Feasibility of Ultrasound-based Measurement of the Intra-scaphoid Using a Three-point Measurement Technique - 06/08/24
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Highlights |
• | We described the inter-poles distance (IPD) and the palmar cortical intra-scaphoid angle (PCISA), as two sonographic measurements of the scaphoid alignment. |
• | This technique is easy to perform, is cost-effective, accessible and radiation-free. |
• | There is moderate to good correlation for PCISA and good to excellent correlation for IPD between the investigators. |
• | There is a fair to moderate correlation for IPD and moderate to good correlation for PCISA in between evaluators. |
Abstract |
Introduction |
Ultrasound is gaining popularity for diagnosing scaphoid fractures. However, it hasn't been used to assess fracture displacement, such as humpback deformity. We propose a sonographic method to measure the intra-scaphoid angle, potentially serving as an alternative to CT scans for detecting fragment malposition after a scaphoid fracture.
Methods |
We recruited 11 healthy adult volunteers without wrist pathology and performed bilateral wrist ultrasounds, totaling 22 examinations. Each wrist was splinted at 50 ° extension and fully supinated. Two hand surgeons independently performed the ultrasounds. All images were then evaluated separately by two evaluators.
The following measurements were taken:
Inter-poles distance (IPD): Distance between the summits of the two scaphoid poles on the palmar cortex.
Palmar cortical intra-scaphoid angle (PCISA): Angle between the two summits and the deepest point of the waist on the palmar cortex.
Measurements were compared for inter-investigator and inter-evaluator reliability using the intraclass correlation coefficient (ICC).
Results |
The study included four males and seven females, with an average age of 35 years (range 21-56). The mean PCISA was 142 ° (SD 10 °) and the mean IPD was 16.3 mm (SD 2.1 mm). Differences in IPD measurements averaged 0.3 mm (range 0 to 5.2 mm) among investigators and 1.0 mm (range 0.1 to 3.8 mm) among evaluators. For PCISA, the differences averaged 4 ° (range 0 to 17 °) among investigators and 6 ° (range 0 to 15 °) among evaluators. The ICC for IPD was 0.804 (investigators) and 0.572 (evaluators); for PCISA, it was 0.704 (investigators) and 0.602 (evaluators).
Conclusion |
This study presents a cost-effective and accessible sonographic technique to measure the intra-scaphoid angle. Further research is required to assess its effectiveness in scaphoid fractures and compare it to CT-based measurements like the H/L ratio, LISA, and DCA.
Le texte complet de cet article est disponible en PDF.Keywords : Sonographic measurement, Ultrasound, Scaphoid fracture, Scaphoid, Scaphoid non-union, Humpback deformity, Diagnostic accuracy
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