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Subluxation of the distal radioulnar joint as a predictor of foveal triangular fibrocartilage complex tears.
MedLine Citation:
PMID:  22036278     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
PURPOSE: The triangular fibrocartilage complex (TFCC) with its ulnar foveal attachment is the primary stabilizer of the distal radioulnar joint (DRUJ). The purpose of this study was to describe a technique for measuring the degree of subluxation of the DRUJ in wrist magnetic resonance imaging (MRI) examinations to predict tears involving the foveal attachment of the TFCC.
METHODS: We measured DRUJ geometry in wrist MRI examinations of 34 patients who were found to have foveal TFCC tears at surgery. We compared the results with DRUJ geometry in 11 asymptomatic controls. Subluxation of the ulnar head was assessed using transaxial MRI images obtained at the level of the DRUJ with the wrist in pronation. We quantified subluxation with a line spanning the sigmoid notch of the radius and a perpendicular line through the center of curvature of the articulating surface of the ulna. We calculated the ratio of the lengths of the dorsal and volar segments and normalized it to the center of the sigmoid notch.
RESULTS: A total of 34 patients with intraoperatively confirmed tears of the foveal attachment of the TFCC had a mean dorsal ulnar subluxation measurement of 16% ± 4%, whereas the 11 controls had a mean subluxation measurement of 5% ± 4%.
CONCLUSIONS: The results confirm the hypothesis that subluxation of the ulnar head relative to the sigmoid notch of the radius, as assessed by MRI with the wrist in pronation, is a predictor of tears of the foveal attachment of the TFCC.
TYPE OF STUDY/LEVEL OF EVIDENCE: Diagnostic II.
Authors:
Eric C Ehman; Meredith L Hayes; Richard A Berger; Joel P Felmlee; Kimberly K Amrami
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of hand surgery     Volume:  36     ISSN:  1531-6564     ISO Abbreviation:  J Hand Surg Am     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-10-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7609631     Medline TA:  J Hand Surg Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1780-4     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
Affiliation:
Mayo Medical School and Departments of Radiology and Orthopedic Surgery, Mayo Clinic, Rochester, MN.
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