Distal Radio-Ulnar Ligament Motion During Supination and Pronation

Acosta, R.; Hnat, William P.; Scheker, Luis R.

doi:10.1016/0266-7681(93)90159-d

Cited by 46 publications

(24 citation statements)

References 8 publications

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“…One may speculate that the load in the dorsal ligament was increased due to its increased length with malunion, but it is possible that the ligament may have torn and/or undergone some remodeling after injury, which would have influenced the stress within the ligament. In cadaver studies using direct tension measurements, 24 kinematic measures, 11,25,26 and gross anatomical observations, 27,28 the palmar ligament has been reported to be tensioned (lengthened) more than the dorsal ligament in supination, whereas the dorsal was tensioned (lengthened) more than the palmar in pronation. However, this description of the role of the radioulnar ligaments is not consistent with the observations of af Ekenstam and Hagert.…”

Section: Discussionmentioning

confidence: 99%

Effects of distal radius malunion on distal radioulnar joint mechanics—an in vivo study

Crisco

Moore

Marai

et al. 2007

Journal Orthopaedic Research

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Patients with a malunited distal radius often have painful and limited forearm rotation, and may progress to arthritis of the distal radioulnar joint (DRUJ). The purpose of this study was to determine if DRUJ congruency and mechanics were altered in patients with malunited distal radius fractures. In nine subjects with unilateral malunions, interbone distances and dorsal and palmar radioulnar ligament lengths were computed from tomographic images of both forearms in multiple forearm positions using markerless bone registration (MBR) techniques. The significance of the changes were assessed using a generalized linear model, which controlled for forearm rotation angle (À608 to 608). In the malunited forearm, compared to the contralateral uninjured arm, we found that ulnar joint space area significantly decreased by approximately 25%, the centroid of this area moved an average of 1.3 mm proximally, and the dorsal radioulnar ligament elongated. Despite our previous findings of insignificant changes in the pattern of radioulnar kinematics in patients with malunited fractures, we found significant changes in DRUJ joint area and ligament lengthening. These findings suggest that alterations in joint mechanics and soft tissues may play an important role in the dysfunction associated with these injuries. ß

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Section: Discussionmentioning

confidence: 99%

Effects of distal radius malunion on distal radioulnar joint mechanics—an in vivo study

Crisco

Moore

Marai

et al. 2007

Journal Orthopaedic Research

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“…An anatomic ligament reconstruction was undertaken on 3 of the dorsal DRUL specimens and 3 of the volar DRUL specimens using the Scheker technique. 8,16 Finally, excision of the ulna head (Darrach's procedure) was performed on 3 specimens and strain gauge measurements were repeated (Table 1). A custom-designed jig was built to hold the limb securely and simultaneously permit application of incremental load in standardized positions of rotation of the forearm.…”

Section: Methodsmentioning

confidence: 99%

the distal radioulnar joint as a load-bearing mechanism—a biomechanical study

Shaaban

Giakas

Bolton

et al. 2004

The Journal of Hand Surgery

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“…3 The DRULs are defined as palmar and dorsal components each with a superficial and deep part blending with the cartilage of the TFC. [4][5][6] This arrangement is illustrated in the human cadaver dissection demonstrating the proximal or deep surface of the TFC complex (Fig 1). These ligament pairs work as a functional couple to stabilise the radius on the ulna head with the deep pair acting as the more powerful stabilisers.…”

Section: Leesmentioning

confidence: 90%

Functional anatomy of the distal radioulnar joint in health and disease

Lees

2013

annals

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The distal radioulnar joint (DRUJ) is critical to the function of the forearm as a mechanical unit. This paper is concerned with the concepts and observations that have changed understanding of the function of the DRUJ, notably with respect to the biomechanics of this joint. The DRUJ has been shown to be important in acting to distribute load and removal of the ulna head leads to the biomechanical equivalent of a one-bone forearm. The soft tissues with topographical relations to the distal forearm and DRUJ have also been investigated in our experimental series with findings including the description of a clinical disorder termed subluxation-related ulna neuropathy syndrome.A working knowledge of the applied anatomy and biomechanics of the forearm and wrist is useful for any practitioner treating traumatic, developmental and degenerative disorders of the distal radioulnar joint (DRUJ), hand and forearm. The elbow, forearm and wrist act as a unified structure to provide a stable, strong and highly mobile strut for positioning the hand in space and for conducting load-bearing tasks. This paper is concerned with illuminating current concepts regarding the DRUJ and defining its place in the function of the forearm as a mechanical unit. What follows is a personal view and details some of our own experiments that have built on the contributions of other authors working in this field. Comparative anatomy of the DRUJThe DRUJ facilitates forearm rotation. During evolution the development of the DRUJ was probably as important as development of the opposable thumb in allowing human beings to manipulate their environment, facilitating development as hunter-gatherers. The human DRUJ is recognisable in that of the great apes whereas 'lower' mammals have a syndesmosis for a DRUJ. Mobility of the forearm allows apes to place the hand in three-dimensional (3D) space and enables them to swing through the tree branches, an action known as brachiation. Mobility of the hand and forearm in hominids that developed an upright stance was instability owing to ligament injury sustained as a result of falls on the outstretched hand. Applied anatomy of the DRUJ, TFC complex and osseoligamentous structures of the forearmThe DRUJ is one of a pair of hemijoints (uniaxial pivot joints) that function simultaneously permitting the movement of the forearm through the range of pronosupination, the other being the proximal radioulnar joint (PRUJ). The articulations occur between the head of the ulna on the sigmoid notch of the radius (DRUJ) and the head of the radius on the radial notch of the ulna (PRUJ). The key concept in understanding the pathophysiology of the DRUJ is to appreciate that one of its components, namely the ulna head, is essentially a fixed structure about which the specially adapted radius bone rotates.The ulna is essentially a straight bone with a dense, strong condensation of stabilising ligaments known as the triangular fibrocartilage (TFC) complex attaching the distal ulna to the hand and the ulna to the radius. The TFC...

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Distal Radio-Ulnar Ligament Motion During Supination and Pronation

Cited by 46 publications

References 8 publications

Effects of distal radius malunion on distal radioulnar joint mechanics—an in vivo study

Effects of distal radius malunion on distal radioulnar joint mechanics—an in vivo study

the distal radioulnar joint as a load-bearing mechanism—a biomechanical study

Functional anatomy of the distal radioulnar joint in health and disease

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