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Journal of the Korean Society for Surgery of the Hand 2006;11(1):1-6.
Published online March 1, 2006.
Diagnostic Usefulness of Ulnocarpal Stress Test for Triangular Fibrocartilage Lesions
Jae Sung Lee, Min Jong Park
삼각 섬유연골 병변에 대한 척 수근 부하 검사의 진단적 유용성
이재성, 박민종
Abstract
Purpose
The purpose of this study is to describe the ulnocarpal stress test and to evaluate its diagnostic usefulness in patients with triangular fibrocartilage(TFC) lesions Materials and Methods: Sixty nine patients who had been initially diagnosed with TFC lesions and had undergone wrist arthroscopy were included in this study. Before the arthrocopic surgery, the ulnocarpal stress test was performed as follows. While the patient`s wrist is ulnarly deviated, hypersupination and hyperpronation stress are applied at a dorsiflexion, neutral and volarflexion position respectively. Evoked pain was rated into 4 grades and recorded in each position. The patients diagnosed with TFC lesions by arthroscopy were divided into traumatic group and degenerative group, and results of ulnocarpal stress test of each group were analyzed. (statistical analysis : GEE, p=0.05) Results: The arthroscopic diagnosis demonstrated traumatic TFC tear in 32 cases, degenerative TFC lesion in 19 cases, combined lesion in 3 cases, lunotriquetral ligament tear in 7 cases, synovitis in 6 cases and no specific abnormal findings in 2 cases. In the traumatic group, hypersupination stress evoked greater pain than hyperpronation especially in dorsiflexed position. In the degenerative TFC lesion group, the intensity of pain showed little relevance to the position of wrist rotation, but the pain was aggravated when the wrist was dorsiflexed during the test. Conclusion: Ulnocarpal stress test can be used effectively not only as a clinical screening test for ulnar sided wrist pain but also as a predictive method of the type of TFC lesions.
 


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