PDF(Pubmed)
Abstract：
The hook test is a widely used intraoperative method for assessing syndesmosis stability. However, there are no recommendations regarding the force required to perform this test. Furthermore, the reliability of the test is unclear. Ten experienced surgeons performed hook tests on a cadaver bone model. The applied forces were recorded in a blinded manner. In addition, standardized hook tests with defined forces (50, 80, and 100 N) were performed on 10 pairs of cadaver lower legs and the syndesmosis was sequentially destabilized. Diastasis of the syndesmosis was recorded using an optical 3D camera system. A median force of 81 N (Range: 50 N-145 N) was applied. A proportion of 82% of the tests showed a force < 100 N. The data showed good intraraterreliability and poor interraterreliability. In the standardized investigation of the hook test on the cadaver bone model, both the force and the instability of the syndesmosis had a significant influence on the syndesmosis diastasis. Nevertheless, even with maximum instability of the syndesmosis, diastasis > 2 mm could only be measured in 12 of the 19 evaluable specimens. The widely used hook test shows a high variability when performed in practice. Even in a standardized manner, the hook test cannot detect a relevant syndesmosis injury.
摘要：
钩试验是一种广泛使用的术中评估联合稳定性的方法。然而,没有关于执行此测试所需的力的建议。此外，测试的可靠性尚不清楚。十名经验丰富的外科医生对尸体骨骼模型进行了钩测试。以盲法方式记录施加的力。此外,在10对尸体小腿上进行了具有定义力（50、80和100N）的标准化钩测试，然后使连骨不稳定。使用光学3D相机系统记录了连骨的转移。施加81N(范围:50N-145N)的中值力。82％的测试显示力<100N。数据显示出良好的内部可靠性和较差的内部可靠性。在尸体骨骼模型的钩试验的标准化调查中，结合的力量和不稳定性都对结合的分离有重要影响。然而，即使有最大的连骨不稳定，>2毫米的舒张只能在19个可评估标本中的12个中测量。广泛使用的吊钩试验在实践中表现出很高的可变性。即使以标准化的方式，钩试验不能检测到相关的韧带损伤。
