Reliability of semi pronated ulnar deviated PA view (Billiard view) of the wrist in evaluating the scaphoid

Publication date: Available online 2 March 2016
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Ho Youn Park, Jun O. Yoon, Keonghwan Kim, KunHyung Bae, Dong Wook Sohn, Jin Sam Kim
Various methods assessing the scaphoid have been reported because of its unique position. 45° pronated oblique with ulnar deviation posteroanterior (PA) view which is called billiard view has been taken pre- and postoperatively in addition to 3DCT scan and PA and lateral view in evaluating the scaphoid alignment in our hospital. This study was to compare the intra- and inter-observer reliability of the lateral intrascaphoid angle and scaphoid length and scaphoid height on the billiard view. A total of 60 patients who underwent surgery for scaphoid nonunion were identified and the preoperative and the final follow-up postoperative plain radiographs were used for measuring. Three observers assessed each image. Intra- and inter-observer reliability was determined using intra-class correlation (ICC) coefficients. Intra-observer reliability was all excellent ranging between 0.855-0.992. Inter-observer reliability ranged between 0.292-0.983. Scaphoid length and height demonstrated excellent agreement whilst ISA demonstrated poor to moderate agreement. The best method for assessing the scaphoid in simple radiograph remains controversial, but our current data suggests that measuring scaphoid length and height on the billiard view is reproducible and can be used to evaluate restoration of scaphoid alignment.



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