Seoul National University Bundang Hospital Seoul National University Children’s Hospital *

Download Seoul National University Bundang Hospital Seoul National University Children’s Hospital *

Post on 23-Feb-2016

52 views

Category:

Documents

0 download

Embed Size (px)

DESCRIPTION

Validity and Reliability of measuring femoral anteversion and neck-shaft angle in patients with cerebral palsy. Seoul National University Bundang Hospital Seoul National University Childrens Hospital *. Introduction. - PowerPoint PPT Presentation

TRANSCRIPT

1

Validity and Reliability of measuring femoral anteversion and neck-shaft angle in patients with cerebral palsySeoul National University Bundang HospitalSeoul National University Childrens Hospital *

1IntroductionIncreased femoral anteversion and coxa valga are common deformities associated with intoeing gait and unstable hips in CP, which need surgical correctionPhysical examination and neck shaft angle measured on hip radiographs are primary tools evaluating femoral anteversion and coxa valgaIntroductionPhysical examinations measuring femoral anteversion includeTrochanteric prominence angle test (TPAT)Hip internal rotation (IR)Hip external rotation (ER)CT measurement is accurate, but expensive and involves radiation exposure

Purpose of StudyTo assess the validity and reliability of physical examinations measuring femoral anteversion and neck shaft angle measured on hip AP radiographsConcurrent validityIntra- and interobserver reliabilityMaterials and methodsProspective study approved by IRB36 consecutive patients with CP scheduled for SEMLSMean age 11.0 years (SD 1.3)M : F = 26 : 106 hemiplegia, 25 diplegia, and 5 quadriplegiaGMFCS I / II / III / IV / V 5 / 11 / 11 / 7 / 2ExclusionPrevious Op, trauma, infection, etc.

TPAT

It is the angle between a vertical line and the long axis of the leg when the prominence of the greater trochanter is palpated in its most lateral position.6Hip IR

Hip ER

NSA on X ray

taken with both hips internally rotated.9Femoral AV on CT

Standard method for concurrent validity of P/EFemoral anteversion on 2D CT was measured according to Murphys technique. This was used as a standard method for concurrent validity.10NSA on CT

Standard method for concurrent validity of NSA on X-ray11ValidityPhysical exam measuring femoral AVCorrelation with femoral anteversion measured on 2D CT

NSA measured on X rayCorrelation with NSA measured on 3D MPR CT imageValidity of physical examination and neck shaft angle on X-ray was obtained by correlating those with CT measurements12ReliabilityInterobserver reliability of physical exam using three orthopaedic surgeons on a single day

Intra- and interobserver reliability of NSA on X- rayRepeated measurements with an interval of 3 wks

StatisticsValidityPearsons correlation coefficientsReliabilityIntraclass correlation coefficients (ICCs)2 way random effects, single measurement & absolute agreementMultiple regression testTo predict the accurate femoral anteversion (CT) from physical examResultsSummary of MeasurementsExamiationMean (deg)SD (deg)Range (deg)TPAT4017-20 to 70Hip IR601710 to 85Hip ER381410 to 70Femoral AT on CT3618-26 to 73NSA on X ray14210119 to 169NSA on CT1398118 to 16216Concurrent Validity of Physical exam and NSA on X rayExaminationsR valuep-valueTPAT0.862

Recommended

View more >