Feipel V, Rinnen D, Rooze M
Laboratory for Functional Anatomy, University of Brussels (CP 619), Belgium.
Surg Radiol Anat. 1999;21(3):207-13. doi: 10.1007/BF01630903.
A normal database of qualitative and quantitative data, obtained from standard posteroanterior wrist radiographs has been established which might be useful in clinical practice. Variations in the parameters obtained could provide an explanation for the variable carpal kinematics and multiple concepts of carpal instability described in the literature. Selected landmarks were digitized on 80 posteroanterior wrist radiographs of asymptomatic volunteers. Besides classical parameters, measurement of carpal dimensions and angular relationships were also taken. Two new parameters, the scapholunate ratios, are described which evaluate the relative lengths of the frontal projections of the scaphoid and lunate: these ratios might prove useful in the diagnosis of carpal instability. The shapes of the frontal projections of the radiocarpal, midcarpal and STT joint spaces were also analysed. Average values for parameters already reported in the literature agreed with previous findings. Some parameters, however, displayed important individual variations, the standard deviations ranging from 1 to 3 mm for dimensions and from 3 to 13 degrees for angular measurements. The posteroanterior and anteroposterior scapholunate ratios averaged 1.41 +/- 0.21 and 0.66 +/- 0.13 respectively. The potential clinical benefit of these ratios is discussed. Different types of joint space projection shapes could be determined. With respect to the difficulty of obtaining reliable lateral wrist radiographs, compared to posteroanterior radiographs, it is suggested that the clinical significance of the proposed parameters must be evaluated.
已经建立了一个从标准腕关节后前位X线片获得的定性和定量数据的正常数据库，这可能在临床实践中有用。所获得参数的变化可以解释文献中描述的腕骨运动学的变异性和腕骨不稳定的多种概念。在80名无症状志愿者的腕关节后前位X线片上对选定的标志点进行数字化处理。除了经典参数外，还测量了腕骨尺寸和角度关系。描述了两个新参数，即舟月比率，用于评估舟骨和月骨额状面投影的相对长度：这些比率可能对腕骨不稳定的诊断有用。还分析了桡腕关节、腕中关节和舟大多角关节间隙额状面投影的形状。文献中已报道的参数的平均值与先前的研究结果一致。然而，一些参数显示出重要的个体差异，尺寸的标准差为1至3毫米，角度测量的标准差为3至13度。舟月比率的后前位和前后位平均值分别为1.41±0.21和0.66±0.13。讨论了这些比率潜在的临床益处。可以确定不同类型的关节间隙投影形状。鉴于与腕关节后前位X线片相比，获得可靠的腕关节侧位X线片存在困难，建议对所提出参数的临床意义进行评估。
