Rehabilitation of distal radioulnar joint instability

Mesplié, Grégory; Grelet, V.; Léger, Olivier; Lemoine, Stéphane; Ricarrère, D.; Geoffroy, Coline

doi:10.1016/j.hansur.2017.02.005

Cited by 18 publications

(12 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There is increasing awareness of the role of dynamic wrist stability, and several studies describe how pronator quadratus (PQ) and extensor carpi ulnaris (ECU) play a role in stabilizing the DRUJ. [6][7][8][9][10][11][12][13] To our knowledge, this theory has not yet been reported in clinical research with regards to non-surgical management of TFCC injuries with symptoms of (sub)acute or chronic DRUJ instability. Hence, it is not clear how an exercise program may contribute may contribute to reduction of pain and functional limitations, and the incidence of surgical intervention in these patients.…”

Section: Introductionmentioning

confidence: 99%

Rehabilitation with a stabilizing exercise program in triangular fibrocartilage complex lesions with distal radioulnar joint instability: A pilot intervention study

et al. 2019

View full text Add to dashboard Cite

Introduction: It is unclear whether rehabilitation with the use of an exercise program can be an alternative to surgery in distal radioulnar joint instability resulting from injuries of the triangular fibrocartilage complex. The purpose of this study was to gain insights into the feasibility and effects in reducing pain and functional limitations by using distal radioulnar stability training. Methods: A prospective pilot cohort intervention study was used including patients with a triangular fibrocartilage complex Palmer 1B lesion and distal radioulnar joint instability. The primary objective was the reduction of pain and functional limitations as measured by the Patient-Rated Wrist-Hand Evaluation. Secondary objectives were to assess number of surgical interventions, treatment sessions, and patient satisfaction. Results: Twenty-one patients (mean age: 33.2 years) were included with a median time of symptom onset of eight months (IQR: 5-24). The distal radioulnar stability training program showed a clinically relevant positive change in the Patient-Rated Wrist-Hand Evaluation total and subscale scores when compared to the baseline assessment. Six patients opted for surgical intervention at six months follow-up, and two patients were considering surgery at the long-term follow-up. Conclusion: Rehabilitation with stabilizing exercises in patients with distal radioulnar joint instability caused by triangular fibrocartilage complex 1B lesions provides pain relief and increases function. Findings should be validated by further controlled prospective studies.

show abstract

Section: Introductionmentioning

confidence: 99%

Rehabilitation with a stabilizing exercise program in triangular fibrocartilage complex lesions with distal radioulnar joint instability: A pilot intervention study

et al. 2019

View full text Add to dashboard Cite

show abstract

“…The literature has recommended immobilizing patients with DRUJ instability for 4–6 weeks in a stable position to reduce symptoms and allow healing prior commencing rehabilitation. 2 However, it is beyond the scope of this study to investigate the effects of splinting on recovery and patients’ subsequent improvements in the outcome measures.…”

Section: Discussionmentioning

confidence: 99%

“…1 TFCC stabilizes the ulnar side of radiocarpal and the distal radioulnar joint (DRUJ). 2,3 As DRUJ is a load-bearing joint, TFCC also has an important role to cushion compressive loads transmitted from the ulnar carpus, and assist with load transmission between the carpus and ulna. 4,5 Studies have reported that injury to the TFCC results in at least 20% reduction in the ability to bear load.…”

Section: Introductionmentioning

confidence: 99%

“…10 Patients with TFCC injury may experience reduced wrist sensorimotor control due to decreased wrist proprioception, in addition to DRUJ instability which causes ulnar sided wrist pain, decreased grip strength and reduced ability to weight bear. 2,10,11 These lead to problems with wrist function in daily activities.…”

Section: Introductionmentioning

confidence: 99%

“…Neuromuscular rehabilitation of DRUJ stabilizers PQ and ECU and reactive muscle activations exercises enhance DRUJ stability by re-establishing proprioceptive reflexes at the joint to react to destabilizing forces in daily activities. 2 In WSRP, DTM exercises are introduced early to help restore wrist movements. Biomechanical studies have found that the mechanical axis of wrist and the orientation of muscle insertions is oriented along the DTM plane.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Clinical evaluation of a wrist sensorimotor rehabilitation program for triangular fibrocartilage complex injuries

Chen

2021

Hand Therapy

View full text Add to dashboard Cite

Introduction Triangular fibrocartilage complex (TFCC) injuries are associated with distal radioulnar joint (DRUJ) instability and impaired wrist proprioception. Sensorimotor training of extensor carpi ulnaris (ECU) and pronator quadratus (PQ) can enhance DRUJ stability. With limited evidence on effectiveness of TFCC sensorimotor rehabilitation, this study aimed to evaluate the effects and feasibility of a novel wrist sensorimotor rehabilitation program (WSRP) for TFCC injuries. Methods Patients diagnosed with TFCC injuries were recruited from May 2018 to January 2020 at an outpatient hand clinic in Singapore General Hospital. There are four stages in WSRP: (1) pain control, (2) muscle re-education and joint awareness, (3) neuromuscular rehabilitation, and (4) movement normalization and function. WSRP also incorporated dart throwing motion and proprioceptive neuromuscular facilitation. Outcome measures included grip strength measured with grip dynamometer, numerical pain rating scale, joint position sense (JPS) measurement, weight bearing measured with the ‘push-off’ test, and wrist function reported on the Patient Rated Wrist Hand Evaluation. Results Ten patients completed the WSRP. Mean changes were compared with minimal clinically important differences (MCID) for outcomes. All patients achieved MCID on pain, 70% of patients achieved MCID on grip strength, weight bearing and wrist function. Paired t-tests and Cohen’s D for outcome measures were calculated. There were large effect sizes of 2.47, 1.35, and 2.81 for function, grip strength and pain respectively, and moderate effect sizes of 0.72 and 0.39 for axial loading and JPS respectively. Discussion WSRP presents a potential treatment approach in TFCC rehabilitation. There is a need for future prospective clinical trials with control groups.

show abstract

Self-Rehabilitation

Parmentier¹

2022

Hand and Wrist Therapy

View full text Add to dashboard Cite

Rehabilitation of distal radioulnar joint instability

Cited by 18 publications

References 42 publications

Rehabilitation with a stabilizing exercise program in triangular fibrocartilage complex lesions with distal radioulnar joint instability: A pilot intervention study

Rehabilitation with a stabilizing exercise program in triangular fibrocartilage complex lesions with distal radioulnar joint instability: A pilot intervention study

Clinical evaluation of a wrist sensorimotor rehabilitation program for triangular fibrocartilage complex injuries

Self-Rehabilitation

Contact Info

Product

Resources

About