Aim: To determine the normal carpal height ratio for the Trinidadian population. Design & method: A retrospective review of wrist radiographs performed during the period January 2022 to June 2022 at San Fernando General Hospital was conducted. A total of 200 radiographs were independently reviewed by two blinded assessors utilizing the PACS system. The carpal height ratio (CHR) and revised carpal height (RCH) ratio was calculated using two methods. A p-value < 0.05 was assumed to be significant. Results: The radiographs reviewed consisted of 94 female and 106 male patients with an age range of 19 to 86 years. The mean CHR was 0.473 and the revised CHR 1.469. The ratio for carpal height as well as the revised CHR was observed to vary amongst the different age groups studied. The CHR and revised CHR for the population was observed to vary based on gender with gender significantly influencing the CHR value (p = 0.001). Conclusions: The CHR of the Trinidadian population as calculated by the data collected falls below the average CHR documented worldwide. However, the interpretation of this value is based on the baseline reference ratio for a population. Therefore, according to our average CHR for our population previous comparison of a CHR index to international figures would have led to erroneous interpretation of results. A decrease in CHR is indicative of carpal collapse. The comparison of CHR to the established normal CHR for the population is believed to allow for early detection of carpal collapse.
References
[1]
Rosberg, H. and Dahlin, L.B. (2004) Epidemiology of Hand Injuries in a Middle-Sized City in Southern Sweden: A Retrospective Comparison of 1989 and 1997. Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, 38, 347-355. https://doi.org/10.1080/02844310410022117
[2]
Trybus, M. and Guzik, P. (2004) Hand Injuries in the Krakow Region. ChirurgiaNarządówRuchuiOrtopedia Polska, 69, 201-206.
[3]
de Putter, C.E., Selles, R.W., Polinder, S., Panneman, M.J.M., Hovius, S.E.R. and van Beeck, E.F. (2012) Economic Impact of Hand and Wrist Injuries: Health-Care Costs and Productivity Costs in a Population-Based Study. Journal of Bone and Joint Surgery, 94, e56. https://doi.org/10.2106/jbjs.k.00561
[4]
Cederlund, R.I., Ramel, E., Rosberg, H. and Dahlin, L.B. (2010) Outcome and Clinical Changes in Patients 3, 6, 12 Months after a Severe or Major Hand Injury—Can Sense of Coherence Be an Indicator for Rehabilitation Focus? BMC Musculoskeletal Disorders, 11, Article No. 286. https://doi.org/10.1186/1471-2474-11-286
[5]
Wang, Y., Tseng, Y., Chang, H., Wang, Y., Chen, C. and Wu, D.Y. (2010) Gender Differences in Carpal Height Ratio in a Taiwanese Population. The Journal of Hand Surgery, 35, 252-255. https://doi.org/10.1016/j.jhsa.2009.11.010
[6]
Nattrass, G.R., King, G.J., McMurtry, R.Y. and Brant, R.F. (1994) An Alternative Method for Determination of the Carpal Height Ratio. The Journal of Bone & Joint Surgery, 76, 88-94. https://doi.org/10.2106/00004623-199401000-00011
[7]
Youm, Y., McMurthy, R.Y., Flatt, A.E. and Gillespie, T.E. (1978) Kinematics of the Wrist. I. an Experimental Study of Radial-Ulnar Deviation and Flexion-Extension. The Journal of Bone & Joint Surgery, 60, 423-431. https://doi.org/10.2106/00004623-197860040-00001
[8]
McMurtry, R.Y., Youm, Y., Flatt, A.E. and Gillespie, T.E. (1978) Kinematics of the Wrist. II. Clinical Applications. The Journal of Bone & Joint Surgery, 60, 955-961. https://doi.org/10.2106/00004623-197860070-00014
[9]
Stahelin, A., Pfeiffer, K., Sennwald, G. and Segmüller, G. (1989) Determining Carpal Collapse. an Improved Method. The Journal of Bone & Joint Surgery, 71, 1400-1405. https://doi.org/10.2106/00004623-198971090-00019
[10]
Schuind, F.A., Linscheid, R.L., An, K.N. and Chao, E.Y. (1992) A Normal Data Base of Posteroanterior Roentgenographic Measurements of the Wrist. The Journal of Bone & Joint Surgery, 74, 1418-1429. https://doi.org/10.2106/00004623-199274090-00018
[11]
Safi Khani, Z., Nozad, H. and Fakour, M. (2000) A Study of the Radiological Carpal Kinematic Index in the Wrist of Normal Individuals in Ahwaz City. Jundishapur Scientific Medical Journal, 28, 56-61.
[12]
Jafari, D., Taheri, H., Shariatzade, H., Mazhar, F.N., Jalili, A. and Ghahramani, M. (2012) Radiographic Indices in One Hundred Fifty Normal Iranian Wrists. Medical Journal of the Islamic Republic of Iran, 26, 132-139.
[13]
Torres-Gonzalez, R., Fuentes-Figueroa, S. and FrancoValencia, M. (2006) Carpal Bones and Joints: Roentgenographic Measurements in 20 to 70-Year Old Healthy Mexicans. Cirugía y Cirujanos, 74, 457-462.
