The reliability of clinical assessment of distal radioulnar joint instability

Accurate assessment of distal radioulnar joint (DRUJ) stability is increasingly recognized as an important part of clinical examination of the wrist. The ability of 30 specialist UK hand surgeons to clinically determine the stability of four volunteers’ wrists was assessed. Volunteers’ wrist stabili...

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Bibliographic Details
Published in:The Journal of hand surgery, European volume European volume, 2022-04, Vol.47 (4), p.375-378
Main Authors: Pickering, Greg Thomas, Fine, Nicola Francesca, Knapper, Thomas David, Giddins, Grey Edward Bence
Format: Article
Language:English
Subjects:
Female
Humans
Joint Instability - diagnosis
Joint Instability - surgery
Physical Examination - methods
Pregnancy
Reproducibility of Results
Wrist Joint - surgery
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Summary:Accurate assessment of distal radioulnar joint (DRUJ) stability is increasingly recognized as an important part of clinical examination of the wrist. The ability of 30 specialist UK hand surgeons to clinically determine the stability of four volunteers’ wrists was assessed. Volunteers’ wrist stability had previously been confirmed with a validated measurement rig. Use of the wrist ballottement test as the primary examination technique yielded a positive predictive value of 81%, a negative predictive value of 55%, a specificity of 94% and a sensitivity of only 24%, for the detection of DRUJ instability. No correlation between background speciality (orthopaedic versus plastic surgery), nor years of clinical experience was found. Clinical assessment of DRUJ instability among experienced clinicians appears unreliable and instability is typically under recognized. Previous research to date using this clinical assessment method as a parameter of success is therefore brought into question. Level of evidence: IV
ISSN:1753-1934
2043-6289
DOI:10.1177/17531934211054282