{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T23:54:00Z","timestamp":1773100440381,"version":"3.50.1"},"reference-count":9,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Wrist Surg"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003The Tolat sigmoid notch classification is a commonly used classification to characterize the distal radioulnar joint (DRUJ). This classification was based on a limited assessment of the entire joint, which may lead to inaccuracies in sigmoid notch evaluation.<\/jats:p><jats:p>\n          Questions\/Purposes\u2003The purpose of this study is to assess the reliability of the Tolat classification for sigmoid notch characterization.<\/jats:p><jats:p>\n          Methods\u2003The sigmoid notch of 52 models of cadaveric forearms was assessed by applying the Tolat classification to the three-dimensional (3D) modeled notch and then slices at the start of the notch (0\u2009mm) and 4\u2009mm more proximal. The inter- and intrarater agreement was assessed using Cohen's and Fleiss' kappa statistic.<\/jats:p><jats:p>\n          Results\u2003Agreement between iterations regardless of slices or surgeons\/radiologists was moderate. Intrarater agreement between pairs of slices (0 vs 4\u2009mm, 0\u2009mm vs 3D, 4\u2009mm vs 3D) was moderate, whereas agreement between all slices was slight. Agreement between surgeons and between radiologists was moderate, while agreement across all raters and slices was fair. Models described as \u201cother\u201d were more consistent in 3D classifications and were commonly classified as a reverse ski slope.<\/jats:p><jats:p>\n          Conclusions\u2003Classification using the Tolat scheme is fair to moderate at best. Classification of the sigmoid notch using an axial view of the distal radius may not accurately reflect the anatomy throughout the notch.<\/jats:p><jats:p>\n          Clinical Relevance\u2003The Tolat classification supplies a limited analysis of the sigmoid notch, and does not represent a comprehensive evaluation of the entire joint. Future classification systems should characterize the entire sigmoid notch.<\/jats:p>","DOI":"10.1055\/s-0042-1758709","type":"journal-article","created":{"date-parts":[[2022,11,19]],"date-time":"2022-11-19T00:00:37Z","timestamp":1668816037000},"page":"359-363","source":"Crossref","is-referenced-by-count":3,"title":["Reliability of the Sigmoid Notch Classification of the Distal Radioulnar Joint"],"prefix":"10.1055","volume":"12","author":[{"given":"Heathcliff","family":"D'Sa","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"Willing","sequence":"additional","affiliation":[{"name":"Department of Mechanical and Materials Engineering, Western University, London, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim","family":"Murray","sequence":"additional","affiliation":[{"name":"Department of Radiology, St Paul's Hospital, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Rowan","sequence":"additional","affiliation":[{"name":"Department of Radiology, Lions Gate Hospital, North Vancouver, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruby","family":"Grewal","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, The Hand and Upper Limb Centre, St. Joseph's Health Centre, London, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Graham","family":"King","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, The Hand and Upper Limb Centre, St. Joseph's Health Centre, London, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parham","family":"Daneshvar","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,11,18]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.hcl.2012.03.002","article-title":"Anatomy and biomechanics of the distal radioulnar joint","volume":"28","author":"J I Huang","year":"2012","journal-title":"Hand Clin"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/S0363-5023(96)80152-3","article-title":"The effect of dorsally angulated distal radius fractures on distal radioulnar joint congruency and forearm rotation","volume":"21","author":"H Kihara","year":"1996","journal-title":"J Hand Surg 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