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目的对3种不同虎口测量方法进行可信度研究,并获得1.5~3岁幼儿虎口大小的正常范围。方法选取1.5~3岁,于我科治疗的100例患儿,平均年龄(24.2±5.1)个月,男64例,女36例,其中包括80例一侧复拇畸形,20例一侧拇指狭窄性腱鞘炎,术前由同1名手外科医生测量其双侧虎口,分别采用Cambridge-Keeling法测量虎口距离、Murugkar法测量第1、2掌骨头间距及第1、2掌骨间夹角,选取健侧数据,计算各均值。对其中40例由另1名手外科医生术前进行复测,2人均独立完成测量,以评价3种测量方法可信度。结果 Cambridge-Keeling法测量的虎口距离健侧均值为(2.60±0.31)cm,正常值范围为1.98~3.22 cm,不同性别(t=1.552,P=0.125)、手别间(t=0.304,P=0.762)差异无统计学意义;Murugkar法测量第1、2掌骨头间距健侧均值为(3.46±0.30)cm,正常值范围为2.86~4.06 cm,男大于女(t=2.117,P=0.038),不同手别间差异无统计学意义(t=0.591,P=0.556);第1、2掌骨间夹角健侧均值为(43.43±3.43)°,正常值范围为36.57°~50.29°,不同性别(t=0.630,P=0.531)、手别间(t=0.588,P=0.559)亦差异无统计学意义。Cambridge-Keeling法测量健侧虎口距离、Murugkar法测量健侧第1、2掌骨头间距及第1、2掌骨间夹角观察者间相关系数(ICC)分别为0.74、0.80及0.71。结论 Cambridge-Keeling法测量虎口距离、Murugkar法测量第1、2掌骨头间距及第1、2掌骨间夹角适用于低龄幼儿评估虎口大小;测量第1、2掌骨头间距可信度最好。
OBJECTIVE To study the credibility of three different methods of measuring the tiger’s mouth and to get the normal range of tiger’s mouth size of 1.5-3 year old children. Methods One hundred and fifty children were enrolled in this study. The average age was (24.2 ± 5.1) months. There were 64 males and 36 females, including 80 cases of one side deformity and 20 cases of one side thumb Stenosing tenosynovitis. One tiger surgeon measured the bilateral tiger’s mouth preoperatively, using the Cambridge-Keeling method to measure the tiger’s mouth distance. Murugkar’s method measured the distance between the first and second metacarpal heads and the first and second metacarpal joints. Side data, calculate each mean. 40 of them were retested preoperatively by another hand surgeon, and 2 of them independently completed the measurement to evaluate the reliability of the 3 measurement methods. Results The Cambridge-Keeling test showed that the distance between the two sides of the tiger’s mouth was (2.60 ± 0.31) cm and the normal range was 1.98 to 3.22 cm (t = 1.552, P = 0.125) = 0.762). There was no statistically significant difference between the two groups (3.46 ± 0.30) cm, normal range of 2.86 ~ 4.06 cm and male over female (t = 2.117, P = 0.038 (T = 0.591, P = 0.556). The mean contralateral angle of the first metacarpal was (43.43 ± 3.43) ° and the normal range was 36.57 ° ~ 50.29 ° There was no significant difference between the sexes (t = 0.630, P = 0.531) and between the hands (t = 0.588, P = 0.559) The Cambridge-Keeling method was used to measure the distance between the healthy side and the tiger’s foot. The Murugkar’s method was used to measure the interobserver agreement (ICC) between the first and second metacarpal bones and the first and second metacarpal at 0.74, 0.80 and 0.71, respectively. Conclusions The Cambridge-Keeling method was used to measure the distance of the tiger’s mouth. Murugkar’s method was used to measure the distance between the first and second metacarpal heads and the first and second metacarpal angles. The confidence of the first and second metacarpal heads was the best.