Quadlbauer S, Pezzei C, Hintringer W, Hausner T, Leixnering M
AUVA Unfallkrankenhaus Lorenz Böhler - European Hand Trauma Center, Donaueschingenstraße 13, 1200, Wien, Österreich.
Ludwig Boltzmann Institut für Experimentelle und Klinische Traumatologie, AUVA Research Center, 1200, Wien, Österreich.
Orthopade. 2018 Aug;47(8):628-636. doi: 10.1007/s00132-018-3584-x.
The distal radioulnar joint (DRUJ) provides the distal link between radius and ulnar and is the centre of rotation during pronation and supination. Pronation and supination are essential in controlling the posture and optimal presentation of the hand to grasp an object. In addition, pronation and supination enable us to rotate tools when they are in the longitudinal axis of the forearm. Due to this, the DRUJ plays a central role in the performance of activities in daily life.
Examination of the ulnar-side of the wrist remains challenging for hand surgeons due to a wide range of pathologies with overlapping clinical symptoms. Therefore, the clinical examination must be carried out carefully to detect the origin of the patient's complaints. Several special examination techniques are available, but their application and interpretation strongly depend on the skills and experience of the physician. Most tests are not evaluated in comparison to the gold standard of wrist arthroscopy with respect to sensitivity and specificity. The most reliable test for the DRUJ are the ulnar fovea sign, the dorsopalmar stress test and the press test.
桡尺远侧关节（DRUJ）是桡骨和尺骨之间的远端连接部位，是旋前和旋后过程中的旋转中心。旋前和旋后对于控制手部姿势以及以最佳方式呈现手部以抓取物体至关重要。此外，当工具位于前臂纵轴时，旋前和旋后使我们能够旋转工具。因此，桡尺远侧关节在日常生活活动中起着核心作用。
由于存在多种具有重叠临床症状的病理情况，手部外科医生对腕部尺侧进行检查仍然具有挑战性。因此，必须仔细进行临床检查以发现患者主诉的根源。有几种特殊检查技术可用，但它们的应用和解读很大程度上取决于医生的技能和经验。大多数测试在敏感性和特异性方面未与腕关节镜检查的金标准进行比较评估。对于桡尺远侧关节最可靠的测试是尺骨凹征、背掌侧应力试验和按压试验。
