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Martanto TW, Rizal Y, Irwanto, Sentono SB, Setiawati R, Utomo SA, Gunawan PI, Wardani NK, Nastiti PH, Widodo RA, Park MS, Zulkarnain A, Yazid H, Kumara HC, Kitta MI. Validity of measurement of femoral anteversion angle using FEMORA® software based on two-dimensional radiographic imaging examination femur in children with cerebral palsy in Indonesia. Heliyon 2023; 9:e22243. [PMID: 38045176 PMCID: PMC10692889 DOI: 10.1016/j.heliyon.2023.e22243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 12/05/2023] Open
Abstract
Introduction Children with spastic cerebral palsy (CP) often show an increase in femoral anteversion angle (FAA). Computed tomography (CT) scan is the main modality for evaluating FAA in these patients, however, due to significant radiation exposure, it carries a high carcinogenic risk. FEMORA® software is expected to be able to accurately assess FAA even with conventional X-ray images that only require low radiation exposure. However, its validity has not been tested in various populations or CT devices. This study aimed to validate the FEMORA® software by comparing it to CT scans done on an Indonesian population. Material and methods All spastic CP patients of the outpatient clinic at Dr. Soetomo Hospital between March and November 2022, were included. The FEMORA® Software evaluation was performed by three examiners. The calculation results were averaged and compared with those of the CT scan. Intraclass correlation coefficient (ICC), reliability, and correlation were be assessed. Results There were 36 patients included in this study. Most were female (n = 22; 61,1 %) and the average age was 7,28 years old. Interobserver preoperative analysis using ICC showed good outcomes (p = 0.918; 95 % CI, 0.858-0.955). FAA measurement results using FEMORA® and CT scans were 41,71 ± 12,90 and 32,68 ± 11,85, respectively. Correlation coefficient between the two values is 0.634 (p < 0.001). Conclusion FEMORA® software demonstrates a good and significant correlation with FAA measurement using CT scan.
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Affiliation(s)
- Tri Wahyu Martanto
- Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Airlangga/ Dr. Soetomo General Academic Hospital, Surabaya 60286, Indonesia
| | - Yusuf Rizal
- Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Airlangga/ Dr. Soetomo General Academic Hospital, Surabaya 60286, Indonesia
| | - Irwanto
- Department of Child Health, Faculty of Medicine, Universitas Airlangga/ Dr. Soetomo General Academic Hospital, Surabaya 60131, Indonesia
| | - Sulis Bayu Sentono
- Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Airlangga/ Dr. Soetomo General Academic Hospital, Surabaya 60286, Indonesia
| | - Rosy Setiawati
- Department of Radiology, Faculty of Medicine, Universitas Airlangga/ Dr. Soetomo General Academic Hospital, Surabaya 60131, Indonesia
| | - Sri Andreani Utomo
- Department of Radiology, Faculty of Medicine, Universitas Airlangga/ Dr. Soetomo General Academic Hospital, Surabaya 60131, Indonesia
| | - Prastiya Indra Gunawan
- Department of Child Health, Faculty of Medicine, Universitas Airlangga/ Dr. Soetomo General Academic Hospital, Surabaya 60131, Indonesia
| | - Nurul Kusuma Wardani
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Universitas Airlangga/ Dr. Soetomo General Academic Hospital, Surabaya 60131, Indonesia
| | - Prima Hari Nastiti
- Department of Child Health, Faculty of Medicine, Universitas Airlangga/ Dr. Soetomo General Academic Hospital, Surabaya 60131, Indonesia
| | - Rachmat Agung Widodo
- Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Airlangga/ Dr. Soetomo General Academic Hospital, Surabaya 60286, Indonesia
| | - Moon Seok Park
- Department of Orthopaedic Surgery, Seoul National University College of Medicine/Seoul National University Bundang Hospital, Sungnam, Gyeonggi, South Korea
| | - Arif Zulkarnain
- Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Airlangga/ Dr. Soetomo General Academic Hospital, Surabaya 60286, Indonesia
| | - Hizbillah Yazid
- Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Airlangga/ Dr. Soetomo General Academic Hospital, Surabaya 60286, Indonesia
| | - Hendra Cahaya Kumara
- Department of Orthopaedic and Traumatology, Prof. Dr. R. Soeharso Orthopaedic Hospital, Sebelas Maret University, Surakarta 57126, Indonesia
| | - Muhammad Ihsan Kitta
- Department of Orthopaedic Surgery, Muhammadiyah University of Makassar, Makassar 90221, Indonesia
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