1402 requests

Resume

Context

The aim of the idea was a study to determine the amplitude torsion profile (TP) errors (femoral twist direction, tibial twist angle, and hindfoot femoral angle) in four orthopedic surgeons, expert or non-specialist in measurement and training.

Methods

Twenty-six renewed limbs from 13 patients with spastic diplegia undergoing femoral / tibial derotation osteotomy acquired preoperative grams for bilateral computed tomography (CT) to determine PT. Each measurement was performed by four orthopedic surgeons, two experienced clinicians, and Clinicians interpreting CT scans and two different stories with limited clinical and imaging evaluations. The images were blind and the surgeons made three measurements at least 5 days apart; three angles were measured daily for each limb. Differences between observers and between observers were determined on the basis of systematic error, standard deviation, and correlation coefficient between classes.

Results

Significant differences between observers and opinions between recognized experts and non-experts (mean variability: ICC experts: 0.88 ± 0.15; non-ICC experts: 0.91 ± 0.09). For non-specialists, there was an extravagant bias (25 ° and 14 °). The associated improvement in bias with additional measurement experience indicates a potentially larger learning curve in the interpretation of these studies. In fact, fewer observer differences were observed between the experts.

Conclusion

PT measurement is likely to be a reliable tool used by staff and are usedUse as a completely new preoperative instrument should be reserved for those experienced in such image evaluation. The information on the size of the laypersons showed poor agreement compared to the experts. End

Context

Deformities of inferior cerebral palsy (ICP) include increased anteversion of the femur and internal or lateral torsion of the tibia. The delay in the organo-physiological resolution of torsion is essentially the same as with an increase in motor tone. The persistence of various torsion of the bones of the lower extremities associated with abnormal motor reactions leads to dysfunction and deterioration of the work of medical workers. Anteversion angle of the femur> 50 ° correlates well with the General Program Functional Classification System (GMFCS) score [ 1 – 5 ].

Routine clinical laboratory x-rays for lower extremity twisting abnormalities, ultrasound, and possibly fluoroscopy may not provide sufficient evidence to determine whethersurgical procedures in carrying case for planned osteotomy correction [ 6 – 8 ]. Number of reviews (times) Computed tomography (CT) for determining rotational deformities of the penis in the lower limbs were very fit prior to surgery, but the accuracy of such estimates is inevitably not always documented [ 9 ].

As far as we know, there are no old reports comparing observer-observer fit when measuring torsion profiles with axial (tp) CT images at different stress levels in orthopedics. The goal of this master was to assess fit and accuracy between observers to determine errors between types of torsion angle of the femur (TFA), tibial opinion (TTA), and perspective of the femoral ankle (FAA)). the lower extremities provided by experienced or inexperienced orthopedic surgeons, and also determine the presence of a certain learning curve.

Methods

Our research was conducted in accordance with ethical standards emanating from all of Helsi The KK Declaration (1964) and subsequent amendments to it. The hospital’s Institutional Review Board recognition was issued in February this year, although PC is usually performed for preoperative decision making in patients with CP.

Inclusion criteria were diplegic patients who were candidates for lower limb osteotomy. All patients have just received computed tomography grams with an absolute multidirectional online computed tomography scanner (Somatomensaton Siemens, Germany) with a 5.5 mm section thickness. Patients are already supine with the kneecap just in front of the hips and the knee extended as much as possible. In this case, no sedatives were required. Lower limb braces were placed on the CT couch to hold the exam in position. The radiologist collected nearly every gram of computed tomography, concealed this patient information, and electronically recorded the images. Any examiner using DICOM has spectator proportions. Each computer scan was numbered and each one measured the imageBlind tapes three times on several occasions with at least 5 days between measurements. During each measurement, lines were drawn on tracing paper for calculation. The box was removed after each measurement. The placement round was selected by the client’s reviewer.

Each measurement was performed by four specialists in the field of orthopedic surgery, two clinicians and translators with experience in computed tomography (Expert 1 and 2), and a number of trained orthopedic surgeons; one is a resident in the first year and the other is a specific person in this last year of the program (non-specialists and 2 people).

• The TFA is actually the angle formed between a line through the center of the femoral knee and a tangent from one of the distal condyles of the posterior femur, and the designated angle of the femoral version.

• TTA is a special angle formed between the tangent to the posterior surface of the proximal plane of the tibial container and a line passing through a particular centralthe point of the tibia fibula, which connects to the ankles and represents the angle of the tibial version.

• 

  The FAA forms between the death line through the center of the thigh side and the line between the center of most tibial and peroneal ankles and denotes the angle of motion of the foot.

Variation within the observer was done using the Bland-Altam method [ 10 ], and the styles were calculated from the difference d ‘of a certain measure versus by the previous capacity, for example measure 1 against 2, 3 instead of 2 and 3 1 against beco bias

Donald Serrano