Locking of the forearm in pronation due to extensor carpi ulnaris tendon dislocation with dorsal distal ulna dislocation.
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Because of the clinical impression that traditional forearm goniometry has several potential sources of error and is therefore inherently unreliable, a new method using a newly designed goniometer was compared with traditional forearm passive range-of-motion goniometry. The new method utilized an offset face with a plumbline design and a patient-held tubular handle. Thirty orthopedic patients (31 wrists) were measured by three experienced hand therapists in a test-retest protocol to determine the reliability of both the traditional and new methods. Both the intraclass correlation coefficients and standard error of the measure showed improved scores with the new goniometric technique, compared with the traditional one. The differences between methods may not be clinically significant.
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Clinical measurement is a fundamental component of podiatric biomechanics. However, recent research has seriously questioned the reliability and validity of the commonly used approaches to clinical measurement of foot posture. A reevaluation of foot-morphology measurement is therefore warranted. This article discusses alternative clinical techniques of measuring foot type reported in the literature (arch height, footprint indices, the valgus index, and navicular drop) that may prove to be superior to the commonly used podiatric measurement system. On the basis of a critical evaluation of the literature, it would appear that arch height and footprint indices are invalid as means of categorizing foot morphology, while the valgus index and navicular drop offer a number of benefits over traditional frontal-plane measurements. An additional clinical measurement suggested by the author, navicular "drift," is also introduced. The advantages, disadvantages, and clinical application of each of these approaches are discussed in detail.
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