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J Wrist Surg
DOI: 10.1055/a-2716-3822
Scientific Article

The Wind Off Test: A Novel Clinical Test for TFCC Tears

Authors

  • Zoe Jones 

    1   Raise Your Hands Ltd, Claremont, Western Australia, Australia

  • Jeff Ecker 

    1   Raise Your Hands Ltd, Claremont, Western Australia, Australia
    2   Jeff Ecker Clinic, Bethesda Hospital, Claremont, Western Australia, Australia
    3   Wrist + Hand Institute, Claremont, Western Australia, Australia
    4   Hand and Upper Limb Centre, Claremont, Western Australia, Australia
    5   Faculty of Health Sciences, Curtin University, Kent Street, Bentley, Western Australia, Australia
    6   Faculty of Medicine and Dentistry, The University of Western Australia, Crawley, Western Australia, Australia

Funding Information The authors received no financial support for the research, authorship, and/or publication of this article.
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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

Contributors' Statement

Both authors reviewed and edited the manuscript and approved the final version.


Ethical Approval

This study was approved by the St John of God Ethics Committee, number 2274.


Informed Consent

Written informed consent was obtained from the patients for their anonymized information to be published in this article.




Publication History

Received: 30 April 2025

Accepted: 03 October 2025

Article published online:
28 October 2025

© 2025. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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