Diagnosis of Complex Pulley Ruptures Using Ultrasound in Cadaver Models
Schoffl I, Hugel A, Schoffl V, Rascher W, Jungert J (2017)
Publication Type: Journal article
Publication year: 2017
Journal
Book Volume: 43
Pages Range: 662-669
Journal Issue: 3
DOI: 10.1016/j.ultrasmedbio.2016.10.005
Abstract
Pulley ruptures are common in climbing athletes. The purposes of this study were to determine the specific positioning of each pulley with regards to the joint, and to evaluate the ultrasound diagnostics of various pulley rupture combinations. For this, 34 cadaver fingers were analyzed via ultrasound, the results of which were compared to anatomic measurements. Different pulley ruptures were then simulated and evaluated using ultrasound in standardized dynamic forced flexion. Visualization of the A2 and A4 pulleys was achieved 100% of the time, while the A3 pulley was visible in 74% of cases. Similarly, injuries to the A2 and A4 pulleys were readily observable, while A3 pulley injuries were more challenging to identify (sensitivity of 0.2 for singular A3 pulley, 0.5 for A2/A4 pulley and 0.33 for A3/A4 pulley ruptures). Receiver operating characteristic analysis was used to evaluate the optimal tendon-bone distance for pulley rupture diagnosis, a threshold which was determined to be 1.9 mm for A2 pulley ruptures and 1.85 for A4 pulley ruptures. This study was the first to carry out a cadaver ultrasound examination of a wide variety of pulley ruptures. Ultrasound is a highly accurate tool for visualizing the A2 and A4 pulleys in a cadaver model. This method of pathology diagnosis was determined to be suitable for injuries to the A2 and A4 pulleys, but inadequate for A3 pulley injuries.
Authors with CRIS profile
Arnika Hugel
Medizinische Fakultät
Wolfgang Rascher
Department of Paediatrics and Adolescent Medicine
Involved external institutions
Germany (DE)How to cite
APA:
Schoffl, I., Hugel, A., Schoffl, V., Rascher, W., & Jungert, J. (2017). Diagnosis of Complex Pulley Ruptures Using Ultrasound in Cadaver Models. Ultrasound in Medicine and Biology, 43(3), 662-669. https://doi.org/10.1016/j.ultrasmedbio.2016.10.005
MLA:
Schoffl, Isabelle, et al. "Diagnosis of Complex Pulley Ruptures Using Ultrasound in Cadaver Models." Ultrasound in Medicine and Biology 43.3 (2017): 662-669.
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