Effect of decrease in radial inclination of distal radius fractures on distal radioulnar joint stability: a biomechanical study

Bessho, Yuki; Nakamura, Toshiyasu; Nishiwaki, Masao; Nagura, Takeo; Matsumoto, Morio; Nakamura, Masaya; Sato, Kazuki

doi:10.1177/1753193418761266

Cited by 6 publications

(4 citation statements)

References 14 publications

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“…Radial inclination was one of the parameters to assess the quality of reduction in distal radius fracture. Decrease in radial inclination had been shown to increase stiffness of distal radioulnar joint (DRUJ) in neutral, pronation and supination position in cadaveric study [16]. Increase stiffness of distal radioulnar joint would cause increased risk of DRUJ arthritis [17].…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Study of Radiographic Anatomy of Wrist in Chinese Population

Tang¹,

Boris²,

Man³

et al. 2018

ETSN

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In wrist pathology, there is a need to establish the normal range of radiographic measurement parameters. Previous study showed that the contralateral wrist might not be valid as a reference for all parameters. There is a lack of literature describing the normal range of wrist radiographic parameters in literature. As a result, a retrospective study was carried out. Patients who underwent standard wrist x-rays during the period February 2012 to February 2013 (one single year) were retrospectively reviewed. 71 patients were included. Scapholunate angle was 54.7˚ (±6.5˚). Scapholunate interval was 2.0 mm (±0.4 mm). Ulnar variance was +1.0 mm (±1.8 mm). Carpal height was 31.8 mm (±3.0 mm). Radial inclination was 25.1˚ (±2.1˚). All 71 patients had 1 sesamoid bone at first metacarpal. 16.9% (12 out of 71) patients had positive cortical ring signs. All these parameters are valuable clinically, especially in monitoring of the wrist disease progression, in the design of wrist implants and for future clinical research.

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Section: Discussionmentioning

confidence: 99%

A Retrospective Study of Radiographic Anatomy of Wrist in Chinese Population

Tang¹,

Boris²,

Man³

et al. 2018

ETSN

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“…27 , 28 Theoretically, in vivo ulnar negativity would not only increase tension on the DOB but also increase tension on the TFCC as described by Bessho et al, generating greater stability. 14…”

Section: Discussionmentioning

confidence: 99%

“…Prior studies have investigated various factors and approaches that may negate subsequent DRUJ instability after a DRF. For example, Bessho et al 14 reported that DRFs with a decreased radial angulation have increased stiffness in both the setting of an intact or partially sectioned radial ulnar ligament (RUL). Specifically, they suggested that 10° of radial angulation from the original radial inclination should be achieved intraoperatively to minimize the risk of postoperative DRUJ instability.…”

Section: Introductionmentioning

confidence: 99%

Negative Ulnar Variance Lessens DRUJ Instability After DRUJ Disruption: A Biomechanical Analysis

Huddleston

Kurtzman

Deegan

et al. 2022

Hand (New York, N,Y.)

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Background: The purpose of this study was to perform a biomechanical investigation on the effect of ulnar variance (UV) on the stability of the distal radioulnar joint (DRUJ) prior to and after DRUJ sectioning. Methods: Ten cadaveric forearm specimens were included in the study and baseline UV was assessed radiographically. Radial motion relative to the ulna was evaluated using Intel real sense cameras and a custom developed program. The forearms were dissected, and a radial osteotomy was performed. Using a custom-made plate, radial stability was assessed with an UV of + 4, 0, and −4 mm by measuring the maximum and minimum radial position relative to the ulna during a simulated Shuck test. The volar radioulnar ligaments and triangular fibrocartilage complex (TFCC) were then sectioned, and testing was repeated at each UV state. Results: Sectioning significantly increased radial translation at neutral ( P = .008), +4 mm UV ( P = .008), and −4 mm UV ( P = .018). There were no significant differences in translation between the 3 UV groups with the DRUJ intact ( P = .124). The ulnar negative (−4 mm) state had significantly lower translation compared to the positive (+4 mm) ( P < .001) and the neutral (0 mm) ( P = .026) UV states. There were no significant differences between the positive and neutral UV groups with the DRUJ sectioned. Conclusions: Fixating the radius in −4 mm of ulnar negativity significantly decreased radial translation after sectioning the volar radioulnar ligament and TFCC. Ulnar variance had no effect on stability with an intact DRUJ. Study Type: Biomechanical Study

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“…Intra-articular fractures of the distal radius (IFDR) are commonly encountered traumas in orthopedics. These fractures are caused by low-energy trauma most often attributed to underlying osteoporosis in elderly individuals, and due to high-energy trauma in young and active individuals (1,2). IFDR occurs as a result of falling on the open hand while the elbow is in extension and the wrist is in dorsiflexion (3).…”

Section: Introductionmentioning

confidence: 99%

Distal Radius Eklem İçi Kırıklarının El Bilek Fiksatörü ile Tedavisinde Radio-Ulnar Açıdaki Değişikliklerin El Bilek Skorlamasına Etkisi

AKAR¹,

YÜCEL²

2023

Düzce Tıp Fakültesi Dergisi

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Aim: This study was aimed to evaluate the effect of radial inclination (RI) angle, assessed with radiological measurement, on the clinical outcomes of intra-articular fractures of the distal radius (IFDR) treated with closed reduction and penning type dynamic wrist fixator. Material and Methods: A total of 120 patients who underwent closed reduction and dynamic wrist fixation due to IFDR between 2012 and 2020 were retrospectively reviewed. The effects of the changes in RI on clinical outcomes according to Mayo wrist scoring (MWS) criteria were investigated by measuring the RI angles in anteroposterior wrist radiographs of the patients at postoperative 2nd, 6th, and 10th weeks. Results: According to the AO fracture classification, 77 (64.2%) of the patients had type C1 and 43 (35.8%) of the patients had type C2 fracture. The patients comprised 69 (57.7%) females and 51 (42.3%) males, and the mean age was 50.08±15.36 years. Fixators were removed at six weeks. RI angles measured at post-op week 10 were 20°-30° in 83 (69.1%) patients, 10°-19° in 32 (26.6%) patients, and 0°-9° in 5 (4.3%) patients. According to MWS, 39 (32.5%) patients were evaluated as excellent, 76 (63.3%) patients as good, and 5 (4.2%) patients as moderate. A statistically significant positive correlation was observed between RI values and MWS (r=0.369, p<0.001). Conclusion: Dynamic wrist fixation with closed reduction is a simple and minimally invasive method, and provides successful clinical and functional results in the treatment of IFDR. We consider that optimal RI angles are effective in clinical and functional outcomes.

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Effect of decrease in radial inclination of distal radius fractures on distal radioulnar joint stability: a biomechanical study

Cited by 6 publications

References 14 publications

A Retrospective Study of Radiographic Anatomy of Wrist in Chinese Population

A Retrospective Study of Radiographic Anatomy of Wrist in Chinese Population

Negative Ulnar Variance Lessens DRUJ Instability After DRUJ Disruption: A Biomechanical Analysis

Distal Radius Eklem İçi Kırıklarının El Bilek Fiksatörü ile Tedavisinde Radio-Ulnar Açıdaki Değişikliklerin El Bilek Skorlamasına Etkisi

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