Kato Masami, Echigo Ayumu, Ohta Hisaaki, Ishiai Sumio, Aoki Mitsuhiro, Tsubota Sadako, Uchiyama Eiichi
Department of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan.
J Hand Ther. 2007 Jan-Mar;20(1):12-8; quiz 19. doi: 10.1197/j.jht.2006.11.015.
This study evaluates the accuracy of goniometric measurement of fixated proximal interphalangeal (PIP) joints using fresh cadavers. Sixteen fingers in four right hands were evaluated. Angles of PIP joints obtained by three examiners, two methods (lateral, dorsal), three goniometers (plastic A, B, and a metal model), and four different fingers were compared for the accuracy of measurement. The difference of angles obtained from goniometric measurement and x-ray films of cadaver fingers was defined as "angle discrepancy." Analysis of interrater reliability proved that there was a high correlation coefficient between examiners. With the lateral method, no statistically significant difference in angle discrepancy between goniometers was observed. On the other hand, with the dorsal method, the angle discrepancy of plastic A was statistically significantly greater than plastic B in the results of two examiners (p<0.05). In both lateral and dorsal methods, the angle discrepancy of the index and ring fingers is statistically significantly greater than that of the middle and little fingers. We recommend use of the lateral method with any of the three goniometers for measurement of PIP range of motion. Goniometers with short arms are considered to be suitable for the dorsal method.
本研究使用新鲜尸体评估固定的近端指间关节(PIP)关节角度测量的准确性。对四只右手的16根手指进行了评估。比较了由三名检查者、两种方法(外侧、背侧)、三种角度测量仪(塑料A、B和金属模型)以及四个不同手指所获得的PIP关节角度测量的准确性。角度测量仪测量结果与尸体手指X线片之间的角度差异定义为“角度偏差”。检查者间可靠性分析证明检查者之间存在较高的相关系数。采用外侧法时,角度测量仪之间的角度偏差无统计学显著差异。另一方面,采用背侧法时,在两名检查者的结果中,塑料A的角度偏差在统计学上显著大于塑料B(p<0.05)。在外侧和背侧两种方法中,示指和环指的角度偏差在统计学上均显著大于中指和小指。我们建议使用三种角度测量仪中的任何一种采用外侧法测量PIP关节活动范围。短臂角度测量仪被认为适用于背侧法。