Pickering Greg Thomas, Fine Nicola Francesca, Knapper Thomas David, Giddins Grey Edward Bence
Department of Trauma & Orthopaedics, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK.
Department of Trauma & Orthopaedics, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK.
J Hand Surg Eur Vol. 2022 Apr;47(4):375-378. doi: 10.1177/17531934211054282. Epub 2021 Nov 2.
Accurate assessment of distal radioulnar joint (DRUJ) stability is increasingly recognized as an important part of clinical examination of the wrist. The ability of 30 specialist UK hand surgeons to clinically determine the stability of four volunteers' wrists was assessed. Volunteers' wrist stability had previously been confirmed with a validated measurement rig. Use of the wrist ballottement test as the primary examination technique yielded a positive predictive value of 81%, a negative predictive value of 55%, a specificity of 94% and a sensitivity of only 24%, for the detection of DRUJ instability. No correlation between background speciality (orthopaedic versus plastic surgery), nor years of clinical experience was found. Clinical assessment of DRUJ instability among experienced clinicians appears unreliable and instability is typically under recognized. Previous research to date using this clinical assessment method as a parameter of success is therefore brought into question. IV.
准确评估桡尺远侧关节（DRUJ）稳定性日益被视为手腕临床检查的重要组成部分。对30名英国手部专科外科医生临床判定四名志愿者手腕稳定性的能力进行了评估。志愿者手腕的稳定性此前已通过经过验证的测量装置得以确认。将腕关节冲击试验作为主要检查技术，对于检测桡尺远侧关节不稳定，其阳性预测值为81%，阴性预测值为55%，特异性为94%，而敏感性仅为24%。未发现背景专业（骨科与整形外科）以及临床经验年限之间存在相关性。经验丰富的临床医生对桡尺远侧关节不稳定的临床评估似乎不可靠，且不稳定情况通常未得到充分认识。因此，以往将这种临床评估方法作为成功参数的研究受到质疑。四、
