title: Visual estimation of pro-supination angle is superior to wrist or elbow angles.
abstract: OBJECTIVE
  To examine our hypothesis that the accuracy of visual estimation, while measuring the angles of forearm, wrist and elbow, may vary between the different angles, and that this may depend on the experience of the observer.
  
  
  METHODS
  A slide show comprising of clinical photos and radiographs of different elbow, forearm and wrist angles was presented to 164 attending orthopedic surgeons, orthopedic residents and medical students who made a visual estimation of the different joints' angles.
  
  
  RESULTS
  Forearm pronation was found to be estimated most accurately (mean 6.1°) while radiographs of wrist flexion (mean 12°) and photos of wrist extension (mean 16°) were estimated the least accurately. Specialists estimated angles more accurately than residents and both were more accurate than students, regardless of the estimated joint.
  
  
  CONCLUSIONS
  The accuracy of visual estimation of a joint's angle depends on the specific joint viewed. Experience in the practice of orthopedic surgery (and not only upper extremity surgery) will improve the accuracy of estimation in general. Regarding the elbow, forearm and wrist, the results of our study suggest that a goniometer should be used whenever an accuracy of up to 10° is important, and for measuring wrist flexion and extension.
authors.affiliation: Hadassah-Hebrew University Medical Center - Orthopedic Surgery , Jerusalem , Israel.
authors.forename: Shai
authors.initials: S
authors.lastname: Luria
authors.forename: Elad
authors.initials: E
authors.lastname: Apt
authors.forename: Leonid
authors.initials: L
authors.lastname: Kandel
authors.forename: Tali
authors.initials: T
authors.lastname: Bdolah-Abram
authors.forename: Gershon
authors.initials: G
authors.lastname: Zinger
mesh_terms: D053587:Arthrometry, Articular / Q000379:methods*; D002983:Clinical Competence; D004550:Elbow; D004551:Elbow Joint; D005542:Forearm; D006801:Humans; D009068:Movement; D015588:Observer Variation; D010820:Physicians; D011403:Pronation; D016059:Range of Motion, Articular; D012044:Regression Analysis; D013337:Students, Medical; D013484:Supination; D014953:Wrist; D014955:Wrist Joint
keywords: Range of motion; elbow flexion; forearm rotation; joint angle; visual estimation; wrist extension; wrist flexion