Multiplanar wrist joint proprioception: The effect of anesthetic blockade of the posterior interosseous nerve or skin envelope surrounding the joint

The Effect of Triangular Fibrocartilage Complex Tear on Wrist Proprioception

PURPOSE

This study examined the influence of triangular fibrocartilage complex (TFCC) deep fiber tears on wrist proprioception.

METHODS

The study involved 48 subjects: 24 with deep fiber TFCC tears and 24 with healthy wrists. A specially created sensor measured wrist proprioception in 3 axes of movement. Absolute differences between target and subject-reproduced angles were compared in injured and healthy wrists and in injured and contralateral patient wrists. A greater difference in reproduced angles was deemed to reflect a lesser ability to approximate a target angle.

RESULTS

In wrists with TFCC injuries, 40° pronation and 60° pronation showed significantly greater differences between target and subject-reproduced angles compared with those in the control wrists. In wrists with TFCC injuries, 40° pronation demonstrated significantly greater differences between target and subject-reproduced angles than did those in patients' contralateral wrists. Proportions of outliers with absolute differences greater than 6° were significantly higher in 60° supination and 40° pronation in wrists with TFCC injuries.

CONCLUSIONS

Deep TFCC fiber detachment may lead to decreased wrist proprioception in 60° and 40° forearm rotation.

CLINICAL RELEVANCE

Deep TFCC fiber tear may contribute to decreased wrist rotational positioning sense and may have biomechanical importance in distal radioulnar joint stability.