The morphological structure of the seven components of triangular fibrocartilage complexes of 11 cadaver wrists of elderly people was assessed microscopically, after staining with Hematoxylin-Eosin and Elastica van Gieson. The articular disc consisted of tight interlaced fibrocartilage without blood vessels except in its ulnar part. Volar and dorsal radioulnar ligaments showed densely parallel collagen bundles. The subsheath of the extensor carpi ulnaris muscle, the ulnotriquetral and ulnolunate ligament showed mainly mixed tight and loose parallel tissue. The ulnolunate ligament contained tighter parallel collagen bundles and clearly less elastic fibres than the ulnotriquetral ligament. The ulnocarpal meniscoid had an irregular morphological composition and loose connective tissue predominated. The structure of the articular disc indicates a buffering function. The tight structure of radioulnar and ulnolunate ligaments reflects a central stabilizing role, whereas the ulnotriquetral ligament and ulnocarpal meniscoid have less stabilizing functions.
Background The triangular fibrocartilage complex is the main stabilizer of the distal radioulnar joint. While static joint stability is constituted by osseous and ligamentous integrity, the dynamic aspects of joint stability chiefly concern proprioceptive control of the compressive and directional muscular forces acting on the joint. Therefore, an investigation of the pattern and types of sensory nerve endings gives more insight in dynamic distal radioulnar joint stability.Questions/purposes We aimed to (1) analyze the general distribution of sensory nerve endings and blood vessels; (2) examine interstructural distribution of sensory nerve endings and blood vessels; (3) compare the number and types of mechanoreceptors in each part; and (4) analyze intrastructural distribution of nerve endings at different tissue depth. Methods The subsheath of the extensor carpi ulnaris tendon sheath, the ulnocarpal meniscoid, the articular disc, the dorsal and volar radioulnar ligaments, and the ulnolunate and ulnotriquetral ligaments were dissected from 11 human cadaver wrists. Sensory nerve endings were counted in five levels per specimen as total cell amount/ cm 2 after staining with low-affinity neurotrophin receptor p75, protein gene product 9.5, and S-100 protein and thereafter classified according to Freeman and Wyke. Results All types of sensory corpuscles were found in the various structures of the triangular fibrocartilage complex with the exception of the ulnolunate ligament, which contained only Golgi-like endings, free nerve endings, and unclassifiable corpuscles. The articular disc had only free nerve endings. Furthermore, free nerve endings were the predominant sensory nerve ending (median, 72.6/cm 2 ; range, 0-469.4/cm 2 ) and more prevalent than all other types of mechanoreceptors: Ruffini (median, 0; range, 0-5.6/cm 2 ; difference of medians, 72.6; p \ 0.001), Pacini (median, 0; range, 0-3.8/cm 2 ; difference of medians, 72.6; p \ 0.001), Golgi-like (median, 0; range, 0-2.1/cm 2 ; difference of medians, 72.6; p \ 0.001), and unclassifiable corpuscles (median, 0; range, 0-2.5/cm 2 ; difference of medians, 72.6; p \ 0.001). The articular disc contained fewer free nerve endings (median, 1.8; range, 0-17.8/cm 2 ) and fewer blood vessels (median, 29.8; range, 0-112.2/ cm 2 ; difference of medians: 255.9) than all other structures of the triangular fibrocartilage complex (p B 0.001, respectively) except the ulnolunate ligament. More blood vessels were seen in the volar radioulnar ligament (median, 363.62; range, 117.8-871.8/cm 2 ) compared with the ulnolunate ligament (median, 107.7; range, 15.9-410.3/cm 2 ; difference of medians: 255.91; p = 0.002) and the dorsal radioulnar ligament (median, 116.2; range, 53.9-185.1/ cm 2 ; difference of medians: 247.47; p = 0.001). Free nerve endings were obtained in each structure more often than all other types of sensory nerve endings (p \ 0.001, respectively). The intrastructural analysis revealed no differences in mechanoreceptor distribution in all investigat...
Background The triangular fibrocartilage complex is the main stabilizer of the distal radioulnar joint. While static joint stability is constituted by osseous and ligamentous integrity, the dynamic aspects of joint stability chiefly concern proprioceptive control of the compressive and directional muscular forces acting on the joint. Therefore, an investigation of the pattern and types of sensory nerve endings gives more insight in dynamic distal radioulnar joint stability.Questions/purposes We aimed to (1) analyze the general distribution of sensory nerve endings and blood vessels; (2) examine interstructural distribution of sensory nerve endings and blood vessels; (3) compare the number and types of mechanoreceptors in each part; and (4) analyze intrastructural distribution of nerve endings at different tissue depth. Methods The subsheath of the extensor carpi ulnaris tendon sheath, the ulnocarpal meniscoid, the articular disc, the dorsal and volar radioulnar ligaments, and the ulnolunate and ulnotriquetral ligaments were dissected from 11 human cadaver wrists. Sensory nerve endings were counted in five levels per specimen as total cell amount/ cm 2 after staining with low-affinity neurotrophin receptor p75, protein gene product 9.5, and S-100 protein and thereafter classified according to Freeman and Wyke. Results All types of sensory corpuscles were found in the various structures of the triangular fibrocartilage complex with the exception of the ulnolunate ligament, which contained only Golgi-like endings, free nerve endings, and unclassifiable corpuscles. The articular disc had only free nerve endings. Furthermore, free nerve endings were the predominant sensory nerve ending (median, 72.6/cm 2 ; range, 0-469.4/cm 2 ) and more prevalent than all other types of mechanoreceptors: Ruffini (median, 0; range, 0-5.6/cm 2 ; difference of medians, 72.6; p \ 0.001), Pacini (median, 0; range, 0-3.8/cm 2 ; difference of medians, 72.6; p \ 0.001), Golgi-like (median, 0; range, 0-2.1/cm 2 ; difference of medians, 72.6; p \ 0.001), and unclassifiable corpuscles (median, 0; range, 0-2.5/cm 2 ; difference of medians, 72.6; p \ 0.001). The articular disc contained fewer free nerve endings (median, 1.8; range, 0-17.8/cm 2 ) and fewer blood vessels (median, 29.8; range, 0-112.2/ cm 2 ; difference of medians: 255.9) than all other structures of the triangular fibrocartilage complex (p B 0.001, respectively) except the ulnolunate ligament. More blood vessels were seen in the volar radioulnar ligament (median, 363.62; range, 117.8-871.8/cm 2 ) compared with the ulnolunate ligament (median, 107.7; range, 15.9-410.3/cm 2 ; difference of medians: 255.91; p = 0.002) and the dorsal radioulnar ligament (median, 116.2; range, 53.9-185.1/ cm 2 ; difference of medians: 247.47; p = 0.001). Free nerve endings were obtained in each structure more often than all other types of sensory nerve endings (p \ 0.001, respectively). The intrastructural analysis revealed no differences in mechanoreceptor distribution in all investigat...
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