Holzgrefe Russell E, Anastasio Albert T, Farley Kevin X, Daly Charles A, Mason Amadeus R, Gottschalk Michael B
Department of Orthopaedic Surgery, Emory University School of Medicine, Altanta, GA, USA.
J Hand Surg Eur Vol. 2019 Oct;44(8):800-804. doi: 10.1177/1753193419863412. Epub 2019 Jul 23.
This study investigated the sensitivity, specificity, and accuracy of physical examination compared with high resolution sonography for the detection of the palmaris longus tendon in 136 wrists. The incidence of tendon absence was 10% by sonography and 14% by physical examination. The sensitivity of the physical examination was 94% and the specificity 86% compared with sonography as the reference standard. Accurate identification of the palmaris longus tendon through physical examination was not influenced by body mass index or wrist circumference. Upon review of the sonography images, none of the palmaris longus tendons missed on physical examination were considered to be adequate for grafting based on expert opinion. While physical exam was 93% accurate for detection of the palmaris longus tendon compared with ultrasound, our study suggests that it is sufficient for detection of those tendons that can be used as donors clinically.
本研究调查了在136例手腕中，体格检查与高分辨率超声检查相比，用于检测掌长肌腱的敏感性、特异性和准确性。超声检查显示肌腱缺失的发生率为10%，体格检查为14%。以超声检查作为参考标准，体格检查的敏感性为94%，特异性为86%。通过体格检查准确识别掌长肌腱不受体重指数或腕围的影响。回顾超声图像，根据专家意见，体格检查漏诊的掌长肌腱均不适合用于移植。虽然与超声检查相比，体格检查检测掌长肌腱的准确率为93%，但我们的研究表明，对于临床上可作为供体的肌腱检测而言，体格检查已足够。
