Execution:
- Ask the patient to perform active dorsiflexion of the wrist
- Ask the patient to perform active radial deviation
- The examiner palpates the distal ulna for sensitivity
- Perform the radioulnar drawer test by stabilizing the patient’s distal radius with the dorsum of his hand facing upwards. Then apply an alternating dorsal and volar stress to the distal ulna
- Perform the axial compression test by fixating the wrist and by compressing the metacarpals I-V along their long axis
Positive Outcome: All of the 5 tests are considered positive if pain is provoked. In the radioulnar drawer test an increased amplitude of movement compared to the other side is considered positive as well.
|
Study |
Reliability | Sn | Sp | LR+ | LR- |
| Karaca et al. (2016): All 5 items negative | NA | 100 | 6.6 | 1.07 |
0 |
| Comment: The rule seems to be able to rule out distal radius, distal ulna and carpal bone fractures within 24 hours after injury. The study of Karaca et al. (2016) had statistical shortcomings and has not been validated yet, which is why its use should be considered with caution. | |||||
