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A SYSTEM OF JOINT MEASUREMENTS
WILLIAM ARTHUR CLARK
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Section on Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota.
The Journal of Bone & Joint Surgery.  1920; 2:687-700 
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Abstract

All joint movements are measured on a half-circle arc from 0° to 180°.

The zero end of this arc is toward the head and the neutral position is 180° for all movements except rotation. For rotation, including pronation and supination, the zero end is toward the median body line (on the left for the spine) and the neutral position is 90°.

Extension is a movement toward 180° and flexion toward 0° on the flexor half-circle arc in the anteroposterior plane.

Hyperextension is a movement toward 0° on the half-circle arc on the extensor side of the joint in the anteroposterior plane.

Abduction and adduction are both movements toward 0° in the lateral plane, the former on the half-circle arc lying external to the joint, and the latter on the half-circle arc lying internal to the joint.

Internal rotation is toward 0° and external toward 180° on the anterior half-circle arc in the transverse plane. For the spine rotation to the patient's left is toward 0° and to his right toward 180°.

The number of degrees stated in records by this system indicates the limit of motion on the half-circle scale and not the amount of motion.

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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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