The Journal of Bone and Joint Surgery, Vol 76, Issue 1 88-94, Copyright © 1994 by Journal of Bone and Joint Surgery, Inc
An alternative method for determination of the carpal height ratio
GR Nattrass, GJ King, RY McMurtry and RF Brant
Department of Surgery, University of Calgary, Alberta, Canada.
Radiographs of the wrist often do not include the entire third metacarpal,
so the standard method for measurement of the carpal height ratio (the
carpal height divided by the length of the third metacarpal) cannot be
used. In this study, the ratio of the carpal height relative to the length
of the capitate was evaluated for its suitability as a reproducible
alternative. The revised carpal height ratio (the carpal height divided by
the capitate length) was evaluated for reproducibility and clinical utility
in both in vitro and in vivo studies: it was determined from the
radiographs of ten cadaveric wrists; those of 100 wrists (fifty pairs) of
normal volunteers, made with controlled positioning; those of 100 wrists,
drawn at random from radiographs that had been previously interpreted as
showing normal findings; and those of fifty wrists of twenty-nine patients
who had documented rheumatoid arthritis. The new ratio was found to be
constant in the normal population, consistent bilaterally, decreased in
patients who had carpal collapse, and reproducible.