Patients with triangular fibrocartilage complex injuries and distal radioulnar joint instability have reduced rotational torque in the forearm

• Published in: The Journal of hand surgery, European volume European volume, 2016-09, Vol.41 (7), p.732-738
• Main Authors: Andersson, J. K., Axelsson, P., Strömberg, J., Karlsson, J., Fridén, J.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Arthroscopy; Cohort Studies; Female; Forearm; Humans; Joint Instability - physiopathology; Male; Middle Aged; Observer Variation; Orthopedics; Ortopedi; Pronation; Range of Motion, Articular; Reproducibility of Results; Supination; Triangular Fibrocartilage - injuries; Wrist Joint; Young Adult
• ISSN: 1753-1934; 2043-6289; 2043-6289
• DOI: 10.1177/1753193415622342

A total of 20 patients scheduled for wrist arthroscopy, all with clinical signs of rupture to the triangular fibrocartilage complex and distal radioulnar joint instability, were tested pre-operatively by an independent observer for strength of forearm rotation. During surgery, the intra-articular pathology was documented by photography and also subsequently individually analysed by another independent hand surgeon. Arthroscopy revealed a type 1-B injury to the triangular fibrocartilage complex in 18 of 20 patients. Inter-rater reliability between the operating surgeon and the independent reviewer showed absolute agreement in all but one patient (95%) in terms of the injury to the triangular fibrocartilage complex and its classification. The average pre-operative torque strength was 71% of the strength of the non-injured contralateral side in pronation and supination. Distal radioulnar joint instability with an arthroscopically verified injury to the triangular fibrocartilage complex is associated with a significant loss of both pronation and supination torque. Level of evidence: Case series, Level IV.