title: Patients with triangular fibrocartilage complex injuries and distal radioulnar joint instability have reduced rotational torque in the forearm.
abstract: 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.
  
  
  METHODS
  Case series, Level IV.
authors.affiliation: Department of Hand Surgery, Sahlgrenska University Hospital, Göteborg, Sweden Department of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden jonny_a@telia.com.
authors.forename: J K
authors.initials: JK
authors.lastname: Andersson
authors.affiliation: Department of Hand Surgery, Sahlgrenska University Hospital, Göteborg, Sweden Department of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
authors.forename: P
authors.initials: P
authors.lastname: Axelsson
authors.affiliation: Department of Hand Surgery, Sahlgrenska University Hospital, Göteborg, Sweden Department of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden Centre for Advanced Reconstruction of Extremities, Sahlgrenska University Hospital, Mölndal, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Strömberg
authors.affiliation: Department of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden Department of Orthopaedics, Sahlgrenska University Hospital, Mölndal, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Karlsson
authors.affiliation: Department of Hand Surgery, Sahlgrenska University Hospital, Göteborg, Sweden Centre for Advanced Reconstruction of Extremities, Sahlgrenska University Hospital, Mölndal, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Fridén
mesh_terms: D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D015331:Cohort Studies; D005260:Female; D005542:Forearm; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011403:Pronation; D016059:Range of Motion, Articular; D015203:Reproducibility of Results; D013484:Supination; D051478:Triangular Fibrocartilage / Q000293:injuries*; D014955:Wrist Joint; D055815:Young Adult
keywords: Distal radioulnar joint; forearm rotation torque; triangular fibrocartilage complex; wrist; wrist arthroscopy