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Determining carpal collapse. An improved method.

A Stahelin1, K Pfeiffer, G Sennwald

  • 1Hand Center, Chirurgie St. Leonhard, St. Gall, Switzerland.

The Journal of Bone and Joint Surgery. American Volume
|October 1, 1989
PubMed
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The carpal height index offers a reliable method for assessing wrist collapse in conditions like lunatomalacia and scaphoid non-union. This index provides a quantitative measure for evaluating treatment effectiveness in unilateral wrist diseases.

Area of Science:

  • Orthopedic Surgery
  • Radiology
  • Biomechanics

Background:

  • Wrist collapse is a significant concern in conditions like lunatomalacia and scaphoid non-union.
  • Accurate quantitative assessment is crucial for evaluating disease progression and treatment efficacy.

Purpose of the Study:

  • To evaluate the reliability and superiority of the carpal height index (CHI) compared to the carpal height ratio (CHR) for assessing unilateral wrist diseases.
  • To establish a standardized method for calculating the CHI using defined radiographic techniques.

Main Methods:

  • Modified Youm et al. method for CHI calculation with standardized radiographic technique and defined reference points.
  • Calculated CHI in 40 normal subjects, 10 patients with Stage-III lunatomalacia, and 8 with scaphoid non-union.

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  • Assessed reproducibility through two reliability tests.

    • Main Results:

    • The modified CHI method demonstrated high reliability.
    • The CHI was found to be superior to the CHR for evaluating unilateral wrist disease.
    • A significant difference was observed between the mean CHI of diseased wrists and normal wrists.

    Conclusions:

    • The carpal height index is a reliable and superior method for quantifying wrist collapse in unilateral diseases.
    • Both CHI (unilateral) and CHR (bilateral) can effectively describe wrist collapse progression and aid in treatment evaluation.