[Carpal instability].

Journal and index pages often block iframe embedding. This reader keeps the evidence details in Orthonotes and leaves the source page one click away.

Abstract

[Indexed for MEDLINE] 11. J Hand Surg Am. 2015 Jan;40(1):62-6.e1. doi: 10.1016/j.jhsa.2014.08.037. Epub 2014 Oct 7. Inter- and intrarater reliability of ulna variance versus lunate subsidence measurements in Madelung deformity. Farr S(1), Bae DS(2). Author information: (1)Department of Pediatric Orthopaedics, Deformity Correction, and Adult Foot & Ankle Surgery, Orthopaedic Hospital Speising, Vienna, Austria; Department of Orthopedic Surgery, Boston Children's Hospital, Boston, MA. Electronic address: sebastian.farr@oss.at. (2)Department of Pediatric Orthopaedics, Deformity Correction, and Adult Foot & Ankle Surgery, Orthopaedic Hospital Speising, Vienna, Austria; Department of Orthopedic Surgery, Boston Children's Hospital, Boston, MA. PURPOSE: To assess inter- and intrarater reliability of both ulna variance and lunate subsidence measurement methods in a large consecutive series of children with Madelung deformity. METHODS: Ulnar variance and lunate subsidence were measured on 41 standard anteroposterior wrist radiographs from 31 patients with Madelung deformity. The patients had a mean age of 13 years (range, 5-25) at the time of presentation. Two pediatric orthopedic hand/upper limb surgeons evaluated all radiographs twice in a 4-week interval using standard digital imaging software. Intraclass correlation coefficients (ICCs) were calculated for inter- and intrarater reliability, and results were reported using the Landis and Koch criteria. RESULTS: The interrater ICC for the ulna variance measurements was substantial, and for the lunate subsidence almost perfect. The intrarater ICC for ulna variance was substantial for both raters. In contrast, the intrarater ICC for lunate subsidence was almost perfect for both raters. CONCLUSIONS: Measurement of lunate subsidence showed both superior interrater and intrarater reliability compared with the ulnar variance method. Whenever relative ulna length is assessed in children and adolescents with Madelung deformity, the lunate subsidence should be the preferred method to characterize deformity. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.jhsa.2014.08.037