Abstract
Background
Distal radioulnar joint (DRUJ) instability is a common yet underdiagnosed cause of
ulnar-sided wrist pain, often associated with triangular fibrocartilage complex (TFCC)
injuries. Clinical assessment of DRUJ instability is challenging due to the limited
reliability of existing tests. This study introduces the wind off test (WOT) as a
novel clinical test for detecting TFCC tears and evaluates its diagnostic accuracy
compared to arthroscopic findings.
Materials and Methods
A retrospective audit was conducted on patients who underwent diagnostic wrist arthroscopy
over 12 months. The WOT result (positive or negative) was compared with arthroscopically
confirmed TFCC tears. Sensitivity, specificity, positive predictive value (PPV), negative
predictive value, and diagnostic accuracy were calculated. Patients without a recorded
WOT result preoperatively were excluded.
Results
79 patients met the inclusion criteria for this study. Of these, 76 had a TFCC tear
confirmed at arthroscopy. The WOT demonstrated a sensitivity of 92.1%, a specificity
of 0.0%, a PPV of 95.9%, and a diagnostic accuracy of 88.6%. Notably, all patients
without a TFCC tear had a positive WOT, resulting in no true negatives.
Conclusion
The WOT is a highly sensitive test for detecting TFCC tears but lacks specificity,
leading to false positives. While the test may serve as a useful screening tool, it
should be interpreted alongside other clinical findings, imaging studies, and arthroscopy
when necessary. Further prospective studies are needed to assess interobserver reliability
and compare the WOT with existing clinical tests for TFCC tears.
Keywords
wind off test - triangular fibrocartilage - TFCC - DRUJ instability - TFCC tears
