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

Andersson, Jonny; Axelsson, Peter; Strömberg, Joakim; Karlsson, Jón; Fridén, Jan

doi:10.1177/1753193415622342

Cited by 25 publications

(27 citation statements)

References 31 publications

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“…2 Contrary to these results, Andersson et al showed in a more recent study that patients who had arthroscopic signs of TFCC also had a concomitant loss in strength in forearm rotation. 7 The difference between these two studies lies in the difference in duration from onset of symptoms until the torque strength test was done. It may be speculated that the long duration of 2 years from injury to test in Landau's patient group enabled compensatory muscle groups to get strong enough to create stability in the test situation.…”

Section: Discussionmentioning

confidence: 99%

A Novel Technique to Assess Distal Radioulnar Joint Stability Using Increasing Torque

et al. 2018

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Background Previous studies on computed tomography (CT) in patients with a suspected triangular fibrocartilage complex (TFCC) injury have not been successful in assessing distal radioulnar joint (DRUJ) laxity. The aim of this study was to develop a novel servomotor-driven device for the assessment of DRUJ by applying increasing torque to the DRUJ in pronation and supination. Methods A custom-built device was designed to function during four-dimensional (4D) CT of the wrist. A torque meter, positioned between the incoming hand holder, and a direct current (DC) servomotor were used for angular positioning and for applying rotational force to the patient's arm. A total of 110 healthy participants were recruited to gather reference values for the range of motion (ROM), maximum torque in neutral and supinated/pronated position, and the ability to withstand an increasing, device-generated torque in these positions. The device was also used during 4D DRUJ CT in five patients with suspected TFCC injuries. Results A gender- and age-relevant reference chart for ROM and torque was created. Men showed a tendency (ns) toward having a larger ROM and increasing strength with increasing age, whereas women showed the opposite. Also, the dominant hand showed a tendency toward having a larger ROM and being stronger than the nondominant hand (ns). A smaller cohort of patients (n = 5) with suspected TFCC injuries showed a significantly decreased ability to withstand increasing torque in both supination (2.1 ± 0.3 vs. 3.1 ± 0.2 s; p < 0.005) and pronation (2.3 ± 0.5 vs. 3.1 ± 0.4 s; p < 0.0005) and also showed a clear laxity on real-time 4D CT image sequences. Decreased strength at all positions was also found (average 74% decrease compared to noninjured side). Conclusion Reference values for torque strength and ability to withstand increasing torque can be used clinically in the assessment of patients with symptoms that could represent ligamentous injuries to the TFCC. The ability to use the device during CT enables radiographic evaluation of instability during increasing torque. Level of Evidence This is a Level II study.

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Section: Discussionmentioning

confidence: 99%

A Novel Technique to Assess Distal Radioulnar Joint Stability Using Increasing Torque

et al. 2018

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“…Pre-and postoperative forearm peak pronation and supination torque measurements were performed using a wrist dynamometer supplied with a digital pressure gauge (Model BL-2000, Baseline, White Plains, New York) ( Figure 1). [4][5][6] The device was calibrated at the Research Institute of Sweden (RISE), division SP (Statens Provningsanstalt). The precision of measurement of the dynamometer was 0.01 Nm.…”

Section: Torque Measurementsmentioning

confidence: 99%

“…The protocol for measurement followed that of a recently published validity study 6 and the preoperative measurement of suspected TFCC 1B injuries by Andersson et al 4 The patient was in a standing position, fully adducted arm and elbow flexed to 90°. Peak supination followed by peak pro-nation torque were measured once starting from a neutral position, with the examiner carefully ensuring that the patient did not bring the elbow into abduction or lean the body in any direction.…”

Section: Torque Measurementsmentioning

confidence: 99%

“…The validity and ICC of the torque dynamometer, modified and adapted to the clinical setting, was earlier shown to be high in 15 healthy volonteers. 4 Peak pronation and supination torque was measured prior to surgery in 21 patients with suspected TFCC injuries with clinical DRUJ instability and arthroscopically confirmed TFCC 1B injury in 18 of them in a prior previously published study. 4 Thirteen of these patients in the initial cohort were operated on with TFCC reinsertion.…”

Section: Torque Measurementsmentioning

confidence: 99%

“…Standardized measurement of forearm peak pronation and supination torque has recently been shown to be a valid method with high intraclass correlation (ICC) and good responsiveness, 5,6 and is suggested to be a beneficial clinical tool in the diagnostics of TFCC 1B injuries. 4 The aim of our study was to evaluate whether patients with TFCC 1B injuries, 13 with concomitant DRUJ instability, improve in forearm peak pronation and supination torque following TFCC reinsertion surgery where postoperative DRUJ stability was achieved.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Patients With Triangular Fibrocartilage Complex Injuries and Distal Radioulnar Joint Instability Gain Improved Forearm Peak Pronation and Supination Torque After Reinsertion

Andersson

Hagert

Fridén

2018

Hand (New York, N,Y.)

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Assessment of distal radioulnar joint stability in healthy subjects: Changes with dominant hand, sex, and age

Yuine

Yoshii

Iwai

et al. 2020

Journal Orthopaedic Research

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This study aimed to elucidate the differences in distal radioulnar stability in dominant/nondominant hand, sex, and age. Bilateral wrists of 60 healthy subjects were evaluated using force-monitoring ultrasonography. This apparatus was developed to apply cyclic compression and measure applied force to displacement during an ultrasound exam. The transducer was placed on the dorsal side of the distal radioulnar joint, and the center of the ulnar head was displayed on the monitor. The distance between the dorsal surface of the distal radius and the ulnar head was measured at an initial and at a pressed-down position. The radioulnar displacement, applied force to displacement, and displacement-to-force ratio were evaluated.The results were compared between the dominant and nondominant hands, and between males and females, and among different age groups. There were no How to cite this article: Yuine H, Yoshii Y, Iwai K, Ishii T, Shiraishi H. Assessment of distal radioulnar joint stability in healthy subjects: Changes with dominant hand, sex, and age.

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

Abstract: Case series, Level IV.

Cited by 25 publications

References 31 publications

A Novel Technique to Assess Distal Radioulnar Joint Stability Using Increasing Torque

A Novel Technique to Assess Distal Radioulnar Joint Stability Using Increasing Torque

Patients With Triangular Fibrocartilage Complex Injuries and Distal Radioulnar Joint Instability Gain Improved Forearm Peak Pronation and Supination Torque After Reinsertion

Assessment of distal radioulnar joint stability in healthy subjects: Changes with dominant hand, sex, and age

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