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

Abstract 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. 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. 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. 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.