scholarly journals Normal values of distal radioulnar translation assessed by three-dimensional C-arm scans: a cadaveric study

2019 ◽  
Vol 44 (5) ◽  
pp. 503-509 ◽  
Author(s):  
Benedict Swartman ◽  
Laura Benner ◽  
Stephan Grechenig ◽  
Jochen Franke ◽  
Paul A. Grützner ◽  
...  
Keyword(s):  
Normal Values ◽  
Intraclass Correlation ◽  
Three Dimensional ◽  
Distal Radioulnar Joint ◽  
Cone Beam ◽  
Ratio Method ◽  
Reference Ranges ◽  
Radioulnar Joint ◽  
Observer Reliability ◽  
Cone Beam Computer Tomography

We investigated whether mobile C-arm cone beam computer tomography (CBCT) could be used to measure radioulnar translation. The study was conducted on 31 Thiel-fixed intact cadaver arms. Three-dimensional scans of each wrist were carried out in pronation and supination. Four established measurement methods were used (radioulnar line, subluxation ratio, epicentre and radioulnar ratio methods) to measure radioulnar translation. The intraclass correlation coefficient for inter-observer and intra-observer reliability were excellent in three of four methods (>0.94). The reference ranges for physiological radioulnar translation were between −30% and 91% (radioulnar line method), −32% and 87% (subluxation ratio method), −40% and 23% (epicentre method), and 2% and 73% (radioulnar ratio method). Our results indicate that radioulnar translation in the distal radioulnar joint can be determined reliably using mobile C-arm CBCT. The normal values provide a basis for further experimental and clinical studies.

Normal Values of Distal Radioulnar Joint Kinematics during a Dynamic Press Test

2021 ◽  
Author(s):  
Janni Kjærgaard Thillemann ◽  
Sepp De Raedt ◽  
Emil Toft Petersen ◽  
Katriina Bøcker Puhakka ◽  
Torben Bæk Hansen ◽  
...  
Keyword(s):  
Normal Values ◽  
Intraclass Correlation ◽  
Case Series ◽  
Distal Radioulnar Joint ◽  
Ulnar Variance ◽  
Patient Specific ◽  
Imaging Method ◽  
Radioulnar Joint ◽  
Case Series Study ◽  
The Press

Abstract Background Measurement of in vivo distal radioulnar joint (DRUJ) pathomechanics during simple activities can represent the disability experienced by patients and may be useful in diagnostics of DRUJ instability. A first step is to describe the physiological normal limits for DRUJ kinematics in a reproducible and precise test setup, which was the aim of this study. Methods DRUJ kinematics were evaluated in 33 participants with dynamic radiostereometry (RSA) while performing a standardized press test examination. AutoRSA software was used for image analyses. Computed tomography (CT) forearm bone models were generated, and standardized anatomical axes were applied to estimate kinematic outcomes including, DRUJ translation, DRUJ position ratio, and changes in ulnar variance. Repeatability of dynamic RSA press test double examinations was evaluated to estimate the precision and intraclass correlation coefficient (ICC) test–retest agreement. Results The maximum force during the press test was 6.0 kg (95% confidence interval [CI]: 5.1–6.9), which resulted in 4.7 mm (95% CI: 4.2–5.1) DRUJ translation, DRUJ position ratio of 0.40 (95% CI: 0.33–0.44), and increase in ulnar variance of 1.1 mm (95% CI: 1.0–1.2). The mean maximum DRUJ translation leveled off after a 5 kg force application. The DRUJ translation ICC coefficient was 0.93 within a prediction interval of ± 0.53mm. Conclusions This clinical study demonstrates the normal values of DRUJ kinematics and reports excellent agreement and high precision of the press tests examination using an automated noninvasive dynamic RSA imaging method based on patient-specific CT bone models. The next step is the application of the method in patients with arthroscopic verified triangular fibrocartilage complex injuries. Level of Evidence This is a Level IV, case series study.

scholarly journals Distal radioulnar joint instability with three different injury patterns assessed by three-dimensional C-arm scans: a cadaveric study

2019 ◽  
Vol 44 (10) ◽  
pp. 1072-1078
Author(s):  
Benedict Swartman ◽  
Laura Benner ◽  
Jochen Franke ◽  
Paul A. Grützner ◽  
Sven Y. Vetter ◽  
...  
Keyword(s):  
Joint Instability ◽  
Three Dimensional ◽  
Distal Radioulnar Joint ◽  
Ratio Method ◽  
Control Group ◽  
Injury Patterns ◽  
Radioulnar Joint ◽  
Sigmoid Notch ◽  
Triangular Fibrocartilage ◽  
Essex Lopresti

The aim of this study was to establish a radiographic method for detecting distal radioulnar joint instability intraoperatively. We created three successive instabilities in 12 intact Thiel-fixed upper limb specimens: lesion of the triangular fibrocartilage complex, Galeazzi injury and Essex–Lopresti injury. We made three-dimensional scans of the wrists in pronation and supination with a mobile C-arm. We used four validated measurement methods to quantify ulnar migration in the standard axial planes: the radioulnar line method, the subluxation ratio method, the epicentre method and the radioulnar ratio method. All types of instability showed significantly increased migration of the ulna compared with the control group. The subluxation ratio and the radioulnar ratio methods showed the highest sensitivity and specificity in detecting the instabilities. We conclude that these two methods are feasible for radiographically assessing distal radioulnar joint instability. Instability may be assumed if the migration of the ulna in the sigmoid notch is at least 45% of the length of the sigmoid notch, in which case wire transfixation of the distal radioulnar joint is advised.

scholarly journals The Effect of Dorsal Angulation on Distal Radioulnar Joint Arthrokinematics Measured Using Intercartilage Distance

2018 ◽  
Vol 08 (01) ◽  
pp. 010-017
Author(s):  
Emily Lalone ◽  
Masao Nishiwaki ◽  
Ryan Willing ◽  
James Johnson ◽  
Graham King ◽  
...  
Keyword(s):  
Distal Radius ◽  
Contact Area ◽  
Three Dimensional ◽  
Distal Radioulnar Joint ◽  
Radioulnar Joint ◽  
Motion Data ◽  
Contact Patterns ◽  
Dorsal Angulation ◽  
Triangular Fibrocartilage

Background The effects of dorsal angulation deformity on in vitro distal radioulnar joint (DRUJ) contact patterns are not well understood. Purpose The purpose of this study was to utilize intercartilage distance to examine the effects of forearm rotation angle, distal radius deformity, and triangular fibrocartilage complex (TFCC) sectioning on DRUJ contact area and centroid position. Methods An adjustable implant permitted the creation of simulated intact state and dorsal angulation deformities of 10, 20, and 30 degrees. Three-dimensional cartilage models of the distal radius and ulna were created using computed tomography data. Using optically tracked motion data, the relative position of the cartilage models was rendered and used to measure DRUJ cartilage contact mechanics. Results DRUJ contact area was highest between 10 and 30 degrees of supination. TFCC sectioning caused a significant decrease in contact area with a mean reduction of 11 ± 7 mm2 between the TFCC intact and sectioned conditions across all variables. The position of the contact centroid moved volarly and proximally with supination for all variables. Deformity had a significant effect on the location of the contact centroid along the volar–dorsal plane. Conclusion Contact area in the DRUJ was maximal between 10 and 30 degrees of supination during the conditions tested. There was a significant effect of simulated TFCC rupture on contact area in the DRUJ, with a mean contact reduction of 11 ± 7 mm2 after sectioning. Increasing dorsal angulation caused the contact centroid to move progressively more volar in the sigmoid notch.

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

Three-dimensional in vivo kinematics of the distal radioulnar joint in malunited distal radius fractures

2002 ◽  
Vol 27 (2) ◽  
pp. 233-242 ◽  
Author(s):  
Douglas C. Moore ◽  
Kathleen A. Hogan ◽  
Joseph J. Crisco ◽  
Edward Akelman ◽  
Manuel F. DaSilva ◽  
...  
Keyword(s):  
Distal Radius ◽  
Three Dimensional ◽  
Distal Radioulnar Joint ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Radioulnar Joint ◽  
In Vivo Kinematics

A Two-Dimensional Kinematic Analysis of the Distal Radioulnar Joint

1996 ◽  
Vol 21 (6) ◽  
pp. 824-829 ◽  
Author(s):  
E. P. A. VAN DER HEIJDEN ◽  
B. HILLEN
Keyword(s):  
Healthy Volunteer ◽  
Ct Scan ◽  
Kinematic Analysis ◽  
Three Dimensional ◽  
Kinematic Chain ◽  
Distal Radioulnar Joint ◽  
Two Dimensional ◽  
Dorsal Part ◽  
Radioulnar Joint ◽  
Triangular Fibrocartilage

The triangular fibrocartilage and its function in the kinematics of pronation and supination in the distal radioulnar joint was studied. Measurements of the constituent parts of this joint in 11 cadavers showed that the palmar radioulnar ligament is at least 2 mm longer than the dorsal radioulnar ligament. Based on these measurements the movements of the joint were modelled in a two-dimensional kinematic chain. Predictions based on this chain could be confirmed by direct observation and videotaping dissections of joints of unfixed specimens and three-dimensional reconstructions of a CT scan of a healthy volunteer. It could be concluded that (a) the dorsal part is tight during pronation and the palmar part during supination and (b) considerable asymmetrical translations, (dorsal translation being the largest) occur because of the length differences of the ligaments.

scholarly journals Computer-based three-dimensional measurement of carpal alignment: measurement techniques and normal ranges

2021 ◽  
pp. 175319342110396
Author(s):  
Robert M. J. Sippo ◽  
Theresa E. K. Höglund ◽  
Eero Waris
Keyword(s):  
Measurement Techniques ◽  
Intraclass Correlation ◽  
Three Dimensional ◽  
Reference Database ◽  
Mean Values ◽  
Observer Reliability ◽  
Normal Ranges ◽  
Asymptomatic Volunteers ◽  
Ct Analysis ◽  
Computer Based

The three-dimensional carpal alignment was measured in the neutral wrist position in 121 asymptomatic volunteers using computer-based cone-beam CT analysis. Normal values and the reliability of the automated analysis are reported. An analysis software based on segmentation of CT images and mathematical modelling was used to determine several axis variants based on different landmarks and to calculate the intercarpal angles automatically. Twenty wrists were imaged twice to determine intra-observer reliability. Mean values using the preferred axis variants were: scapholunate angle 57° (SD 9°), radiolunate angle 2° (SD 10°), lunocapitate angle –14° (SD 9°). Using alternate axis variants notably changed the angles produced. The intra-observer reliability of the analysis was excellent (mean intraclass correlation coefficient 0.97, SD 0.03). Computer-based CT analysis enables highly reproducible and automated assessment of carpal alignment. This study provides a reference database for measurement techniques and normal carpal angle values in three-dimensional imaging.

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