The Hook Test Is More Accurate Than the Trampoline Test to Detect Foveal Tears of the Triangular Fibrocartilage Complex of the Wrist

被引:26
作者
Atzei, Andrea [1 ,2 ]
Luchetti, Riccardo [3 ]
Carletti, Daniele [4 ]
Marcovici, Lucian Lior [5 ]
Cazzoletti, Lucia [6 ]
Barbon, Silvia [7 ]
机构
[1] Hand Surg & Rehabil Ctr, PRO Mano, Treviso, Italy
[2] Osped Koelliker, Hand Surg Unit, Turin, Italy
[3] Rimini Hand Surg & Rehabil Ctr, Rimini, Italy
[4] Osped Mater Salutis, Dept Orthopaed, Legnago, Italy
[5] Jewish Hosp Rome, Hand & Microsurg Unit, Rome, Italy
[6] Univ Verona, Sect Epidemiol & Med Stat, Dept Diagnost & Publ Hlth, Verona, Italy
[7] Univ Padua, Dept Neurosci, Padua, Italy
关键词
ARTHROSCOPY; CLASSIFICATION; ANATOMY;
D O I
10.1016/j.arthro.2021.03.005
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
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 < .001) for distal tears and 78.85% and 100.00% (P < .001) and 58.33% and 100.00% (P < .001) for complete or isolated proximal tears, respectively. Specificity for the trampoline and hook tests was 67.27% and 96.36% (P < .001) respectively. 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.
引用
收藏
页码:1800 / 1807
页数:8
相关论文
共 26 条
  • [1] Midterm Results after Open versus Arthroscopic Transosseous Repair for Foveal Tears of the Triangular Fibrocartilage Complex
    Abe, Yukio
    Fujii, Kenzo
    Fujisawa, Takeyoshi
    [J]. JOURNAL OF WRIST SURGERY, 2018, 7 (04) : 292 - 297
  • [2] Classification of ulnar triangular fibrocartilage complex tears. A treatment algorithm for Palmer type IB tears
    Atzei, A.
    Luchetti, R.
    Garagnani, L.
    [J]. JOURNAL OF HAND SURGERY-EUROPEAN VOLUME, 2017, 42 (04) : 405 - 414
  • [3] NEW TRENDS IN ARTHROSCOPIC MANAGEMENT OF TYPE 1-B TFCC INJURIES WITH DRUJ INSTABILITY
    Atzei, A.
    [J]. JOURNAL OF HAND SURGERY-EUROPEAN VOLUME, 2009, 34E (05) : 582 - 591
  • [4] Arthroscopic Foveal Repair of the Triangular Fibrocartilage Complex
    Atzei, Andrea
    Luchetti, Riccardo
    Braidotti, Federica
    [J]. JOURNAL OF WRIST SURGERY, 2015, 4 (01) : 22 - 30
  • [5] Foveal TFCC Tear Classification and Treatment
    Atzei, Andrea
    Luchetti, Riccardo
    [J]. HAND CLINICS, 2011, 27 (03) : 263 - +
  • [6] Badur N., 2015, Wrist and Elbow Arthroscopy: A Practical Surgical Guide to Techniques, V2nd ed., P1
  • [7] New advances in wrist arthroscopy
    Bain, Gregory I.
    Munt, Justin
    Turner, Perry C.
    [J]. ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, 2008, 24 (03) : 355 - 367
  • [8] Chen WJ, 2017, ARTHROSC TEC, V6, pE57, DOI 10.1016/j.eats.2016.09.004
  • [9] Wrist arthrography versus arthroscopy: A comparative study of 150 cases
    Chung, KC
    Zimmerman, NB
    [J]. JOURNAL OF HAND SURGERY-AMERICAN VOLUME, 1996, 21A (04): : 591 - 594
  • [10] Dry arthroscopy of the wrist:: Surgical technique
    del Pinal, Francisco
    Garcia-Bernal, Francisco J.
    Pisani, Daniele
    Regalado, Javier
    Ayala, Higinio
    Studer, Alexis
    [J]. JOURNAL OF HAND SURGERY-AMERICAN VOLUME, 2007, 32A (01): : 119 - 123