Journal ArticleDOI
The Hook Test Is More Accurate Than the Trampoline Test to Detect Foveal Tears of the Triangular Fibrocartilage Complex of the Wrist.
Andrea Atzei,Riccardo Luchetti,Daniele Carletti,Lucian Lior Marcovici,Lucia Cazzoletti,Silvia Barbon +5 more
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TLDR
In this article, the trampoline and hook tests were used in the arthroscopic assessment of triangular fibrocartilage complex (TFCC) tears compared with direct visualization of the radiocarpal joint (RCJ) and of the distal radial ulnar joint (DRUJ).Abstract:
Purpose To evaluate the accuracy of the trampoline and hook tests, used in the arthroscopic assessment of triangular fibrocartilage complex (TFCC) tears compared with arthroscopic direct visualization of the radiocarpal joint (RCJ) and of the distal radial ulnar joint (DRUJ). Methods In total, 135 patients (97 male, 38 female, mean age 43.5 years) were divided into 2 groups: (1) 80 patients with chronic ulnar-sided wrist pain and positive fovea sign and (2) 55 patients with other complaints. TFCC was assessed by RCJ and DRUJ arthroscopy and by the trampoline and hook tests to detect rupture of distal and proximal components of the TFCC. Accuracy, specificity, sensitivity, and likelihood ratio of the 2 diagnostic methods were measured and compared, using RCJ and DRUJ arthroscopy as reference. Results The trampoline and the hook tests showed an overall accuracy of 70.37% and 86.67%, respectively. The accuracy of the trampoline test was similar for distal (69%), proximal (66%), and complete (73%) TFCC tears. The hook test was more accurate when evaluating proximal (97%) and complete (98%) tears, rather than distal lesions (75%). Sensitivity for the trampoline and hook tests was 75.00% and 0.00% (P Conclusions The trampoline and hook tests can assure accurate diagnosis of peripheral TFCC tear. The hook test shows greater specificity and sensitivity to recognize foveal TFCC tears. Values of positive likelihood ratio suggest a greater probability to detect foveal laceration of peripheral TFCC for the hook test than for the trampoline test. These findings suggest that DRUJ arthroscopy is not necessary to confirm foveal incompetence of the TFCC, if the hook test is positive. Level of Evidence Level II, retrospective diagnostic trial.read more
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The Pre-1D Lesion of the TFCC—A New Variant of the Palmer 1D Class
TL;DR: In this paper , the authors describe a variant of radial tears (1D according to Palmer), in which the radio-ulnar ligaments were ruptured in the midsubstance just before their insertion on the sigmoid notch and illustrate the arthroscopic surgical technique used for its treatment.
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Arthroscopic Foveal Repair of the Triangular Fibrocartilage Complex Improved the Clinical Outcomes in Patients With Persistent Symptomatic Distal Radio-Ulnar Joint Instability After Plate Fixation of Distal Radius Fractures: Minimum 2-Year Follow-Up
TL;DR: In this article , the authors investigated the longitudinal trend of symptomatic distal radioulnar joint (DRUJ) instability after plate fixation for distal radius fractures (DRFs), determine which factors are associated with persistent symptomatic DRUJ instability, and evaluate the postoperative outcomes of arthroscopic foveal repair of the triangular fibrocartilage complex (TFCC) in patients with persistent symptom adverse events after DRF.
Journal ArticleDOI
Wrist arthroscopy: indications, portal anatomy and therapeutic advances
TL;DR: An overview of wrist arthroscopy, its indications, set-up, and its applications, both diagnostic and therapeutic are provided.
Journal ArticleDOI
Symptomatic Radial-Sided Tears of the Triangular Fibrocartilage Complex: An All-Arthroscopic Repair Using Bone Anchors
Muntasir Mannan Choudhury,Robert Tze-Jin Yap,Dawn Sinn Yii Chia,Suraj Sajeev,Ghulam S. Alizada,Jackson Jiang +5 more
TL;DR: In this paper , an all-arthroscopic technique of repairing radial-sided tears using a bone anchor was described, which can be done in the hands of an orthopaedic or hand surgeon trained in arthroscopy.
Journal ArticleDOI
A modified arthroscopic ulnar tunnel technique for foveal triangular fibrocartilage complex injury
TL;DR: In this paper , a prospective cohort study of 44 patients aimed to evaluate the clinical and patient-reported outcome after arthroscopic foveal reattachment using a novel, modified ulnar tunnel technique.
References
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Triangular fibrocartilage complex lesions: A classification
TL;DR: Based on anatomic and biomechanical studies and review of the clinical experience of the past 10 years, a classification of injuries to the triangular fibrocartilage complex is presented.
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The triangular fibrocartilage complex of the wrist-Anatomy and function
TL;DR: The TFCC was found to be perforated in 53% of specimens dissected, and all of the wrists with a demonstrable perforation showed evidence of damage or erosion of the cartilage of the lunate and/or distal ulna.
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A readers' guide to the interpretation of diagnostic test properties: clinical example of sepsis.
TL;DR: Various measures of test accuracy are discussed: specificity, specificity, receiver operating characteristic curves, positive and negative predictive values, likelihood ratios, pretest probability, posttest probability, and diagnostic odds ratio.
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The McNemar test for binary matched-pairs data: mid-p and asymptotic are better than exact conditional
TL;DR: An easy-to-calculate mid-p version of the McNemar exact conditional test is examined for the analysis of paired binomial proportions and is an excellent alternative to the complex exact unconditional test.
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Management of chronic peripheral tears of the triangular fibrocartilage complex
TL;DR: Thirteen patients with traumatic separation of the triangular fibrocartilage complex from its peripheral origin had anatomic reconstitution by surgical reattachment to the ulna by postoperative rehabilitation, and two of the three unsatisfactory results responded well to subsequent surgery.