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Journal of Hand Surgery (European Volume)
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Articles

Effect of Triangular Ligament Tears on Distal Radioulnar Joint Instability and Evaluation of Three Clinical Tests: A Biomechanical Study

T. MORIYA
M. AOKI
K. IBA
Y. OZASA
T. WADA
T. YAMASHITA

From the Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine and Department of Physical Therapy, Sapporo Medical University School of Health Sciences, Sapporo, Japan

Correspondence: Mitsuhiro Aoki, MD, PhD, Department of Physical Therapy, Sapporo Medical University, School of Health Sciences, South-3, West-17, Chuo-ku, Sapporo 060-8556, Japan. Tel.: +81-11-611-2111; fax: +81-11-611-2150. E-mail:maoki{at}sapmed.ac.jp.

Using 11 fresh/frozen cadaver specimens, instability of the distal radioulnar joint (DRUJ) during passive wrist motion was measured by motion analysis and three clinical tests (ulno-carpal stress test, piano-key test, and DRUJ ballottement test) were performed. Release of the triangular ligament from the palmar approach was performed to simulate instability of the DRUJ. Displacement of the distal radius against the ulnar head was measured at various degrees of forearm rotation. Release of the triangular ligament at the ulnar fovea and around the base of the ulnar styloid process caused various degrees of DRUJ instability during passive wrist motion. After complete triangular ligament release, only the DRUJ ballottement test demonstrated a statistically significant degree of accuracy in the evaluation of distal radioulnar joint instability.

Key Words: distal radioulnar joint • instability • cadaver • motion analysis • clinical test

This version was published on April 1, 2009

Journal of Hand Surgery (European Volume), Vol. 34, No. 2, 219-223 (2009)
DOI: 10.1177/1753193408098482
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