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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Intraoperative Technique for Evaluation of the Interosseous Ligament of the Forearm

Meeting Abstract

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  • presenting/speaker Amir Reza Kachooei - Orthopedic Research Center, Ghaem Hospital, Mashhad, Iran
  • Michael Rivlin - Department of Hand and Orthopedic Surgery, Rothman Institute, Thomas Jefferson University, Philadelphia, United States
  • Babak Shojaie - Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, United States
  • C. Niek Van Dijk - Department of Orthopaedic Surgery, Academic Medical Center Amsterdam, Amsterdam, Netherlands
  • Chaitanya Mudgal - Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, United States

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-973

doi: 10.3205/19ifssh1351, urn:nbn:de:0183-19ifssh13514

Published: February 6, 2020

© 2020 Kachooei et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: To introduce a technique for the diagnosis of interosseous ligament (IOL) disruption based on lateral displacement of the radius after radial head resection and to determine the cutoff value of the lateral displacement for the diagnosis of disruption, the best elbow position for testing, and the diagnostic performance of the technique in different positions.

Methods: We used 10 fresh-frozen cadavers. After resection of the radial head, a Steinman pin was placed into the radius medullary canal and used to mark the pin location on the capitellum. We applied 1 kg force to pull the proximal radius laterally and measured the displacement in full supination, neutral, and full pronation of the forearm with the elbow in extension and then in 90 flexion. All measurements were performed once with the IOL intact and again with it cut. To assess diagnostic efficacy, receiver operating characteristics curves were constructed. To determine the quality of the technique, we measured the area under the receiver operating characteristics curve for each position. We also determined the cutoff value to obtain the highest sensitivity and specificity.

Results and Conclusions: The area under the curve of the test in extension-supination and flexion-supination showed that these positions were excellent for the diagnosis of IOL disruption. The cutoff value of 5.5 mm lateral displacement in extension-supination had 100% sensitivity and 90% specificity. In flexion-supination, the cutoff value of 9 mm had 100% sensitivity and 90% specificity for the diagnosis of IOL disruption.

This maneuver was reliable and accurate in cadavers with complete IOL disruption. It is likely that in an intraoperative setting, these results will be reproducible.