Morphological characteristics of the sigmoid notch of the distal radius affect the stress distribution patterns in the distal radioulnar joint

2018 ◽  
Vol 44 (5) ◽  
pp. 496-502 ◽  
Author(s):  
Yukinori Tsukuda ◽  
Daisuke Kawamura ◽  
Yuichiro Matsui ◽  
Norimasa Iwasaki
Keyword(s):  
Stress Distribution ◽  
Articular Surface ◽  
Morphological Characteristics ◽  
Distribution Patterns ◽  
Distal Radioulnar Joint ◽  
High Density ◽  
Radioulnar Joint ◽  
Sigmoid Notch ◽  
Group 16 ◽  
Morphological Differences

The aim of this study was to clarify the effects of morphological patterns of the sigmoid notch on the stress distribution across the articular surface of the distal radioulnar joint using a computed tomography osteoabsorptiometry method. Fourteen wrists from 13 patients were classified into two groups according to the type of sigmoid notch, namely the ‘C’ type and ski-slope sigmoids, and the percentages of high-density areas on the articular surface were quantitatively analysed. The percentage of the high-density area of the dorsal region in the ski-slope sigmoid group was significantly greater than that of the ‘C’ type sigmoid group (16% vs 4.1%) and of the volar region of the ski-slope sigmoid group (16% vs 2.4%). The results indicate that bony morphological differences in the radial sigmoid notch affect the stress distribution pattern through the distal radioulnar joint.

scholarly journals Long-term Stress Distribution Patterns Across the Ankle Joint in Soccer Players: A Computed Tomography Osteoabsorptiometry Study

2020 ◽  
Vol 8 (11) ◽  
pp. 232596712096308
Author(s):  
Junki Shiota ◽  
Daisuke Momma ◽  
Takayoshi Yamaguchi ◽  
Norimasa Iwasaki
Keyword(s):  
Bone Density ◽  
Stress Distribution ◽  
Ankle Joint ◽  
Subchondral Bone ◽  
Articular Surface ◽  
Distribution Patterns ◽  
High Density ◽  
Soccer Players ◽  
Subchondral Bone Density

Background: The distribution pattern of subchondral bone density is considered to accurately reflect the stress distribution over a joint under long-term physiologic loading. The biomechanical characteristics of the surface of the ankle joint in soccer players can be determined by measuring this distribution pattern under long-term loading. Purpose: To evaluate the distribution of subchondral bone density across the ankle joint in soccer players and to determine the effects of soccer activities, including kicking motion, on the ankle joint surface under long-term loading conditions by computed tomography (CT) osteoabsorptiometry (CTOAM). Study Design: Cross-sectional study; Level of evidence, 3. Methods: CT imaging data were obtained from both ankles of 10 soccer players (soccer group) and 10 nonathletic volunteers (control group). The distribution patterns of subchondral bone density across the articular surface of the ankle joints were assessed by CTOAM. Quantitative analysis was performed of the locations and percentages of high-density areas on the articular surface. Results: Stress distribution patterns over the ankle joint differed between the soccer players and controls. In the soccer players, the high-density areas were found in the anterior part of the distal tibia and proximal talus as well as the distal fibula. The percentages of high-density areas were greater in the soccer players compared with controls ( P < .0001). Conclusion: Stress distribution over the articular surface of the ankle joint was affected by soccer activities. A high stress concentration was seen in soccer players in the anterior part of the tibia and talus and in the fibula; such excessive stress may lead to anterior impingement.

scholarly journals Stress distribution pattern in the distal radioulnar joint before and after ulnar shortening osteotomy in patients with ulnar impaction syndrome

2021 ◽  
Author(s):  
Kazutoshi Hontani ◽  
Yuichiro Matsui ◽  
Daisuke Kawamura ◽  
Atsushi Urita ◽  
Daisuke Momma ◽  
...  
Keyword(s):  
Stress Distribution ◽  
Distribution Pattern ◽  
Distal Radioulnar Joint ◽  
Radioulnar Joint ◽  
Sigmoid Notch ◽  
Ulnar Shortening Osteotomy ◽  
Ulnar Impaction ◽  
Shortening Osteotomy ◽  
Type C ◽  
Ulnar Impaction Syndrome

Abstract Ulnar shortening osteotomy (USO) for ulnar impaction syndrome potentially leads to degenerative changes of the distal radioulnar joint (DRUJ). The aim of this study was to evaluate the effect of the sigmoid notch morphology on the stress distribution pattern of the DRUJ using computed tomography (CT) osteoabsorptiometry (CT-OAM). We reviewed the pre- and postoperative transverse CT images of 15 wrists that had undergone USO. The examined wrists were classified into two groups based on the sigmoid notch morphology: the linear-type notch (type L) and the curved-type notch (type C). We calculated and statistically compared the percentage of the high-density area (%HDA) in each divided region of the sigmoid notch. In type L, %HDA was significantly larger in the distal-dorsal region of the sigmoid notch before USO. Postoperatively, in type L, no specific regions showed significantly different %HDA. In type C, %HDA was significantly larger in the distal-volar region of the sigmoid notch before USO. Postoperatively, %HDA of type C was significantly larger in the proximal-volar region. Our results suggest that in patients with USO, morphological evaluation of the sigmoid notch can serve as a predictor of osteoarthritis in the DRUJ with or without USO.

A Cadaveric Study of The Anatomy and Stability of The Distal Radioulnar Joint in The Coronal and Transverse Planes

1996 ◽  
Vol 21 (5) ◽  
pp. 587-594 ◽  
Author(s):  
A. R. TOLAT ◽  
J. K. STANLEY ◽  
I. A. TRAIL
Keyword(s):  
Small Area ◽  
Articular Surface ◽  
Type A ◽  
Distal Radioulnar Joint ◽  
Transverse Plane ◽  
Cadaveric Study ◽  
Interosseous Membrane ◽  
Radioulnar Joint ◽  
Face Type ◽  
Sigmoid Notch

Fifty preserved cadaver wrist specimens were studied. The anatomy of the distal radioulnar joint is complex, with varying configurations in the transverse and midcoronal planes. There is disparity in the radii of curvature of the sigmoid notch and the ulna-articular surface in the transverse plane, with resultant articular incongruity. Motion at the distal radioulnar joint is, hence, likely to be a combination of sliding and rotation with a small area of true appositional contact. The palmar osteocartilaginous lip of the sigmoid notch, along with the interosseous membrane, may be of importance in distal radioulnar stability. Palmar and dorsal radioulnar ligaments may act as “check-rein” ligaments, especially when seen with the “flat face” (type A) sigmoid notch.

scholarly journals Stress distribution pattern in the distal radioulnar joint before and after ulnar shortening osteotomy in patients with ulnar impaction syndrome

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kazutoshi Hontani ◽  
Yuichiro Matsui ◽  
Daisuke Kawamura ◽  
Atsushi Urita ◽  
Daisuke Momma ◽  
...  
Keyword(s):  
Stress Distribution ◽  
Distribution Pattern ◽  
Distal Radioulnar Joint ◽  
Radioulnar Joint ◽  
Sigmoid Notch ◽  
Ulnar Shortening Osteotomy ◽  
Ulnar Impaction ◽  
Shortening Osteotomy ◽  
Type C ◽  
Ulnar Impaction Syndrome

AbstractUlnar shortening osteotomy (USO) for ulnar impaction syndrome potentially leads to degenerative changes of the distal radioulnar joint (DRUJ). This study was performed to evaluate the effect of the sigmoid notch morphology on the stress distribution pattern of the DRUJ using computed tomography (CT) osteoabsorptiometry (CT-OAM). We reviewed the pre- and postoperative transverse CT images of 15 wrists that had undergone USO. The examined wrists were classified into two groups based on the sigmoid notch morphology: the linear-type notch (type L) and the curved-type notch (type C). We calculated and statistically compared the percentage of the high-density area (%HDA) in each divided region of the sigmoid notch. In type L, %HDA was significantly larger in the distal-dorsal region of the sigmoid notch before USO. Postoperatively, in type L, no specific regions showed a significantly different %HDA. In type C, %HDA was significantly larger in the distal-volar region of the sigmoid notch before USO. Postoperatively, %HDA of type C was significantly larger in the proximal-volar region. Our results suggest that in patients with ulnar impaction syndrome, morphological evaluation of the sigmoid notch can serve as a predictor of osteoarthritis in the DRUJ with or without USO.

scholarly journals Three-Dimensional Automated Assessment of the Distal Radioulnar Joint Morphology According to Sigmoid Notch Surface Orientation

2020 ◽  
Vol 45 (11) ◽  
pp. 1083.e1-1083.e11
Author(s):  
Simon Roner ◽  
Philipp Fürnstahl ◽  
Anne-Gita Scheibler ◽  
Reto Sutter ◽  
Ladislav Nagy ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Distal Radioulnar Joint ◽  
Surface Orientation ◽  
Automated Assessment ◽  
Radioulnar Joint ◽  
Sigmoid Notch ◽  
Joint Morphology

Extensor Tendon Rupture Associated with Osteoarthritis of the Distal Radioulnar Joint

2008 ◽  
Vol 33 (4) ◽  
pp. 469-474 ◽  
Author(s):  
H. YAMAZAKI ◽  
S. UCHIYAMA ◽  
Y. HATA ◽  
N. MURAKAMI ◽  
H. KATO
Keyword(s):  
Risk Factors ◽  
Tendon Rupture ◽  
Extensor Tendon ◽  
Distal Radioulnar Joint ◽  
X Rays ◽  
Radioulnar Joint ◽  
Ulnar Head ◽  
Sigmoid Notch ◽  
Tendon Ruptures ◽  
Grade 3

Non-rheumatoid osteoarthritis of the distal radioulnar joint can cause extensor tendon rupture. We analysed the radiographic morphology of the distal radioulnar joint to identify the risk factors for this complication. Forty-one wrist X-rays of 37 patients with extensor tendon rupture caused by distal radioulnar joint osteoarthritis were evaluated retrospectively for the severity of osteoarthritis by the Kellgren/Lawrence scoring system. Measurements were obtained from posteroanterior views. All but one wrist had severe osteoarthritic changes exceeding grade 3. The radiographic features that were different from those of the contralateral wrists included deepening and widening of the sigmoid notch, radial shift of the ulnar head and dorsal inclination of the sigmoid notch. There was no significant association between tendon rupture and the morphology of the ulnar head or ulnar variance. The scallop sign, dorsal inclination of the sigmoid notch and radial shift of the ulnar head are radiological risk factors for extensor tendon ruptures.

Salvage Procedure for Failed Bowers' Hemiresection Interposition Technique in the Distal Radioulnar Joint

1998 ◽  
Vol 23 (6) ◽  
pp. 749-753 ◽  
Author(s):  
J. GONZALEZ DEL PINO ◽  
D. L. FERNANDEZ
Keyword(s):  
Bone Graft ◽  
Joint Pain ◽  
Distal Radioulnar Joint ◽  
Resection Arthroplasty ◽  
Salvage Procedure ◽  
Radioulnar Joint ◽  
Sigmoid Notch

Three patients who continued to have distal radioulnar joint pain following Bowers' hemiresection interposition technique were treated by converting the resection arthroplasty into a Sauvé-Kapandji procedure. The resected 10 mm segment from the distal ulnar metaphysis was used as an interposition bone graft in the arthrodesis site, placed between the sigmoid notch of the radius and distal end of the ulna. After a minimum follow-up of 3 years, all three patients were satisfied with the procedure, were pain-free, and the preoperative range of wrist and forearm motion had increased. All three returned to their previous working activities.

Dorsoradial Avulsion of the Triangular Fibrocartilage Complex with an Avulsion Fracture of the Sigmoid Notch of the Radius

2007 ◽  
Vol 32 (6) ◽  
pp. 705-708 ◽  
Author(s):  
Y. MORISAWA ◽  
T. NAKAMURA ◽  
K. TAZAKI
Keyword(s):  
Avulsion Fracture ◽  
Distal Radioulnar Joint ◽  
Triangular Fibrocartilage Complex ◽  
Bone Fragment ◽  
Anatomical Reduction ◽  
Avulsion Injury ◽  
Radioulnar Joint ◽  
Sigmoid Notch ◽  
Dorsal Portion ◽  
Triangular Fibrocartilage

We report two extremely rare cases of dorsal radial avulsion injury of the triangular fibrocartilage complex accompanied by an avulsion fracture of the sigmoid notch of the radius. Anatomical reduction of the bone fragment in conjunction with reattachment of the dorsal portion of the radioulnar ligament to the radial sigmoid notch were necessary to restore stability of the distal radioulnar joint and tension of the triangular fibrocartilage proper.

THE BEAUTY OF STABILITY: DISTAL RADIOULNAR JOINT STABILITY IN ARTHROSCOPIC TRIANGULAR FIBROCARTILAGE COMPLEX REPAIR

Hand Surgery ◽  
2013 ◽  
Vol 18 (01) ◽  
pp. 21-26 ◽  
Author(s):  
Chris Tang ◽  
Boris Fung ◽  
Rebecca Chan ◽  
Margaret Fok
Keyword(s):  
Stress Test ◽  
Distal Radioulnar Joint ◽  
Small Sample ◽  
Triangular Fibrocartilage Complex ◽  
Radioulnar Joint ◽  
Transosseous Suture ◽  
Sigmoid Notch ◽  
Druj Instability ◽  
Triangular Fibrocartilage

The triangular fibrocartilage complex (TFCC) has an important role in the stability of the distal radioulnar joint (DRUJ) stability. We designed a new method of TFCC tear repair that has satisfactory post-operative DRUJ stability. From May 2004 to August 2010, 14 patients who underwent this operation were reviewed. The average post-operative follow-up period was 8.2 months; 66.7% of the patients with TFCC tear in sigmoid notch had clinical DRUJ instability, while only 50% of tear in fovea and 16.7% of tear in base of ulnar styloid had clinical DRUJ instability. Transosseous suture via inside-outside technique was used for repair. At the final follow-up, all 14 patients have soft end point with < 5 mm translations of the DRUJ shown by the stress test. Based on this small sample with satisfactory outcome assessed by the Mayo modified wrist score and DRUJ stability, we recommend TFCC tear in sigmoid notch, which has a higher chance of DRUJ instability, to be repaired by transosseous suture.

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