PPM for predicting the presence of stable versus unstable groups. Additionally, the chi-square test examined the linear relation between separated groups based on the defined threshold PPM value and the stable/unstable groups. Results A total of 106 pertrochanteric fractures were identified using CT scan images and plain radiographs in the 3D CT classification system, revealing the stable group of 35 patients and the unstable group of 71 patients. The PPM values for
stable/unstable fractures were, on average (± standard deviation), 0.34±0.25/0.50±0.29 for observer 1, 0.31±0.23/0.57±0.31 for observer 2, and 0.41±0.29/0.57±0.26 for observer 3, respectively (p<0.01). We established 0.3 as the cut-off value for PPM. The average PPM value among three observers represented each patient to assess fracture stability. The group with PPM <0.3 included 27 patients (16
stable and 11 unstable), and the group with PPM ≥0.3 group comprised 79 patients (19
stable and 60 unstable; p<0.005). Conclusion The present study revealed a significant difference in PPM values among stable and unstable 3D CT classification groups. Additionally, a threshold PPM value of 0.3 suggests a pivotal point for differentiating fracture stability. This innovative methodology makes a substantial contribution to clinical endeavors, potentially circumventing the necessity for 3D CT scanning.