The Diagnostic Value of the Scapholunate C-Sign: A New Tool for Detecting Through-and-Through Scapholunate Interosseous Ligament Injuries.

IF 2.1 2区 医学 Q2 ORTHOPEDICS
Parunyu Vilai, Sanjeev Kakar
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引用次数: 0

Abstract

Purpose: Currently, there is a lack of a validated clinical sign to accurately detect through-and-through or complete injuries to both the dorsal and volar scapholunate interosseous ligament. The aim of this study was to evaluate the validity of a clinical sign for detecting this condition.

Methods: This study included 28 patients with suspected high-grade tears of the scapholunate interosseous ligament who underwent the C-sign maneuver. Each patient received a comprehensive evaluation, including a history, physical examination, magnetic resonance imaging interpretations by a musculoskeletal radiologist, and wrist arthroscopy. The diagnostic performance of the C-sign was assessed by calculating its sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratios, and overall accuracy, using wrist arthroscopy as the reference standard.

Results: The C-sign, which includes both a characteristic patient reported symptom and a corresponding physical examination finding, demonstrated high sensitivity and specificity (86% and 83%, respectively) when present together. The positive likelihood ratio for the C-sign was 5.18, and the negative likelihood ratio was 0.16. The overall diagnostic accuracy was 85.7%. The diagnostic performance decreased when only one component of the C-sign was considered alone.

Conclusions: The scapholunate C-sign is a valuable clinical indicator, demonstrating good diagnostic accuracy in detecting high-grade, through-and-through scapholunate interosseous ligament injuries that may warrant surgical intervention.

Type of study/level of evidence: Diagnostic II.

舟月骨c征的诊断价值:一种检测舟月骨骨间韧带贯通损伤的新工具。
目的:目前,缺乏一种有效的临床体征来准确检测舟月骨间韧带背侧和掌侧的穿透性或完全性损伤。本研究的目的是评估检测这种情况的临床体征的有效性。方法:本研究包括28例疑似舟月骨间韧带高度撕裂的患者,均行c征操作。每位患者都接受了全面的评估,包括病史、体格检查、肌肉骨骼放射科医生的磁共振成像解释和腕部关节镜检查。以腕部关节镜为参考标准,通过计算c征的敏感性、特异性、阳性预测值、阴性预测值、似然比和总体准确率来评估c征的诊断效能。结果:c征既包括患者报告的特征性症状,也包括相应的体检结果,同时出现时具有很高的敏感性和特异性(分别为86%和83%)。c符号的正似然比为5.18,负似然比为0.16。总体诊断正确率为85.7%。当仅考虑c征的一个组成部分时,诊断性能下降。结论:舟月骨c征是一个有价值的临床指标,在检测高级别、贯穿性舟月骨间韧带损伤时具有良好的诊断准确性,可能需要手术干预。研究类型/证据水平:诊断性II。
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来源期刊
CiteScore
3.20
自引率
10.50%
发文量
402
审稿时长
12 weeks
期刊介绍: The Journal of Hand Surgery publishes original, peer-reviewed articles related to the pathophysiology, diagnosis, and treatment of diseases and conditions of the upper extremity; these include both clinical and basic science studies, along with case reports. Special features include Review Articles (including Current Concepts and The Hand Surgery Landscape), Reviews of Books and Media, and Letters to the Editor.
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