Zhu Tong,Zheng Haolin,Jia Guoqiang,et al.Inter/intra-observer reliability of evaluating femoral shaft fracture healing in children through Modified Radiographic Union Score for Tibial Fractures (MRUST)[J].Journal of Clinical Pediatric Surgery,2023,22(06):533-537.[doi:10.3760/cma.j.cn101785-202206041-007]
改良胫骨骨折X线愈合评分系统评价儿童股骨干骨折愈合的可信度及可重复性研究
- Title:
- Inter/intra-observer reliability of evaluating femoral shaft fracture healing in children through Modified Radiographic Union Score for Tibial Fractures (MRUST)
- Keywords:
- Modified Radiographic Union Score for Tibial fractures (MRUST); Femoral Shaft Fractures; Radiography; Fracture Healing; Treatment Outcome; Reproducibility of Results; Child
- 摘要:
- 目的 探讨改良胫骨骨折X线愈合评分系统（modified radiographic union score for tibial fractures，MRUST）评价儿童股骨干骨折愈合的可信度及可重复性，为儿童股骨干骨折手术后骨愈合的评估与负重管理提供理论依据。方法 本研究为回顾性研究，收集中国医科大学附属盛京医院2012年1月至2021年1月收治的45例儿童股骨干骨折弹性稳定髓内针（elastic stable intramedullary nailing，ESIN）固定术后4~8周的正位及侧位股骨X线片。共收集到45组正位及侧位X线片，由3名观测者使用MRUST分别进行3次评分。采用95%置信区间（95%CI）的组内相关系数（intraclass correlation coefficient，ICC）评价观测者内和观测者间MRUST评分的一致性。结果 本组45例MRUST评分为（9.02±1.94）分，范围为4~12分。总体ICC评分为0.81（95%CI：0.74~0.88）。在3次观测中，3名观测者之间一致性评价较强或强，ICC评分分别为0.74（95%CI：0.62~0.84）、0.88（95%CI：0.82~0.93）和0.88（95%CI：0.81~0.92）。每名观测者的观测值平均后，3名观测者之间一致性评价强，ICC为0.92（95%CI：0.88~0.95）。3名观测者内一致性评价为较强或强，ICC分别为0.93（95%CI：0.89~0.96）、0.78（95%CI：0.68~0.87）和0.73（95%CI：0.60~0.83）。每次3名医师的观测值平均后，3名观测者内一致性评价为强，ICC为0.89（95%CI：0.83~0.94）。结论 MRUST评分系统评价儿童股骨干骨折ESIN治疗后骨愈合情况，可信度及可重复性好，这为儿童股骨干骨折的愈合评估及负重管理提供了理论依据。
- Abstract:
- Objective To assess inter/intra-observer reliability of evaluating femoral shaft fracture healing in children through Modified Radiographic Union Score for Tibial Fractures (MRUST) and provide theoretical rationales for weight-bearing management and bone healing after femoral shaft fractures in children.Methods A total of 45 sets (i.e.AP & lateral) of radiographs of femoral shaft fractures in children treated by elastic stable intramedullary nailing (ESIN) within 4-8 weeks post-operation were scored thrice.The intraclass correlation coefficient (ICC) with 95% confidence intervals was utilized for quantifying inter/intra-observer agreement of MRUST score.Results RUST scores of all 45 radiographs were measured.The values of MRUST score ranged from 4 to 12 with a mean score of 9.02[standard deviation (SD) 1.94].The overall ICC score was 0.81 (95%CI, 0.74 to 0.88).Among three observers, inter-observer agreement was strong with ICC of 0.74 (95%CI, 0.62-0.84), 0.88 (95%CI, 0.82 to 0.93) and 0.88 (95%CI, 0.8 to 0.92).After averaging the observations of observers, inter-observer agreement was strong with ICC of 0.92 (95%CI, 0.88 to 0.95).The intra-observer agreement was strong with ICC of 0.93 (95%CI, 0.89 to 0.96), 0.78 (95%CI, 0.68 to 0.87) and 0.73 (95%CI, 0.60 to 0.83).After averaging the observations of observers, the agreement of intra-observer was strong with ICC of 0.89 (95%CI, 0.83 to 0.94).Conclusion With excellent inter/intra-observer reliability agreements in evaluating femoral shaft fracture healing in children, MRUST scoring system provides theoretical rationales for weight-bearing management and bone healing.
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备注/Memo
收稿日期:2022-06-16。
通讯作者:王恩波,Email:wangenbodor@163.com