Reliability and Validity Analysis of the Distal Radioulnar Joint Ballottement Test.

Autor:	Nagashima M; Department of Orthopedic Surgery, Osaka Gyoumeikan Hospital, Osaka City, Osaka Prefecture, Japan., Omokawa S; Department of Hand Surgery, Nara Medical University, Kashihara City, Nara Prefecture, Japan. Electronic address: omokawa@gaia.eonet.ne.jp., Hasegawa H; Department of Orthopedic Surgery, Nara Medical University, Kashihara City, Nara Prefecture, Japan., Nakanishi Y; Department of Orthopedic Surgery, Nara Medical University, Kashihara City, Nara Prefecture, Japan., Kawamura K; Department of Orthopedic Surgery, Nara Medical University, Kashihara City, Nara Prefecture, Japan., Tanaka Y; Department of Orthopedic Surgery, Nara Medical University, Kashihara City, Nara Prefecture, Japan.
Jazyk:	angličtina
Zdroj:	The Journal of hand surgery [J Hand Surg Am] 2024 Jan; Vol. 49 (1), pp. 15-22. Date of Electronic Publication: 2023 Nov 22.
DOI:	10.1016/j.jhsa.2023.10.006
Abstrakt:	Purpose: Triangular fibrocartilage complex injuries can cause distal radioulnar joint (DRUJ) instability, which can be evaluated clinically with the DRUJ ballottement test. However, the reliability and validity of the test are unclear. This study aimed to analyze the reliability and validity of the test using a tracking device on healthy participants and patients with triangular fibrocartilage complex injuries. Methods: In this cross-sectional study, three orthopedic hand surgeons performed the DRUJ ballottement test using a technique of holding the carpal bones to the radius on 25 healthy participants (50 hands; 10 men and 15 women; mean age, 33 years; range, 20-51 years) and eight patients with triangular fibrocartilage complex injuries (16 hands; six men and two women; mean age, 43 years; range, 27-59 years). We used a three-dimensional electromagnetic tracking device to quantify the movement of the DRUJ and verify the reliability and validity of the test. Results: The intrarater and interrater intraclass correlation coefficients for DRUJ movement were 0.77 and 0.61, respectively, and the kappa coefficient for grading of DRUJ instability was 0.79. The correlation coefficient between DRUJ movement measured using the tracking device and instability judged clinically was 0.77. A comparison of healthy participants and the patients showed significantly greater DRUJ movement in the patients. Conclusions: The test showed substantial intrarater and interrater reliability for assessing DRUJ movement and instability. The significant positive correlation between DRUJ movement and instability indicates the concurrent validity of the test. Moreover, the test showed discriminative validity in identifying mild or moderate DRUJ instability. Clinical Relevance: The DRUJ ballottement test using the holding technique has a relatively high diagnostic accuracy and can be used to assess DRUJ instability. (Copyright © 2024 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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