The stabilizing mechanism of the distal radioulnar joint during pronation and supination

The Distal Oblique Bundle of the Distal Interosseous Membrane of the Forearm

“…3 The TFCC is the primary soft-tissue DRUJ stabilizer, and the DIOM acts as a secondary stabilizer of the DRUJ when the dorsal and palmar radioulnar ligaments of the TFCC are cut. 4,5 In normal situations, the influence of the DIOM on DRUJ stability is relatively inconsequential. However, after a TFCC injury, an ulnar head resection, or a Sauvé-Kapandji procedure, the DIOM has a more important role in the stability of the ulnar head or ulnar stump.…”

Clinical and Radiographic Factors Associated With Distal Radioulnar Joint Instability in Distal Radius Fractures

“…The triangular fibrocartilage complex has been regarded as the most important stabilizer of the DRUJ [2,17]. The triangular fibrocartilage complex, especially the deep part, plays a major role in dorsopalmar and rotational stability of the DRUJ [2,13,14,41,43], and to be related to DRUJ instability and subsequent pain after distal radius fractures [23,24]. Fujitani et al observed a deep triangular fibrocartilage complex tear from the fovea of the ulnar head in all patients with DRUJ instability [8].…”

The radioulnar joint in distal radial fractures: A review

“…Cadaveric studies have shown that during maximum pronation, the small joint surface contact the palmar aspect is stabilized by taut deep ligament bers on the dorsal aspect of the joint, but at the same time, there is some passive tautness in the more super cial bers on the palmar aspect (af Hagert 1985b, Hagert 1992). Som authors of other cadaveric studies have asserted that it is only the palmar ligaments that are taut during pronation, with consequent generation of stability (Schuind et al 1991, Adams and Holley 1993, Kihara et al 1995. The controversy re ects the problem of determining which bers stabilize the joint and which are taut by passive distension.…”

“…The commonest complaint after distal radial fractures is ulnar-sided wrist pain (Frykman 1967, Cooney et al 1980, Altissimi et al 1986, Solgaard 1988, found in every fth patient (Frykman 1967), which affects the end-result adversely (Frykman 1967, Hollingsworth and Morris 1976, Jupiter et al 1992, Stoffelen et al 1998. Such pain has been attributed mainly to malunion of the distal radius (Lidström 1959, Frykman 1967, Hollingsworth and Morris 1976, van der Linden and Ericson 1981, Villar et al 1987, Kopylov et al 1993, Warwick et al 1993, Hove et al 1995, Stoffelen 1997) thus creating an imbalance distally, which may lead to both ulnocarpal abutment (Bowers 1999), as well as incongruency (Kihara et al 1995) and osteoarthrosis of the distal radioulnar (DRU) joint (Fernandez 1993). It has recently been suggested that in many cases common distal radial fractures are complicated by ligament injuries, found on wrist arthroscopy (Geissler et al 1996a, Lindau et al 1997, Richards et al 1997).…”