Reconstruction of the Distal Oblique Bundle of the Interosseous Membrane: A Technique to Restore Distal Radioulnar Joint Stability

2015 ◽  
Vol 40 (11) ◽  
pp. 2279-2282 ◽  
Author(s):  
Michael D. Riggenbach ◽  
Thomas W. Wright ◽  
Paul C. Dell
Keyword(s):  
Distal Radioulnar Joint ◽  
Interosseous Membrane ◽  
Joint Stability ◽  
Radioulnar Joint

The Biomechanical Effect of the Distal Interosseous Membrane on Distal Radioulnar Joint Stability: A Preliminary Anatomic Study

2011 ◽  
Vol 36 (10) ◽  
pp. 1626-1630 ◽  
Author(s):  
Takashi Kitamura ◽  
Hisao Moritomo ◽  
Sayuri Arimitsu ◽  
Lawrence J. Berglund ◽  
Kristin D. Zhao ◽  
...  
Keyword(s):  
Distal Radioulnar Joint ◽  
Interosseous Membrane ◽  
Joint Stability ◽  
Anatomic Study ◽  
Radioulnar Joint ◽  
Biomechanical Effect

The rein-type arthroscopic capsular suture for triangular fibrocartilage complex foveal tears: midterm results for 90 patients

2021 ◽  
pp. 175319342110241
Author(s):  
I-Ning Lo ◽  
Kuan-Jung Chen ◽  
Tung-Fu Huang ◽  
Yi-Chao Huang
Keyword(s):  
Simple Procedure ◽  
Distal Radioulnar Joint ◽  
Triangular Fibrocartilage Complex ◽  
Joint Stability ◽  
Level Of Evidence ◽  
Radioulnar Joint ◽  
High Satisfaction ◽  
Ultrasound Assessment ◽  
Triangular Fibrocartilage

We describe an arthroscopic rein-type capsular suture that approximates the triangular fibrocartilage complex to the anatomical footprint, and report the results at a minimum 12 month follow-up. The procedure involves two 3-0 polydioxanone horizontal mattress sutures inserted 1.5 cm proximal to the 6-R and 6-U portals to obtain purchase on the dorsal and anterior radioulnar ligaments, respectively. The two sutures work as a rein to approximate the triangular fibrocartilage complex to the fovea. Ninety patients with Type IB triangular fibrocartilage complex injuries were included retrospectively. The 12-month postoperative Modified Mayo Wrist scores, Disabilities of Arm, Shoulder and Hand scores and visual analogue scale for pain showed significant improvements on preoperative values. Postoperative range of wrist motion, grip strength and ultrasound assessment of the distal radioulnar joint stability were comparable with the normal wrist. The patients had high satisfaction scores for surgery. There were minor complications of knot irritation. No revision surgery for distal radioulnar joint instability was required. It is an effective and technically simple procedure that provides a foveal footprint contact for the triangular fibrocartilage complex. Level of evidence: IV

Effect of decrease in radial inclination of distal radius fractures on distal radioulnar joint stability: a biomechanical study

2018 ◽  
Vol 43 (9) ◽  
pp. 967-973 ◽  
Author(s):  
Yuki Bessho ◽  
Toshiyasu Nakamura ◽  
Masao Nishiwaki ◽  
Takeo Nagura ◽  
Morio Matsumoto ◽  
...  
Keyword(s):  
Distal Radius ◽  
Joint Stiffness ◽  
Distal Radioulnar Joint ◽  
Biomechanical Study ◽  
Joint Stability ◽  
Radius Fractures ◽  
Radioulnar Joint ◽  
Radial Inclination ◽  
Fresh Frozen ◽  
The Relationship

We investigated the relationship between the radial inclination of the distal radius and distal radioulnar joint stability. Six fresh-frozen upper extremities were used. Radial inclination was decreased by 10° and 20° and increased by 10° from the original radial inclination. Distal radioulnar joint stiffness was assessed with an intact radioulnar ligament and after partial and then complete sectioning of the radioulnar ligament. Radial angulation deformities significantly increased distal radioulnar joint stiffness when the radioulnar ligament is totally or partially attached to the ulnar fovea. After complete sectioning of the radioulnar ligament, distal radioulnar joint stiffness decreased significantly; additional radial angulation deformity slightly increased distal radioulnar joint stiffness, but the distal radioulnar joint never recovered to the original stiffness. Based on the results, radial angulation deformities of the distal radius should be corrected within 10° when the radioulnar ligament is intact, to reduce the risk of symptomatic distal radioulnar joint instability.

Outcomes after anatomic reconstruction of the radioulnar ligaments for distal radioulnar joint instability

2020 ◽  
Vol 45 (9) ◽  
pp. 909-915 ◽  
Author(s):  
Lisa M. Frantz ◽  
Elizabeth A. Helsper ◽  
Harry A. Morris ◽  
Bernard F. Hearon
Keyword(s):  
Joint Instability ◽  
Stress Test ◽  
Distal Radioulnar Joint ◽  
Tendon Graft ◽  
Anatomic Reconstruction ◽  
Joint Stability ◽  
Level Of Evidence ◽  
Radioulnar Joint ◽  
High Satisfaction ◽  
Graft Rupture

This retrospective study investigated the clinical outcomes of patients treated for chronic distal radioulnar joint instability with open anatomic reconstruction of the palmar and dorsal radioulnar ligaments. After the midpoint of a tendon graft is anchored at the ulnar fovea, the two graft limbs traverse the distal radioulnar joint. One limb is woven into the palmar wrist capsule and the other is secured to the dorsal wrist capsule and retinaculum to stabilize the joint. Of 30 patients (31 wrists) treated with this technique, 19 were followed longitudinally for a mean of 10 years (range 3–21). In this long-term cohort, there were statistically significant improvements in ulnar-sided wrist pain on the visual analogue scale and in distal radioulnar joint stability on the dorsopalmar stress test. The modified Mayo Wrist Scores were classified as three excellent, 12 good, three fair and one poor. Of the 30 patients studied, failure occurred in four patients, two from graft rupture and two from distal radioulnar joint arthrosis. We conclude that anatomic reconstruction of the palmar and dorsal radioulnar ligaments is an effective treatment for distal radioulnar joint instability and is associated with high satisfaction and durable outcomes. Level of evidence: IV

scholarly journals Reconstruction of the Distal Oblique Bundle of the Interosseous Membrane with Extensor Carpi Radialis Hemitendon: A New Minimally-Invasive Technique

2020 ◽  
Vol 48 (02) ◽  
pp. 138-142
Author(s):  
Francisco Martínez-Martínez ◽  
Alberto Giménez-Ros ◽  
Vicente J. León-Muñoz ◽  
Fernando Santonja-Medina
Keyword(s):  
Minimally Invasive ◽  
Therapeutic Option ◽  
Distal Radioulnar Joint ◽  
Minimally Invasive Technique ◽  
Interosseous Membrane ◽  
Invasive Technique ◽  
Radioulnar Joint ◽  
Triangular Fibrocartilage ◽  
Extensor Carpi Radialis ◽  
Stabilizing Element

AbstractThe main stabilizing element of the distal radioulnar joint (DRUJ) is the triangular fibrocartilage complex (TFCC). Secondary stabilizers include the distal oblique band (DOB), which is inconsistently found. When TFCC repair has failed or cannot be performed, DOB reconstruction is a therapeutic option. Even though distal radioulnar ligamentoplasty remains the technique of choice, recent papers show similar outcomes from both methods. We present two cases of successful DOB repair with the extensor carpi radialis longus (ECRL) hemitendon.

The Stabilizing Effect of the Distal Interosseous Membrane on the Distal Radioulnar Joint in an Ulnar Shortening Procedure: A Biomechanical Study

2011 ◽  
Vol 93 (21) ◽  
pp. 2022-2030 ◽  
Author(s):  
Sayuri Arimitsu ◽  
Hisao Moritomo ◽  
Takashi Kitamura ◽  
Lawrence J Berglund ◽  
Kristin D Zhao ◽  
...  
Keyword(s):  
Distal Radioulnar Joint ◽  
Biomechanical Study ◽  
Interosseous Membrane ◽  
Radioulnar Joint ◽  
Stabilizing Effect

Effect of volar angulation of extra-articular distal radius fractures on distal radioulnar joint stability: a biomechanical study

2015 ◽  
Vol 40 (8) ◽  
pp. 775-782 ◽  
Author(s):  
Y. Bessho ◽  
T. Nakamura ◽  
T. Nagura ◽  
M. Nishiwaki ◽  
K. Sato ◽  
...  
Keyword(s):  
Distal Radius ◽  
Joint Stiffness ◽  
Distal Radioulnar Joint ◽  
Biomechanical Study ◽  
Joint Stability ◽  
Level Of Evidence ◽  
Radioulnar Joint ◽  
Dorsal Angulation ◽  
Triangular Fibrocartilage ◽  
The Relationship

The relationship between increased volar tilt of the distal radius and distal radioulnar joint stability was examined. Distal radioulnar joint stiffness was recorded at 10° intervals from 10° dorsal angulation to 20° of volar angulation from the anatomical position of the radius. Tests were performed with the intact radioulnar ligament and repeated after partial and then complete sectioning of the radioulnar ligament at the ulnar fovea. With the intact radioulnar ligament, distal radioulnar joint stiffness increased significantly at 10° and 20° of volar angulation. Partial sectioning of the radioulnar ligament resulted in an approximate 10% decrease of distal radioulnar joint stiffness compared with the intact state, but distal radioulnar joint stiffness still increased significantly with greater volar tilt. Complete sectioning of the radioulnar ligament significantly decreased distal radioulnar joint stiffness, and increasing the volar tilt did not result in increased distal radioulnar joint stiffness. These results suggest that volar angulation deformities of the distal radius should be corrected to 10° of volar tilt when the triangular fibrocartilage complex is intact. Level of Evidence: N/A

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