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Stress examination of flexor tendon pulley rupture in the crimp grip position: a 1.5-Tesla MRI cadaver study

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An Erratum to this article was published on 28 October 2014

Abstract

Objective

The objectives of this study were the evaluation of flexor tendon pulley rupture of the fingers in the crimp grip position using magnetic resonance imaging (MRI) and the comparison of the results with MRI in the neutral position in a cadaver study.

Materials and methods

MRI in the crimp grip position and in the neutral position was performed in 21 cadaver fingers with artificially created flexor tendon pulley tears (combined pulley rupture, n = 14; single pulley rupture, n = 7). Measurement of the distance between the tendon and bone was performed. Images were evaluated by two readers, first independently and in cases of discrepancy in consensus. Sensitivity and specificity for detecting combined pulley ruptures were calculated.

Results

Tendon bone distances were significantly higher in the crimp grip position than in the neutral position. Sensitivity and specificity for detecting combined pulley rupture were 92.86 % and 100 % respectively in the crimp grip position and 78.57 % and 85.71 % respectively in the neutral position. Kappa values for interobserver reliability were 0.87 in the crimp grip position and 0.59 in the neutral position.

Conclusion

MRI examination in the crimp grip position results in higher tendon bone distances by subjecting the pulleys to a higher strain, which facilitates image evaluation with higher interobserver reliability, higher sensitivity, and higher specificity for combined pulley rupture compared with examination in the neutral position.

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Conflict of interest

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Authors and Affiliations

  1. Department of Radiology, University of Erlangen-Nuremberg, Maximiliansplatz 1, 91054, Erlangen, Germany

    Thomas Bayer & Rolf Janka

  2. Orthopaedic Department, Cantonal Hospital Lucerne, Wolhusen, Switzerland

    Simon Fries

  3. Department of Orthopaedics, Balgrist, University of Zurich, Zurich, Switzerland

    Andreas Schweizer

  4. Department of Pediatrics, Klinikum Bamberg, Bamberg, Germany

    Isabelle Schöffl

  5. Department of Radiology, University Basel, Basel, Switzerland

    Georg Bongartz

Authors
  1. Thomas Bayer
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  2. Simon Fries
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  3. Andreas Schweizer
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  4. Isabelle Schöffl
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  5. Rolf Janka
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  6. Georg Bongartz
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Correspondence to Thomas Bayer.

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Bayer, T., Fries, S., Schweizer, A. et al. Stress examination of flexor tendon pulley rupture in the crimp grip position: a 1.5-Tesla MRI cadaver study. Skeletal Radiol 44, 77–84 (2015). https://doi.org/10.1007/s00256-014-2002-7

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  • DOI: https://doi.org/10.1007/s00256-014-2002-7

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