Purpose
Tears of the proximal component of the triangular fibrocartilage complex (pc-TFCC)
lead to instability in the distal radioulnar joint. The aim of this study was to measure
the load-bearing radioulnar distances (RaUls) and to evaluate its diagnostic suitability
in patients with pc-TFCC tears.
Methods
We retrospectively assessed and compared the lateral wrist radiographs of 61 adult
patients with arthroscopically confirmed tears of pc-TFCC with those of a control
group of 64 healthy participants. The RaUl was measured on lateral radiographs, and
the difference in RaUl (D-value) between load-bearing and nonloading conditions was
calculated in the 2 groups. Receiver operator characteristic curves were plotted to
determine the diagnostic accuracy and optimal cutoff-score of load-bearing RaUl and
RaUl D-value. The diagnostic performance was verified in a validation sample of patients
(30 wrists) with pc-TFCC tears and a control group of healthy individuals (30 wrists).
Results
In the training sample, load-bearing RaUls of the affected wrists were higher than the same side of the controls
(12.0 mm vs 7.1 mm). The TFCC-injury group showed a significantly higher RaUl D-value
than the control group (8.5 mm vs 3.4 mm). Using a receiver operator characteristic
curve, the cutoff value of load-bearing RaUl was 10 mm (sensitivity = 97.6%, specificity =
85.7%) and that of RaUl D-value was 6.5 mm (sensitivity = 90.2%, specificity = 78.5%).
The areas under the curve of load-bearing RaUl and RaUl D-value were 0.96 and 0.88,
respectively. In the test sample, the sensitivity, specificity, and accuracy of RaUl
were 0.93, 0.70, and 0.82 and those of RaUl D-value were 0.77, 0.83, and 0.80 respectively.
Conclusions
Load-bearing RaUl measurement is a simple method to diagnose an unstable distal radioulnar
joint in patients with TFCC injury. The load bearing RaUl of >10 mm or RaUl D-value
of >6.5 mm can be used to differentiate TFCC injuries and showed acceptable accuracy.
Type of study/level of evidence
Diagnostic II.
Key words
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Article info
Publication history
Published online: March 02, 2022
Accepted:
January 7,
2022
Received:
February 27,
2021
Footnotes
A.Y., X.Z., and H.Z. contributed equally to the manuscript.
No benefits in any form have been received or wills be received by the authors related directly or indirectly to the subject of this article.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.
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