Osinga Rik, Estermann L, Klein H J, Schibli-Beer S, Jandali A R, Hug U
* Clinic for Hand and Plastic Surgery, Luzerner Kantonsspital, Lucerne, Switzerland.
† Department of Plastic, Reconstructive Aesthetic and Hand Surgery, University Hospital of Basel, Basel, Switzerland.
J Hand Surg Asian Pac Vol. 2019 Mar;24(1):13-16. doi: 10.1142/S2424835519500036.
Literature provides little and controversial evidence regarding the influence of ulnar variance (UV) on the incidence of scaphoid fractures. The aim of this retrospective study was to assess UV in a large number of patients with acute scaphoid fracture in comparison to a control group of the same population.
During a two year period, 182 patients with acute scaphoid fractures (fracture group) and 182 ethnicity-, gender- and age-matched patients with wrist contusions (control group) were treated in three non-university hospitals. Using standardized digital wrist radiographs, UV values were measured by means of the method of perpendiculars by two independent examiners. The UV values of the fracture group were then compared to the UV values of the control group.
Analyses of the agreement between the two raters resulted in a good to excellent inter-item correlation of 0.89, with a high intra-class coefficient of 0.93 (95% confidence interval: 0.87-0.95). Mean (SD) UV value was -0.82 mm (1.77) in the fracture group and 0.27 mm (1.44) in the control group. Paired sample t-test showed a significant difference between the two groups (p < 0.0001).
According to this study, patients with scaphoid fractures are significantly more likely to show a negative UV than matched patients with wrist contusions.
关于尺骨变异（UV）对舟骨骨折发生率的影响，文献提供的证据很少且存在争议。这项回顾性研究的目的是，与同一人群的对照组相比，评估大量急性舟骨骨折患者的尺骨变异情况。
在两年期间，三家非大学附属医院治疗了182例急性舟骨骨折患者（骨折组）和182例种族、性别和年龄匹配的腕部挫伤患者（对照组）。使用标准化的数字腕部X光片，由两名独立的检查人员通过垂直测量法测量尺骨变异值。然后将骨折组的尺骨变异值与对照组的尺骨变异值进行比较。
对两位评估者之间一致性的分析得出，项目间相关性良好至优秀，为0.89，组内系数较高，为0.93（95%置信区间：0.87 - 0.95）。骨折组的平均（标准差）尺骨变异值为-0.82毫米（1.77），对照组为0.27毫米（1.44）。配对样本t检验显示两组之间存在显著差异（p < 0.0001）。
根据这项研究，舟骨骨折患者出现负性尺骨变异的可能性明显高于匹配的腕部挫伤患者。
