Purpose
Many methods for measuring ulnar variance have been described. The purpose of this study
was to introduce the use of both lunate height and ulnolunate distance on the zero-rotation
view as well as to assess the intra- and interobserver reliabilities of these measurements.
The hypothesis was that the use of concave surfaces in the measurement of both lunate
height and ulnolunate distance will yield a higher intra- and interobserver reliability
than ulnar variance, which uses the convex surface of the distal radius.
Methods
Seven hand fellows reviewed 32 radiographs. Measurements of lunate height, ulnolunate
distance, and ulnar variance, using the method of perpendiculars, were recorded to
the nearest 0.5 mm. Intraclass correlation coefficient (ICC) was then calculated for
each radiograph for intra- and interobserver reliability.
Results
The ICC measurements were similar for lunate height, ulnolunate distance, and ulnar
variance. The inter- and intraobserver reliability was similar for all 3 measurements.
Conclusions
Measurements of ulnar variance utilize the concave surface of the distal radius. The
use of the convex surface of the lunate and pole of the ulna does not seem to improve
the reliability of these measurements. Further studies are necessary to confirm the
clinical utility of these measurements.
Clinical relevance
The use of ulnolunate distance and lunate height as an adjunct to ulnar variance may
assist in evaluation of distal radius fractures and ulnocarpal abutment, improve surgeon
communication, and contribute to our overall knowledge of the wrist.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Hand SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Measurement of ulnar variance from the lateral radiograph: a comparison of techniques.J Hand Surg Am. 2014; 39: 1114-1121
- Resection of the radial head for fracture of the radial head. Long-term follow-up of seventeen cases.J Bone Joint Surg Am. 1987; 69: 385-392
- Anatomical variations in the hand bones [in German].Acta Radiol. 1928; 9: 155-169
- Ulnar variance—the effect of wrist positioning and roentgen filming technique.J Hand Surg Am. 1982; 7: 298-305
- Stability of the distal radioulna joint: biomechanics, pathophysiology, physical diagnosis, and restoration of function what we have learned in 25 years [review].J Hand Surg Am. 2007; 32: 1086-1106
- Ulnar variance in Kienböck's disease.J Bone Joint Surg Am. 1975; 57: 674-676
- Ulnar variance determination.J Hand Surg Am. 1982; 7: 376-379
- Essential radiographic evaluation for distal radius fractures.Hand Clin. 2005; 21: 279-288
- A comparison of 3-D computed tomography versus 2-D radiography measurements of ulnar variance and ulnolunate distance during forearm rotation.J Hand Surg Eur Vol. 2014; 39: 526-532
- Study of ulnar variance with high-resolution MRI: correlation with triangular fibrocartilage complex and cartilage of ulnar side of wrist.J Magn Reson Imaging. 2007; 26: 714-719
- Measuring ulnar variance: a comparison of techniques.J Hand Surg Am. 1989; 14: 607-612
Article info
Publication history
Published online: February 15, 2019
Accepted:
December 17,
2018
Received:
June 12,
2017
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2019 by the American Society for Surgery of the Hand. All rights reserved.
