[A holder for standardized radiological detection of ulnar capsule-ligament lesions of the thumb base joint].
OBJECTIVE
To evaluate the usefulness of a self-constructed holding device for standardized, investigator-independent radiodiagnostics for ulnar capsulo-ligamentous lesions of the thumb metacarpophalangeal joint compared to the uninjured side.


METHODS
A holding device for stress roentgenograms was constructed. Normal abduction arcs were evaluated in 20 degrees flexion in 28 healthy volunteers. The investigator-dependent variance was assessed. The study group comprised 123 consecutive patients (68 male, 55 female, aged 7 to 68 years, mean age 30 years).


RESULTS
The normal arc of abduction was calculated to be 12 degrees (range 3 degrees to 24 degrees), while the mean individual difference in side by side comparison in volunteers was 0.3 degree (SD 2.69 degrees, range 0 degree-8 degrees). A rupture was diagnosed in 47 patients; 41 were operated. The preoperative diagnoses confirmed correct in all operated patients. A difference of greater than 6 degrees is indicative of a rupture with a sensitivity of 66.7% and a specificity of 96.9%.


CONCLUSIONS
In summary, the holding device is useful for the practical work. Individual differences of less than 4 degrees are negative, between 4 degrees and 7 degrees questionable positive, between 7 degrees and 12 degrees are positive and over 12 degrees proof indicator of a rupture of the ulnar collateral ligament of the thumb metacarpophalangeal joint.
Schnabel
M
M
Klinik für Unfallchirurgie, Zentrum für Operative Medizin, Klinikum der Philipps-Universität Marburg, Baldingerstrasse, 35043 Marburg an der Lahn. schnabem@mailer.uni-marburg.de
Alfke
H
H
Kurtz
C
C
Walthers
E M
EM
Gotzen
L
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004867:Equipment Design; D005260:Female; D006801:Humans; D007103:Immobilization; D008023:Ligaments, Articular / Q000000981:diagnostic imaging / Q000293:injuries*; D008297:Male; D008662:Metacarpophalangeal Joint / Q000000981:diagnostic imaging / Q000293:injuries*; D008875:Middle Aged; D011859:Radiography; D012016:Reference Values; D013933:Thumb / Q000000981:diagnostic imaging / Q000293:injuries*