Anatomical relationship between the morphology of the styloid process of the ulna and the attachment of the radioulnar ligaments

Horiuchi, Saya; Nimura, Akimoto; Tsutsumi, Masahiro; Suzuki, S.; Fujita, Koji; Nozaki, Taiki; Akita, Keiichi

doi:10.1111/joa.13275

Cited by 9 publications

(18 citation statements)

References 22 publications

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“…There are reports that the deep and superficial layers of the triangular fibrocartilage complex could not be clearly divided. 7 , 14 Therefore, superficial and deep layers were created for comparison with previous reports. For convenience, the thickness of the RUL was divided in half.…”

Section: Discussionmentioning

confidence: 99%

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Prediction of Stress Distribution Applied to the Triangular Fibrocartilage Complex: A Finite Element Analysis

Yamazaki

Matsuura

Nimura

et al. 2021

Journal of Hand Surgery Global Online

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The triangular fibrocartilage complex (TFCC) is an important tissue stabilizer for the distal radioulnar joint, but stress distribution on the TFCC is not clear. The purpose of this study was to report the stress distribution of the TFCC using finite element analysis (FEA). Methods: Pathological specimens of the wrist joint from an 80-year-old man were imported into a finite element analysis software package, and regions of interest including bone, soft tissue, and TFCC were extracted to create a 3-dimensional model. The material properties were obtained from previous research using cadaver specimens. To allow large deformations, we used hyperelastic elements to model the TFCC and soft tissue. Bone was defined as a uniform tissue that did not break. With the carpals and radius constrained, the rotation axis was set at the center of the ulnar head and a force was applied to move the ulnar head in pronation and supination. Under these boundary conditions, the behavior of the TFCC was extracted as a moving image. The average value of the maximum principal stress for each component of the TFCC was extracted and graphed. Results: In the supinated position, the maximum principal stress was found on the palmar side of the TFCC (eg, on the tension side). In pronation, the maximum principal stress was found on the dorsal side. Conclusions: This study clearly showed the 3-dimensional structure of the TFCC and analyzed its stress distribution under load. In supination, mean values of the maximum principal stress were greater on the palmar fibers than the dorsal fibers. In pronation, mean maximum principal stress was greater on the dorsal fibers than the palmar fibers. Clinical relevance: Knowing the distribution of stresses in the TFCC is an important factor in developing treatment strategies for a pathologic TFCC.

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Section: Discussionmentioning

confidence: 99%

“…We obtained the wrist joint from an 80-year-old male cadaver. 7 We decalcified the wrist for 1 week in a solution containing aluminum chloride, hydrochloric acid, and formic acid, as described by Plank and Rychlo. 8 After decalcification, we dehydrated the block with a graded series of ethanols and embedded them in paraffin.…”

Section: Methodsmentioning

confidence: 99%

Prediction of Stress Distribution Applied to the Triangular Fibrocartilage Complex: A Finite Element Analysis

Yamazaki

Matsuura

Nimura

et al. 2021

Journal of Hand Surgery Global Online

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“…3 B). These bony morphological features, particularly cortical bone thickening, are reported to correspond to the high tensile stress from dense connective tissues (Horiuchi et al 2020 ; Tano et al 2021 ). In addition, histological analysis revealed that the ligament-like structure independent of the joint capsule did not exist in the inferior area of the AIIS, and the joint capsule attaches to the inferior area of the AIIS via the fibrocartilage (Fig.…”

Section: Capsular Attachment On the Anterosuperior Acetabular Marginmentioning

confidence: 99%

Clinical anatomy of the musculoskeletal system in the hip region

2021

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Although the hip joint is regarded as inherently stable, hip pain and injuries caused by traumatic/non-traumatic hip instability are relatively common in active individuals. A comprehensive understanding of hip anatomy may provide better insight into the relationships between hip stability and clinical problems. In this review, we present our recent findings on the hip morphological characteristics, especially focusing on the intramuscular tendon of the gluteus medius tendon and its insertion sites, hip capsular attachment on the anterosuperior region of the acetabular margin, and composition of the iliofemoral ligament. We further discussed the hip stabilization mechanism based on these findings. The characteristics of the gluteus medius tendon suggest that even a single muscle has multiple functional subunits within the muscle. In addition, the characteristics of the hip capsular attachment suggest that the width of the capsular attachment is wider than previously reported, and its wide area shows adaptive morphology to mechanical stress, such as bony impression and distribution of the fibrocartilage. The composition of the iliofemoral ligament and its relation to periarticular structures suggest that some ligaments should be defined based on the pericapsular structures, such as the joint capsule, tendon, and aponeurosis, and also have the ability to dynamically coordinate joint stability. These anatomical perspectives provide a better understanding of the hip stabilization mechanism, and a biomechanical study or an in vivo imaging study, considering these perspectives, is expected in the future.

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“…The terminology used in the anatomical studies for this structure showed a large variety with articular disc (proper) ( n = 9) (Benjamin et al, 1990; Chidgey et al, 1991; Ekenstam & Hagert, 1985; Ishii et al, 1998; Kleinman & Graham, 1998; Ohmori & Azuma, 1998; Rein et al, 2015; Semisch et al, 2016; Shigemitsu et al, 2007), disc/disk proper ( n = 6) (Horiuchi et al, 2020; Nakamura et al, 1996; Nakamura et al, 2001; Nakamura & Makita, 2000; Nakamura & Yabe, 2000; Saka et al, 2021), triangular fibrocartilage ( n = 4) (Bednar et al, 1991; Mikic, 1978; Viegas & Ballantyne, 1987; Zhan, Li, et al, 2017), or central disk ( n = 1) (Totterman & Miller, 1995). One study referred to the ulnar attachment fibers of the disc with the term “triangular ligament” (Zhan, Li, et al, 2017).…”

Section: Tfcc Componentsmentioning

confidence: 99%

“…The terminology used for the ligaments showed some variety with the most commonly used terms being: (distal) dorsal and volar/palmar radioulnar ligaments ( n = 8) (Chidgey et al, 1991; Ekenstam & Hagert, 1985; Ishii et al, 1998; Kleinman & Graham, 1998; Rein et al, 2015; Semisch et al, 2016; Totterman & Miller, 1995; Zhan, Li, et al, 2017), (distal) radioulnar ligaments ( n = 8) (Benjamin et al, 1990; Horiuchi et al, 2020; Maniglio et al, 2020; Nakamura et al, 2001; Nakamura & Yabe, 2000; Saka et al, 2021; Shigemitsu et al, 2007; Shin et al, 2017), triangular ligament ( n = 1) (Nakamura et al, 1996) or proximal ligamentous complex ( n = 1) (Nakamura & Makita, 2000). The origin was defined by some studies at the radial attachment and the insertion at the ulnar attachment (Chidgey et al, 1991; Ekenstam & Hagert, 1985; Maniglio et al, 2020; Totterman & Miller, 1995).…”

Section: Tfcc Componentsmentioning

confidence: 99%

The triangular fibrocartilage complex in the human wrist: A scoping review toward uniform and clinically relevant terminology

et al. 2022

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Anatomical relationship between the morphology of the styloid process of the ulna and the attachment of the radioulnar ligaments

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Cited by 9 publications

References 22 publications

Prediction of Stress Distribution Applied to the Triangular Fibrocartilage Complex: A Finite Element Analysis

Prediction of Stress Distribution Applied to the Triangular Fibrocartilage Complex: A Finite Element Analysis

Clinical anatomy of the musculoskeletal system in the hip region

The triangular fibrocartilage complex in the human wrist: A scoping review toward uniform and clinically relevant terminology

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