Right Versus Left Symmetry of Ulnar Variance: A Radiographic Assessment

Abstract

One hundred skeletally mature healthy volunteers underwent standardized bilateral posteroanterior radiographs in unloaded (static) and loaded(dynamic) conditions to determine the symmetry of ulnar variance. The mean age was 32 ± 9 years (range, 19-61 years), with 58 women and 42 men. Ulnar variance was measured to the closest 0.5 mm using the method of perpendiculars. Three separate measurements were made of each radiograph in a blinded fashion by the same investigator. An intraobserver standard deviation of 0.21 was used to calculate a 95% tolerance interval of 0.7 mm (rounded up to 1 mm) as a measure of significance. The average static ulnar variance was-0.13 ± 1.5 mm on the left and -0.29 ± 1.6 mm on the right. The average dynamic ulnar variance was 0.93 ± 1.5 mm on the left and 0.82± 1.5 mm on the right. When compared individually, there was a greater than or equal to 1 mm side to side difference in 37% of volunteers under static and 38% under dynamic conditions. There were no significant correlations between ulnar variance measurements and patient age, gender, race, or handedness. Use of the normal wrist radiograph as a baseline for static radial length measurements is valid in only 63% of cases.