Wolf Jennifer Moriatis, Schreier Star, Tomsick Scott, Williams Allison, Petersen Brian
Department of Orthopaedic Surgery, University of Colorado-Denver, and the Division of Nursing/Research, Denver Veterans Administration Medical Center, Denver, CO, USA.
J Hand Surg Am. 2011 Jul;36(7):1165-9. doi: 10.1016/j.jhsa.2011.03.017. Epub 2011 May 7.
Increased joint laxity has been associated with the risk of ligament injury and development of osteoarthritis in large joints such as the knee, but this has not been investigated in depth in the hand. We hypothesized that generalized joint laxity would correlate with radiographic measures of trapeziometacarpal (TM) joint subluxation, as measured in carpometacarpal stress view radiographs.
We recruited volunteer subjects of all ages and examined them for generalized laxity using the Beighton-Horan index. A total of 163 subjects, 81 men and 82 women, with an average age of 48 years (range, 20-83 y), were examined. Each subject underwent a stress view radiograph of both TM joints using a previously described technique. Different examiners independently measured radial subluxation of the thumb metacarpal over the trapezium and the articular width of the thumb metacarpal and averaged them. The ratio of the radial subluxation to the articular width was calculated as a measure of radiographic TM laxity.
The average Beighton score was 2 (range, 0-9). A total of 40 subjects had Beighton scores greater than 4. The mean stress view ratio was 0.31 (range, 0.06-0.58). When we calculated the Pearson correlation coefficient to assess the relationship between the stress view ratio and the Beighton score, a statistically significant correlation was demonstrated.
In normal volunteers generalized joint laxity is positively correlated with increased mobility of the TM joint, as demonstrated on carpometacarpal stress view radiographs.
TYPE OF STUDY/LEVEL OF EVIDENCE: Diagnostic I.
关节松弛度增加与膝关节等大关节韧带损伤及骨关节炎的发生风险相关，但手部情况尚未得到深入研究。我们推测，掌骨应力位X线片测量的广泛性关节松弛度与大多角骨-第一掌骨（TM）关节半脱位的影像学测量值相关。
我们招募了各年龄段的志愿者，使用贝顿-霍兰指数检查他们的广泛性关节松弛度。共检查了163名受试者，其中81名男性和82名女性，平均年龄48岁（范围20 - 83岁）。每位受试者使用先前描述的技术接受双侧TM关节的应力位X线片检查。不同的检查者独立测量第一掌骨在大多角骨上的桡侧半脱位以及第一掌骨的关节宽度，并计算平均值。计算桡侧半脱位与关节宽度的比值作为TM关节影像学松弛度的指标。
贝顿评分的平均值为2（范围0 - 9）。共有40名受试者的贝顿评分大于4。应力位X线片比值的平均值为0.31（范围0.06 - 0.58）。当我们计算皮尔逊相关系数以评估应力位X线片比值与贝顿评分之间的关系时，显示出具有统计学意义的相关性。
在正常志愿者中，如掌骨应力位X线片所示，广泛性关节松弛度与TM关节活动度增加呈正相关。
研究类型/证据水平：诊断性研究I级
