Giddins Grey, Knapper Thomas, Fine Nicola, Pickering Greg
Orthopaedic Department, Royal United Hospital, Bath, UK.
Orthopaedic Department, Royal Devon and Exeter Hospital, Exeter, UK.
J Hand Surg Eur Vol. 2025 Mar;50(3):389-392. doi: 10.1177/17531934241275456. Epub 2024 Sep 14.
Clinical assessment of distal radioulnar joint (DRUJ) instability has been shown to be unreliable among experienced hand surgeons in the United Kingdom (UK). The aim of this study was to test the reliability of assessing DRUJ stability in European surgeons outside the UK. Four participants (eight wrists) with four unstable and four stable DRUJs as measured with a proven jig were assessed by 34 surgeons (22 men and 12 women) with a mean age of 43 years (range 29-61). Clinical assessment of DRUJ instability had a sensitivity of 32%, specificity of 88%, a positive predictive value of 72% and a negative predictive value of 56%. Surgeons who had attended a 1-hour workshop on clinical assessment of DRUJ stability the day before the testing were no more reliable at assessing DRUJ instability when compared with those who did not. This further highlights the need for better training with feedback when assessing the DRUJ and the need for objective assessment of DRUJ instability when reported in scientific studies. V.
在英国，经验丰富的手外科医生对桡尺远侧关节（DRUJ）不稳定的临床评估已被证明不可靠。本研究的目的是测试英国以外的欧洲外科医生评估DRUJ稳定性的可靠性。34名外科医生（22名男性和12名女性）对4名参与者（8个腕关节）进行了评估，这些参与者中有4个DRUJ不稳定，4个稳定，通过经过验证的夹具测量。DRUJ不稳定的临床评估敏感性为32%，特异性为88%，阳性预测值为72%，阴性预测值为56%。与未参加者相比，在测试前一天参加了1小时DRUJ稳定性临床评估研讨会的外科医生在评估DRUJ不稳定方面并没有更可靠。这进一步凸显了在评估DRUJ时需要更好的带反馈培训，以及在科学研究报告中对DRUJ不稳定进行客观评估的必要性。五。
