scholarly journals A new quantitative evaluation system for distal radioulnar joint instability using a three-dimensional electromagnetic sensor

2021 ◽  
Author(s):  
Shintaro Mukohara ◽  
Yutaka Mifune ◽  
Atsuyuki Inui ◽  
Hanako Nishimoto ◽  
Kohei Yamaura ◽  
...  
Keyword(s):  
Healthy Volunteers ◽  
Measurement Method ◽  
Three Dimensional ◽  
Distal Radioulnar Joint ◽  
High Accuracy ◽  
Rater Reliability ◽  
Radioulnar Joint ◽  
Ulnar Head ◽  
Electromagnetic Sensor ◽  
Head Translation

Abstract Background The accurate assessment of distal radioulnar joint (DRUJ) instability is still challenging as there is no established objective evaluation method. This study aimed to develop a noninvasive measurement method using a three-dimensional electromagnetic sensor system (EMS) to quantitatively assess and characterize the normal DRUJ movement in healthy volunteers. Methods The DRUJ movement was mimicked using both a block model and saw bone. Movement of the models was measured by EMS, and the accuracy and reproducibility of the measurements were assessed. The movement was evaluated in 14 healthy volunteers (7 men and 7 women) by three hand surgeons. Measurement was done in a sitting position with the elbow flexed and the forearm pronated. One sensor each was attached to the distal radial shaft and the ulnar head. The examiners fixed the distal radius and moved the ulnar head from the dorsal to the volar side, measuring the dorsovolar ulnar head translation. The intraclass and interrater correlation coefficients (ICCs) were calculated using the average values of the measurements. The differences between the dominant and non-dominant sides and between men and women were also assessed. Results The accuracy and reproducibility assessment results of the EMS showed high accuracy and reproducibility. The ICC (1,5) for the intra-rater reliability was 0.856, and the ICC (2,5) for inter-rater reliability was 0.868. The mean ulnar head translation and difference between dominant and non-dominant sides were 6.00 ± 1.16 mm (Mean ± SD) and -0.12 ± 0.40 mm, respectively. There were no significant differences between any of the parameters.Conclusions A new measurement method using EMS could evaluate DRUJ movement with high accuracy, reproducibility, and intra- and inter-rater reliability. In healthy volunteers, the dorsovolar ulnar head translation was 6.00 mm. The difference between the dominant and non-dominant sides was < 1.0 mm with no significant difference. EMS provided an objective, non-invasive, real-time assessment of dynamic changes in the DRUJ. These findings could be useful in the treatment of patients with DRUJ instability.

scholarly journals A new quantitative evaluation system for distal radioulnar joint instability using a three-dimensional electromagnetic sensor

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Shintaro Mukohara ◽  
Yutaka Mifune ◽  
Atsuyuki Inui ◽  
Hanako Nishimoto ◽  
Takashi Kurosawa ◽  
...  
Keyword(s):  
Healthy Volunteers ◽  
Measurement Method ◽  
Three Dimensional ◽  
Distal Radioulnar Joint ◽  
High Accuracy ◽  
Rater Reliability ◽  
Radioulnar Joint ◽  
Ulnar Head ◽  
Electromagnetic Sensor ◽  
Head Translation

Abstract Background The accurate assessment of distal radioulnar joint (DRUJ) instability is still challenging as there is no established objective evaluation method. This study aimed to develop a noninvasive measurement method using a three-dimensional electromagnetic sensor system (EMS) to quantitatively assess and characterize the normal DRUJ movement in healthy volunteers. Methods The DRUJ movement was mimicked using both a block model and saw bone. Movement of the models was measured by EMS, and the accuracy and reproducibility of the measurements were assessed. In vivo measurement was performed in a sitting position with the elbow flexed and the forearm pronated. One sensor each was attached to the distal radial shaft and the ulnar head. The examiners fixed the distal radius and the carpal bones, moved the ulnar head from the dorsal to the volar side and measured the dorsovolar translation. The volar translation was measured by EMS and ultrasonography, and the correlation coefficient was calculated. The dorsovolar translation was evaluated in 14 healthy volunteers (7 men and 7 women) by three hand surgeons. The intraclass and inter-rater correlation coefficients (ICCs), the differences between the dominant and non-dominant sides and between men and women were assessed. Results The accuracy and reproducibility assessment results of the EMS showed high accuracy and reproducibility. In the comparison between EMS and ultrasonography, the correlation coefficient was 0.920 (p = 0.16 × 10-3). The ICC (1,5) for the intra-rater reliability was 0.856, and the ICC (2,5) for inter-rater reliability was 0.868. The mean ulnar head translation and difference between dominant and non-dominant sides were 6.00 ± 1.16 mm (mean ± SD) and − 0.12 ± 0.40 mm, respectively. There were no significant differences between any of the parameters. Conclusions A new measurement method using EMS could evaluate DRUJ movement with high accuracy, reproducibility, and intra- and inter-rater reliability. In healthy volunteers, the dorsovolar ulnar head translation was 6.00 mm. The difference between the dominant and non-dominant sides was < 1.0 mm with no significant difference. EMS provided an objective, non-invasive, real-time assessment of dynamic changes in the DRUJ. These findings could be useful in the treatment of patients with DRUJ instability.

Distal radioulnar joint configurations in three-dimensional computed tomography in patients with idiopathic ulnar impaction syndrome

2019 ◽  
Vol 44 (5) ◽  
pp. 488-495 ◽  
Author(s):  
Jihyeung Kim ◽  
Jaewoo Cho ◽  
Yo-Han Lee ◽  
Sohee Oh ◽  
Hyun Sik Gong ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Three Dimensional ◽  
Joint Space ◽  
Distal Radioulnar Joint ◽  
Radioulnar Joint ◽  
Ulnar Head ◽  
Sigmoid Notch ◽  
Ulnar Shortening Osteotomy ◽  
Ulnar Impaction ◽  
Ulnar Impaction Syndrome

We retrospectively reviewed 26 patients diagnosed with idiopathic ulnar impaction syndrome and measured the slopes of the sigmoid notch and ulnar head at their centre using their preoperative three-dimensional computed tomography. We found that the slope of the sigmoid notch and that of the ulnar head were not parallel to each other. There was a significant linear relation between the slope of the ulnar head and the changes in the closest joint space of the distal radioulnar joint at the centre of the sigmoid notch after ulnar shortening. We conclude that the slope of the ulnar head is more strongly correlated with changes in the closest joint space in the distal radioulnar joint than that of the sigmoid notch. Our findings suggest that slope of the ulnar head might be as important a predisposing factor as that of the sigmoid notch for the progression of distal radioulnar joint arthritis after ulnar-shortening osteotomy. We should consider the slopes of both the sigmoid notch and ulnar head before the osteotomy. Level of evidence: IV

Non-constrained implant arthroplasty for the distal radioulnar joint

2017 ◽  
Vol 42 (4) ◽  
pp. 415-421 ◽  
Author(s):  
B. D. Adams ◽  
J. L. Gaffey
Keyword(s):  
Surgical Techniques ◽  
Distal Radioulnar Joint ◽  
Implant Loosening ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Radioulnar Joint ◽  
Ulnar Head ◽  
Strenuous Activity

A variety of surgical techniques are used to treat the arthritic distal radioulnar joint, which is influenced by aetiology and previous procedures. Four types of ulnar head arthroplasty exist: total ulnar head, partial ulnar head, unlinked total distal radioulnar joint, and linked distal radioulnar joint. Although long-term outcome studies are sparse, short-term clinical and biomechanical studies have shown encouraging results, leading to expanded indications. Based on our experience and a literature review, patients are advised that pain is improved but minor pain is common after strenuous activity. Ulnar neck resorption is common, however, implant loosening is rare. Sigmoid notch erosion is concerning, but appears to stabilize and not affect outcome. A partial ulnar head replacement that retains bony architecture and soft tissue restraints may have benefit over a total ulnar head in appropriate patients. If appropriate selection criteria are met, ulnar head replacement typically produces reliable results, with low revision.

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 The Optimal Suture Placement and Bone Tunnels for TFCC Repair: A Cadaveric Study

2018 ◽  
Vol 07 (05) ◽  
pp. 375-381 ◽  
Author(s):  
Peter Tang ◽  
Keiji Fujio ◽  
Robert Strauch ◽  
Melvin Rosenwasser ◽  
Taiichi Matsumoto
Keyword(s):  
Distal Radioulnar Joint ◽  
Radioulnar Joint ◽  
Ulnar Head ◽  
Transosseous Repair ◽  
Triangular Fibrocartilage ◽  
The Mean ◽  
Group 5 ◽  
Bone Tunnels ◽  
Isometric Point ◽  
Suture Placement

Background Transosseous repair of foveal detachment of the triangular fibrocartilage complex (TFCC) is effective for distal radioulnar joint stabilization. However, studies of the optimal foveal and TFCC suture positions are scant. Purpose The purpose of this study was to clarify the optimal TFCC suture position and bone tunnels for transosseous foveal repair. Materials and Methods Seven cadavers were utilized. The TFCC was incised at the foveal insertion and sutured at six locations (TFCCs 1–6) using inelastic sutures. Six osseous tunnels were created in the fovea (foveae 1–6). Fovea 2 is located at the center of the circle formed by the ulnar head overlooking the distal end of the ulna (theoretical center of rotation); fovea 5 is located 2 mm ulnar to fovea 2. TFCC 5 is at the ulnar apex of the TFCC disc; TFCC 4 is 2 mm dorsal to TFCC 5. TFCC 1 to 6 sutures were then placed through each of the six osseous tunnels, resulting in 36 combinations, which were individually tested. The forearm was placed in five positions between supination and pronation, and the degree of suture displacement was measured. The position with the least displacement indicated the isometric point of the TFCC and fovea. Results The mean distance of suture displacement was 2.4 ± 1.6 mm. Fovea 2, combined with any TFCC location, (0.7 ± 0.6 mm) and fovea group 5, combined with TFCC 4 location (0.8 ± 0.8) or with TFCC 5 location (0.9 ± 0.6) had statistically shorter suture displacements than any other fovea groups. Conclusion For TFCC transosseous repair, osseous tunnel position was more important than TFCC suture location.

Clinical, radiological and patient-rated outcome comparison between total and partial ulnar head implants

2021 ◽  
pp. 175319342110484
Author(s):  
Lea Estermann ◽  
Lisa Reissner ◽  
Andrea B. Rosskopf ◽  
Andreas Schweizer ◽  
Ladislav Nagy
Keyword(s):  
Grip Strength ◽  
Distal Radioulnar Joint ◽  
Joint Arthroplasty ◽  
Dash Score ◽  
Level Of Evidence ◽  
Radioulnar Joint ◽  
Ulnar Head ◽  
Outcome Comparison ◽  
Pain At Rest

This study aimed to analyse the clinical and radiological outcomes after ulnar head replacement and to compare partial and total ulnar head implants. Twenty-two patients with 23 implants were available with a mean follow-up time of 7 years (range 1.3 to 17) after distal radioulnar joint arthroplasty. At the final follow-up, patients had a low level of pain at rest and during effort, a median Disabilities of the Arm, Shoulder, and Hand (DASH) score of 12 and Patient-Rated Wrist Evaluation score of 12 with partial ulnar head implants, and scores of 20 and 22 in total ulnar head implants, respectively. While the range of motion in patients with partial ulnar head implants was slightly reduced in comparison with the preoperative condition and to the patients with total ulnar head implants, there was a tendency to a higher grip strength and rotational torque. Both types of prosthesis showed sigmoid notch resorptions and resorptions around the neck. We conclude that the results after partial ulnar head replacement do not significantly differ from the total ulnar head implants in many aspects. Level of evidence: III

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

INTRA-RATER AND INTER-RATER RELIABILITY STUDY OF A MEASUREMENT METHOD FOR THE PATHWAY OF THE SUPRASPINATUS INTRAMUSCULAR TENDON BY 3.0 TESLA MRI IMAGES: THE SHEAR FORCE ANGLE ANTERIOR POSTERIOR

2018 ◽  
Vol 21 (02) ◽  
pp. 1850009
Author(s):  
Yohei Kanno ◽  
Hajime Toda ◽  
Tsutomu Horiuchi ◽  
Masaki Katayose
Keyword(s):  
Shear Force ◽  
Measurement Method ◽  
Intraclass Correlation ◽  
Three Dimensional ◽  
3D Models ◽  
Minimal Detectable Change ◽  
3.0 Tesla ◽  
Rater Reliability ◽  
The Mean ◽  
Anterior Posterior

Objective: The aim of this study was to establish intra-rater and inter-rater reliability of a measurement method for the pathway of the supraspinatus intramuscular tendon by 3.0 tesla MRI images. Methods: The scapula and intramuscular tendon extraction DICOM data was made to extract only a scapula domain and intramuscular tendon domain. The shear force angle anterior posterior (SFA-AP) was measured as the pathway of supraspinatus intramuscular tendon with respect to the glenoid plane on three-dimensional (3D) models of the bone and intramuscular tendon. SFA-AP of supraspinatus was measured on 3D models of the bone and intramuscular tendon. The mean and standard deviation of SFA-AP of supraspinatus was calculated. Intra-rater reliability and inter-rater reliability were evaluated by the intraclass correlation coefficient (ICC), the standard error of the mean (SEM) and the minimal detectable change (MDC). Inter-rater reliability was evaluated by three raters. Results: As for intra-rater reliability, SFA-AP of supraspinatus measured averaged [Formula: see text], with ICC (1,1) of 0.978, with ICC (1,3) of 0.993, with SEM of 0.53, with MDC of 1.46[Formula: see text]. As for inter-rater reliability, SFA-AP of supraspinatus measured averaged [Formula: see text] (rater1), SFA-AP measured averaged [Formula: see text] (rater2), SFA-AP measured averaged [Formula: see text] (rater3), with ICC (2,1) of 0.896, with ICC (2,3) of 0.963, with SEM of 1.11, with MDC of 3.09[Formula: see text]. Conclusions: 3D models of the bone and intramuscular tendon were evaluated as intra-rater and inter-rater reliabilities. SFA-AP of supraspinatus is guaranteed by one measurement.

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