The intermetacarpal angle screening test for ulnar-sided carpometacarpal fracture-dislocations.
J Hand Surg Am
; 37(9): 1839-44, 2012 Sep.
Article
em En
| MEDLINE
| ID: mdl-22854252
ABSTRACT
PURPOSE:
Ulnar-sided carpometacarpal injuries can be difficult to diagnose radiographically. We hypothesized that the resting position of the normal hand during lateral radiography provides a consistent relationship between the rays and that dorsal subluxation of the metacarpal base in fracture-dislocations increases the angle between the uninjured index and long metacarpals and the injured small metacarpal.METHODS:
A control group of 100 consecutive patients with normal hand radiographs and a series of 12 patients with known carpometacarpal fracture-dislocations were examined. Angles between the index and small metacarpal shaft (I-S IMA) and between the long and small metacarpal shaft (L-S IMA) were measured on the lateral hand radiograph.RESULTS:
In the control group, the mean I-S IMA and L-S IMA were both 6°. In the study group, the mean I-S IMA was 18°, and the mean L-S IMA was 16°. Intraobserver and interobserver reliability was good to excellent for both groups, and a statistical difference existed between the normal and study groups. Based on box-plot analysis of normal and abnormal IMAs, a natural dividing line existed at 10°. With this dividing line, the I-S IMA had a sensitivity of 92% and a specificity of 81%, and the L-S IMA had a sensitivity of 83% and a specificity of 84%.CONCLUSIONS:
Both the I-S IMA and the L-S IMA were useful screening measurements on lateral hand radiographs for detection of ulnar-sided carpometacarpal fracture-dislocations. When evaluating posttraumatic ulnar-sided hand pain, advanced imaging should be considered if the I-S IMA or the L-S IMA is greater than 10°.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Programas de Rastreamento
/
Luxações Articulares
/
Hamato
/
Articulações Carpometacarpais
/
Fraturas Intra-Articulares
/
Traumatismos da Mão
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Screening_studies
Limite:
Adult
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
J Hand Surg Am
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
Estados Unidos