Contribution of a distal radioulnar joint stabilizer on forearm stability: A modeling study

Author(s):  
Batbayar Khuyagbaatar ◽  
Sang-Jin Lee ◽  
Ulziikhutag Bayarjargal ◽  
Maro Cheon ◽  
Temuujin Batbayar ◽  
...  

Instability of the forearm is a complex problem that leads to pain and limited motions. Up to this time, no universal consensus has yet been reached as regards the optimal treatment for forearm instability. In some cases, conservative treatments are recommended for forearm instability injuries. However, quantitative studies on the conservative treatment of forearm instability are lacking. The present study developed a finite element model of the forearm to investigate the contribution of the distal radioulnar joint stabilizer on forearm stability. The stabilizer was designed to provide stability between the radius and ulna. The forearm model with and without the stabilizer was tested using the pure transverse separation and radial pull test for the different ligament sectioned models. The percentage contribution of the stabilizer and ligament structures resisting the load on the forearm was estimated. For the transverse stability of the forearm, the central band resisted approximately 50% of the total transverse load. In the longitudinal instability, the interosseous membrane resisted approximately 70% of the axial load. With the stabilizer, models showed that the stabilizer provided the transverse stability and resisted almost 1/4 of the total transverse load in the ligament sectioned models. The stabilizer provided transverse stability and reduced the loading on the ligaments. We suggested that a stabilizer can be applied in the conservative management of patients who do not have the gross longitudinal instability with the interosseous membrane and the triangular fibrocartilage complex disruption.

2020 ◽  
Vol 48 (02) ◽  
pp. 138-142
Author(s):  
Francisco Martínez-Martínez ◽  
Alberto Giménez-Ros ◽  
Vicente J. León-Muñoz ◽  
Fernando Santonja-Medina

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.


2011 ◽  
Vol 93 (21) ◽  
pp. 2022-2030 ◽  
Author(s):  
Sayuri Arimitsu ◽  
Hisao Moritomo ◽  
Takashi Kitamura ◽  
Lawrence J Berglund ◽  
Kristin D Zhao ◽  
...  

2019 ◽  
Vol 24 (03) ◽  
pp. 251-257 ◽  
Author(s):  
Kate Elzinga ◽  
Kevin Chung

Geometrically, rings distribute their stress along their arc instead of concentrating at any one point. The forearm ring is composed of the radius, ulna, proximal radioulnar joint, and distal radioulnar joint. The annular ligament, interosseous membrane, and triangular fibrocartilage complex link and stabilize the ring. Injuries to the forearm occur along a continuum with recognized patterns of ring disruption, including Galeazzi, Monteggia, and Essex-Lopresti injuries. The Darrach procedure causes a disruption to the forearm ring and can lead to painful convergence between the radius and distal ulnar stump. Injuries to the forearm ring are unstable. Management of forearm injuries is centered on the restoration of the anatomy and stability of the forearm ring. Forearm ring injuries and their treatment are discussed in this article.


2011 ◽  
Vol 36 (10) ◽  
pp. 1626-1630 ◽  
Author(s):  
Takashi Kitamura ◽  
Hisao Moritomo ◽  
Sayuri Arimitsu ◽  
Lawrence J. Berglund ◽  
Kristin D. Zhao ◽  
...  

2016 ◽  
Vol 16 (02) ◽  
pp. 1650010
Author(s):  
JIANWEI SUN ◽  
BINGSHAN YAN ◽  
WENZHONG NIE ◽  
ZHONGZHENG ZHI ◽  
KEKE GUI ◽  
...  

Objectives: The study was to establish a precise three-dimensional (3D) finite element model (FEM) of the distal radioulnar joint (DRUJ) and then to validate its accuracy for the application to the research on clinical biomechanics. Materials and methods: The right forearm DRUJ of a volunteer (male, 28 years old, 62 kilograms) was scanned by computed tomography (CT) and magnetic resonance imaging (MRI). The resulting sectional images were input into MIMICS10.1 and ANSYS10.0 to generate 3D FEM of the DRUJ. With this FEM, the bending load, axial compression load and the torsion load conditions were simulated, and the vonmises stress distribution of the DRUJ was detected. The simulation results were compared with the biomechanics experiment results which were reported by the literatures. Results: The constructed FEM consisted of 333,805 elements and 508,384 nodes. Together, the simulation results with this FEM were in consistent with those of the reported experiments in bending load, axial compression load and torsion load conditions. Discussion: The 3D FEM of the DRUJ can reflect the real geometric structure of the DRUJ objectively and the simulation with this FEM can predict the results of the biomechanics experiments successfully.


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