Faculty of Medicine, Johannes Kepler University Linz, Linz, Austria.
Department for Trauma Surgery and Sport Traumatology, Kepler University Hospital Linz, Linz, Austria.
J Plast Surg Hand Surg. 2021 Feb;55(1):41-47. doi: 10.1080/2000656X.2020.1828899. Epub 2020 Oct 6.
The current study aims to assess the reliability of 6 range-of-motion measurement methods for the thumb carpometacarpal joint: Pollexograph-thumb, Pollexograph-metacarpal, radius-metacarpal goniometry, intermetacarpal goniometry, intermetacarpal distance, and thumb-distal-interphalangeal distance. A senior hand surgeon, an experienced resident, and a less experienced research fellow evaluated the dominant hands of 29 healthy subjects. All 6 methods were performed for radial adduction, radial abduction, and palmar abduction, but only distance methods were measured for palmar adduction. Intrarater and interrater reliability were computed using intraclass correlation coefficient, standard error of measurement, and smallest detectable difference. Pollexograph-thumb method showed the highest active range of movement for radial adduction (12°) and abduction (71°), while all the other angular methods resulted in approximately 20° for radial adduction and 50° for radial abduction. Distance methods showed comparable mean results for radial and palmar range of motion (adduction/abduction): intermetacarpal distance (50 mm/60 mm) and thumb-distal-interphalangeal distance (50 mm/120 mm). Interrater reliability using the results of the intraclass correlation coefficient demonstrates that Pollexograph-thumb and Pollexograph-metacarpal showed excellent reliability for radial adduction and abduction, whereas Pollexograph-thumb method revealed the best reliability for palmar abduction. Moreover, thumb-distal-interphalangeal distance also showed excellent reliability for radial and palmar abduction. Conventional goniometry showed a large variety of reliability results, ranging from poor to excellent. No clinical benefit can be derived from assessing the palmar adduction. We found that the Pollexograph-thumb showed excellent reliability results throughout all measurements. Thumb-distal-interphalangeal-joint distance is especially valuable for assessing radial and palmar abduction.
本研究旨在评估拇指腕掌关节的 6 种活动范围测量方法的可靠性：拇指侧 Pollexograph、掌骨侧 Pollexograph、桡骨掌骨测角法、掌骨间测角法、掌骨间距离和拇指远节指间关节距离。一位资深手外科医生、一位经验丰富的住院医生和一位经验较少的研究员评估了 29 名健康受试者的优势手。所有 6 种方法均用于桡侧内收、桡侧外展和掌侧外展，但仅在掌侧内收时测量距离方法。使用组内相关系数、测量标准误差和最小可检测差异计算内部和外部可靠性。拇指侧 Pollexograph 方法在桡侧内收（12°）和外展（71°）时表现出最高的主动活动范围，而所有其他角度方法的桡侧内收和外展结果均约为 20°和 50°。距离方法在桡侧和掌侧活动范围（内收/外展）方面显示出相似的平均值结果：掌骨间距离（50 毫米/60 毫米）和拇指远节指间关节距离（50 毫米/120 毫米）。使用组内相关系数的结果进行的外部可靠性表明，拇指侧 Pollexograph 和掌骨侧 Pollexograph 在外展和内收方面具有极好的可靠性，而拇指侧 Pollexograph 方法在掌侧外展方面显示出最佳的可靠性。此外，拇指远节指间关节距离在桡侧和掌侧外展方面也具有极好的可靠性。传统测角法的可靠性结果差异很大，从很差到很好。评估掌侧内收不能带来任何临床益处。我们发现，拇指侧 Pollexograph 在所有测量中均显示出极好的可靠性结果。拇指远节指间关节距离特别适合评估桡侧和掌侧外展。
