A Biomechanical Evaluation of the DRUJ After Distal Oblique Bundle Reconstruction

Low, Sara; Clippinger, Benjamin; Landfair, Germanuel L.; Criner-Woozley, Katharine

doi:10.1016/j.jhsa.2019.10.011

Cited by 14 publications

(16 citation statements)

References 19 publications

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“…It is indicated in cases of failure or impossibility of TFCC repair, to support a non-acute TFCC injury, and in wrist fractures with distal radioulnar instability after osteosynthesis. Recently, articles such as the one by Low et al 9 reported similar outcomes from the reconstruction of radioulnar ligaments and of the DOB.…”

Section: Discussionmentioning

confidence: 91%

Reconstruction of the Distal Oblique Bundle of the Interosseous Membrane with Extensor Carpi Radialis Hemitendon: A New Minimally-Invasive Technique

Martínez‐Martínez

Giménez-Ros²,

León‐Muñoz

et al. 2020

Revista Iberoamericana de Cirugía de la Mano

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The main stabilizing element of the distal radioulnar joint (DRUJ) is the triangular fibrocartilage complex (TFCC). Secondary stabilizers include the distal oblique band (DOB), which is inconsistently found. When TFCC repair has failed or cannot be performed, DOB reconstruction is a therapeutic option. Even though distal radioulnar ligamentoplasty remains the technique of choice, recent papers show similar outcomes from both methods. We present two cases of successful DOB repair with the extensor carpi radialis longus (ECRL) hemitendon.

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Section: Discussionmentioning

confidence: 91%

Reconstruction of the Distal Oblique Bundle of the Interosseous Membrane with Extensor Carpi Radialis Hemitendon: A New Minimally-Invasive Technique

Martínez‐Martínez

Giménez-Ros²,

León‐Muñoz

et al. 2020

Revista Iberoamericana de Cirugía de la Mano

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“…In the study proposed by Aita and Low the surgical technique is also more aggressive, with the complete loss of the brachioradialis muscle, which they use as a stabilizing graft through a tunnel that crosses the radius and ulna. It also requires the use of a temporary Kirschner needle blocking the joint, which must then be removed [19,20]. On the other hand, the BOD rupture after the TCCC rupture does present significant differences in dorsal and volar in the three positions of the specimens, less in dorsal pronation.…”

Section: Discussionmentioning

confidence: 99%

“…Under normal conditions it is a secondary stabilizer of DRUJ, however, when there is a TFCC lesion, it becomes an important stabilizer of the joint, both in palmar and dorsal deviation [11][12][13][14]. Because of this, in recent years various techniques have been developed that try to reconstruct this ligamentous reinforcement [15][16][17][18][19][20]. Other way to improve the DRUJ stability is to protect wrist band brace in both normal and TFCC-torn wrists [21].The proposed technique wants to validate the biomechanically effective option to restore TFCC in athletes (baseball, racquet, handball, volleyball players and other sports which use their hands), the recommended alternative can be done when the TFCC is irreparable or to complement its repair.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical invasive reconstruction of the distal oblique band of the interosseous membrane with extensor carpi radialis longus in radioulnar instability: A new clinical therapy for athletes

Ros¹,

Munoz²,

Medina³

et al. 2022

J Clin Images Med Case Rep

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Distal Radioulnar Joint (DRUJ) instability is a pathology without a clear reconstructive procedure. Throughout history, numerous techniques have been described whose objectives have been to increase stability as well as relieve pain. The main stabilizing element is the Triangular Fibrocartilage Complex (TFCC) and, there are also secondary stabilizers among where the Distal Oblique Bundle (DOB) is consistently located. We performed a biomechanical study with three cadaveric arms to verify the influence of DOB on joint stability and performing a new reconstruction technique with hemi tendon of carpi radialis longus extensor to get distal radio cubital stability for fiber cartilage repair. There are positive results in the volar and dorsal displacement of the ulna on the radius with the reconstruction technique presented to restore joint stability. The proposed technique is a valid and biomechanically effective option to restore joint stability as a complement to the repair of the TFCC or as a unique technique if the TFCC is irreparable. This technique became important when you cannot repair TFCC in athletes, the recommended alternative can be done and distal oblique soft plasty.

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“…A biomechanical study demonstrated that, in terms of translation, cyclical loading, and maximal load to failure, the DOB reconstruction performed to resolve DURJ instability was similar to the Adams reconstruction method. [ 23 ] A cadaveric study showed that DOB reconstruction by extensor indicis proprius tendon grafting could improve the stability of the DRUJ. [ 24 ] Another cadaveric study utilized a suturebutton construct, placing it approximately in the direction of the DOB; therefore, DRUJ instability decreased considerably.…”

Section: Discussionmentioning

confidence: 99%

Treatment of acute distal radioulnar joint instability with distal oblique bundle augmentation of the interosseous membrane by suture-button suspension: A case series

Hsiao

Chien²,

Wu³

2022

Jt Dis Relat Surg

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The distal radioulnar joint (DRUJ) is a diarthrodial trochoid synovial joint, [1] composed of two parts: bony radioulnar articulation and peripheral soft-tissue stabilizers. The bony articulation accounts for only approximately 20% of the stability of the DRUJ [2] The primary soft-tissue stabilizers are structures surrounding the DRUJ, collectively referred to as the ulnoligamentous complex or more popularly as the triangular fibrocartilaginous complex (TFCC). [3,4] Among the stabilizers, the volar and dorsal radioulnar ligaments contribute the most to the stability of DRUJs.Injuries of the DRUJ require special consideration due to the complex motion and function of this joint. [5] Acute traumatic DRUJ injuries occur commonly with fractures of the forearm such as ulnar styloid fracture, Essex-Lopresti injury, and distal radius fracture, with 10 to 19% of suchThe stability of distal radioulnar joints is afforded by bony radioulnar articulation and peripheral soft-tissue stabilizers. The primary soft-tissue stabilizers are structures that surround the distal radioulnar joint and are collectively referred to as the triangular fibrocartilaginous complex. Among the stabilizers, the volar and dorsal radioulnar ligaments contribute the most to the stability of distal radioulnar joints. For acute traumatic distal radioulnar joint instability accompanied by purely ligamentous injury, traditional surgical treatments involve the repair or reconstruction of the distal radioulnar ligament; however, these intra-articular procedures are highly invasive and difficult. The extra-articular reconstruction of the secondary stabilizer such as the distal oblique bundle of the interosseous membrane has attracted significant attention in recent years; however, most studies have only conducted cadaveric or laboratory model-based investigations. In this article, we present three patients who suffered from acute dorsal wrist pain after a trauma event. Radiographic and physical examinations revealed distal radioulnar joint instability. All patients were treated with minimally invasive suture-button suspension augmentation in the direction of distal oblique bundle of the interosseous membrane. The instability was resolved after the surgical procedure, but two patients developed ulnar wrist pain and one patient underwent implant removal. All patients have been continually followed at our outpatient department and exhibited stable wrists, despite mild limitation in the range of motion after the procedure. In conclusion, acute traumatic distal radioulnar joint instability may be sufficiently treated with suture-button suspension for augmentation of the distal oblique bundle; however, some obstacles impede the in vivo adoption of this treatment.

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A Biomechanical Evaluation of the DRUJ After Distal Oblique Bundle Reconstruction

Cited by 14 publications

References 19 publications

Reconstruction of the Distal Oblique Bundle of the Interosseous Membrane with Extensor Carpi Radialis Hemitendon: A New Minimally-Invasive Technique

Reconstruction of the Distal Oblique Bundle of the Interosseous Membrane with Extensor Carpi Radialis Hemitendon: A New Minimally-Invasive Technique

Biomechanical invasive reconstruction of the distal oblique band of the interosseous membrane with extensor carpi radialis longus in radioulnar instability: A new clinical therapy for athletes

Treatment of acute distal radioulnar joint instability with distal oblique bundle augmentation of the interosseous membrane by suture-button suspension: A case series

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