The congruence of the distal radioulnar joint

Olerud, Claes; Kongsholm, Jörgen; Thuomas, K.-Å.

doi:10.1080/17453678809169705

Cited by 14 publications

(4 citation statements)

References 11 publications

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“…21,22 Our results are consistent with these observations, but our analysis of forearm rotation did not include measurements beyond 608 of supination or pronation. Ishii et al 23 reported the contact center to shift dorsally in pronation, and palmar in supination in the uninjured DRUJ, which is in contrast to our finding of no appreciable shift during normal forearm rotation.…”

Section: Discussionsupporting

confidence: 82%

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: Discussionsupporting

confidence: 82%

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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“…Several investigators have agreed with the result of Schuind et al (Acosta et al, 1993;Adams and Holley, 1993;De Smet and Fabry, 1995;Kihara et al, 1995;Linscheid, 1992;Van Der Heijden and Hillen, 1996), whereas Hagert (1987) continued to support the restraint characteristics of the ligaments (Ekenstam, 1992;Ekenstam and Hagert, 1985a;1985b). Olerud et al (1988), who measured axial MRI images of the TFCC, speculated that the palmar and dorsal portions maintained their lengths during rotation and acted as check rein ligaments over the distance between the centre of the ulnar head and the sigmoid notch of the radius, although there was no direct evidence to support their idea.…”

Section: Discussionmentioning

confidence: 99%

The Proximal Ligamentous Component of the Triangular Fibrocartilage Complex

Nakamura

Makita

2000

Journal of Hand Surgery

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The proximal ligamentous component of the triangular fibrocartilage complex (TFCC) was studied anatomically using 15 fresh-frozen cadaver hand forearm specimens. Changes in the length of either side of this component were analysed during forearm rotation with the complete three-dimensional structure of the TFCC preserved. The proximal ligamentous component consists of three portions: dorsal, central and palmar. The dorsal and palmar portions connect the radius and ulna directly. These were recognized in all specimens whereas the central portion was not constant. The morphology of the proximal component was categorized into three types: fan-shaped, V-shaped, and funnel-shaped in five wrists each. Changes in ligament length during forearm rotation were measured using fine wires under slight tension that paralleled the ligaments from origin to insertion. The dorsal and palmar portions demonstrated three trends: the dorsal portion increased in length from supination to pronation whereas the palmar portion increased in length from pronation to supination; the length of the dorsal portion remained almost constant as the palmar portion increased in length from pronation to supination; the length of the palmar portion remained almost constant while the dorsal portion lengthened from supination to pronation. These variations appear to be related to which portion of the ligament was attached nearest to the centre of the ulnar fovea, where the rotational axis of the forearm passes. The portion attaching nearest to the fovea demonstrated a nearly isometric length pattern, whereas the portion which attached at a distance showed greater extensibility. These findings suggest that the proximal component of the TFCC corresponds to a true radioulnar ligament, and the isometric and eccentric fibres act mutually during forearm rotation.

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“…Such a determination would require long-term follow-up in a larger number of cases. Geometric criteria are valuable, nevertheless, because they help radiologists to avoid purely subjective judgments regarding the geometry of a joint which normally possesses anatomic incongruity [15]. As shown by this study, such geometric criteria can be applied to routine MR wrist examinations just as they have been applied to CT scans.…”

Section: Discussionmentioning

confidence: 92%

Abnormal geometry of the distal radioulnar joint: MR findings

et al. 1994

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Previously developed criteria of normal distal radioulnar joint (DRUJ) axial geometry were applied to routine magnetic resonance (MR) images of 50 wrists. All wrists lacked clinically evident DRUJ instability. An attempt to apply the three geometric criteria to seven of the cases was not possible, since the prescribed landmarks were not visible. The remaining 43 cases were retrospectively divided into a symptomatic group (25 wrists), with clinical abnormalities referable to the ulnar side of the wrist, and an asymptomatic group (18 wrists), with no such abnormalities. Abnormal DRUJ geometry was found in 12 symptomatic and 2 asymptomatic wrists. This difference between the groups is significant (p = 0.02), suggesting that many symptomatic wrists exhibit different DRUJ geometry than is found in most asymptomatic wrists.

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The congruence of the distal radioulnar joint

Cited by 14 publications

References 11 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 Proximal Ligamentous Component of the Triangular Fibrocartilage Complex

Abnormal geometry of the distal radioulnar joint: MR findings

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