Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Korea;Department of Hand and Foot Surgery, Yanbian University Hospital, Jilin province, China.
Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
Acta Orthop Traumatol Turc. 2021 Mar;55(2):107-111. doi: 10.5152/j.aott.2021.20114.
This study aims to investigate compensatory rotational movements of the wrist joint in patients with proximal congenital radioulnar synostosis (CRUS), using a valid and reliable three-dimensional (3D) motion analysis technique.
A total of 26 patients (6 females, 14 males; mean age=15.3 years; and age range=6-32 years) who were diagnosed with unilateral proximal CRUS but were not operated were enrolled in this study. Patients were then categorized into 2 groups: Group I included 5 patients younger than 10 years, and Group II included 15 patients older than 10 years. Eighteen light-reflective skin markers were placed on the bony landmarks of both upper limbs, and both distal forearms were fixed using a U-shaped device to minimize forearm rotation. Each patient grasped the handle of an instrument that used a goniometer to measure wrist rotation; maximal passive pronation and supination angles of the wrist were measured in this manner and also using 3D motion analysis.
There was a significant correlation between measurements by the goniometer and 3D motion analysis (r=0.985, p<0.001). The test-retest reliability of the 3D motion analysis was acceptable for both the affected side (ICC=0.992) and the contralateral normal side (ICC=0.997) with low standard measurement errors (1.3° and 0.8°, respectively). Although no significant difference was observed in the range of the wrist rotation between the affected and contralateral sides in Group I (p=0.686), there was a significant difference in the wrist rotation between the affected and contralateral sides in Group II (p=0.001). Further, the pronation angle of the wrist joint was significantly larger in the affected side than that in the contralateral normal side in Group II (p=0.001).
The 3D motion analysis technique seems to be a valid and reliable method to measure the rotation of the wrist joint. Unilateral proximal CRUS patients older than 10 years of age may develop rotational hypermobility of the wrist joint compared to the contralateral normal side as a compensatory phenomenon.
Level III, Diagnostic Study.
本研究旨在使用一种有效且可靠的三维（3D）运动分析技术，研究先天性近侧尺桡骨融合（CRUS）患者腕关节的代偿性旋转运动。
共纳入 26 名（6 名女性，14 名男性；平均年龄 15.3 岁；年龄范围 6-32 岁）被诊断为单侧近侧 CRUS 但未接受手术的患者。然后将患者分为两组：I 组包括 5 名年龄小于 10 岁的患者，II 组包括 15 名年龄大于 10 岁的患者。在双侧上肢的骨性标志上放置 18 个反光皮肤标记物，并使用 U 形装置固定双侧远端前臂，以尽量减少前臂旋转。每位患者握住仪器手柄，仪器使用量角器测量腕关节旋转；以这种方式以及使用 3D 运动分析测量腕关节的最大被动旋前和旋后角度。
量角器测量值与 3D 运动分析值之间存在显著相关性（r=0.985，p<0.001）。3D 运动分析的测试-重测信度对于患侧（ICC=0.992）和对侧正常侧（ICC=0.997）均可接受，标准测量误差较低（分别为 1.3°和 0.8°）。虽然 I 组患侧和对侧的腕关节旋转范围无显著差异（p=0.686），但 II 组患侧和对侧的腕关节旋转范围有显著差异（p=0.001）。此外，II 组患侧腕关节的旋前角度明显大于对侧正常侧（p=0.001）。
3D 运动分析技术似乎是一种有效且可靠的方法，可用于测量腕关节的旋转。与对侧正常侧相比，10 岁以上单侧近侧 CRUS 患者可能会出现腕关节旋转过度活动，作为代偿现象。
III 级，诊断研究。
