Westbrook A P, Davis T R C
Department of Trauma, Queen's Medical Centre, University Hospital, Nottingham, UK.
J Hand Surg Eur Vol. 2007 Dec;32(6):641-6. doi: 10.1016/J.JHSE.2007.09.006. Epub 2007 Oct 29.
This study assessed the reliability, responsiveness and validity of two clinical measurements for the assessment of malunion of little finger metacarpal neck and shaft fractures. Both compared the relative lengths of the ring and little fingers in the injured and contralateral hands. One measurement was taken with the metacarpophalangeal joints extended (straight-MCP), and the other with them flexed to 90 degrees (90-MCP). Ninety-five percent of the differences between the relative lengths of the ring and little fingers in the two hands of 50 normal subjects were less than 3mm and the 95% limits of agreement for repeat measurements (intra-observer reproducibility) was +/- 1 mm for both measurements. Both measurements were significantly altered in a group of 218 patients with a past history of a metacarpal shaft or neck fracture. Although both measurements correlated with the patient's assessment of the cosmetic result (p = 0.01), neither measurement correlated with the severity of palmar angulation of the fracture at presentation. It is concluded that these measurements are reliable and responsive, but their validity is uncertain.
本研究评估了两种临床测量方法在评估小指掌骨颈和骨干骨折畸形愈合方面的可靠性、反应性和有效性。两种方法均比较了患手和对侧手中环指和小指的相对长度。一种测量是在掌指关节伸展时（伸直-掌指关节）进行，另一种是在掌指关节屈曲至90度时（90-掌指关节）进行。50名正常受试者双手中环指和小指相对长度差异的95%小于3mm，两种测量方法重复测量的95%一致性界限（观察者内再现性）均为±1mm。在一组218例有掌骨干或颈骨折既往史的患者中，两种测量均有显著改变。虽然两种测量均与患者对美容效果的评估相关（p = 0.01），但两种测量均与骨折初诊时掌侧成角的严重程度无关。结论是这些测量方法可靠且有反应性，但它们的有效性尚不确定。
