An analysis of the constraint properties of the distal radioulnar ligament attachments to the ulna

Haugstvedt, Jan Ragnar; Berger, Richard A.; Berglund, Lawrence J.; Neale, Patricia G.; Sabick, Michelle B.

doi:10.1053/jhsu.2002.30912

Cited by 43 publications

(29 citation statements)

References 19 publications

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“…Ward et al 7 reported no significant increase in DRUJ instability after sectioning the joint capsule when measured at the extremes of forearm rotation. In another cadaver study Haugstvedt et al 8 showed that with forearm pronation the dorsal joint capsule could progressively tighten, constraining volar displacement of the radius and, conversely, in forearm supination the palmar portion would tighten, restricting volar displacement of the radius.…”

mentioning

confidence: 99%

Stability of the distal radioulnar joint contributed by the joint capsule

Watanabe¹,

Berger²,

An³

et al. 2004

The Journal of Hand Surgery

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confidence: 99%

Stability of the distal radioulnar joint contributed by the joint capsule

Watanabe¹,

Berger²,

An³

et al. 2004

The Journal of Hand Surgery

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“…To divide the styloid insertion the scalpel was drawn distally along the radial border of the styloid process. 14 …”

Section: Testing Sequencementioning

confidence: 99%

“…[7][8][9][10] Different studies of DRUJ biomechanics have evaluated the stabilizing contributions of the dorsal and palmar radioulnar ligaments. The studies have involved sectioning of the ligaments from their radial [11][12][13] or ulnar 14 …”

mentioning

confidence: 99%

Relative Contributions of the Ulnar Attachments of the Triangular Fibrocartilage Complex to the Dynamic Stability of the Distal Radioulnar Joint

Haugstvedt

Berger

Nakamura

et al. 2006

The Journal of Hand Surgery

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“…The dorsal radioulnar ligament (DRUL) has been shown to be important for both palmar and dorsal stability of the distal radioulnar joint. 6,7 The extensor carpi ulnaris subsheath (ECUS) is an integral part of the dorsoulnar capsule, and it is an important stabilizer of the wrist, 8 but it is poorly seen through a dorsal portal.…”

Section: Historical Perspectivementioning

confidence: 99%

Distal Radioulnar Joint Arthroscopy and the Volar Ulnar Portal

Slutsky

2007

Techniques in Hand &Amp; Upper Extremity Surgery

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Pain on the ulnar side of the wrist remains poorly understood. As attention has shifted toward the myriad causes of ulnar-sided wrist pain, the utility of viewing the wrist from a volar ulnar (VU) perspective has emerged. Lunotriquetral ligament tears have been implicated in the pathogenesis of volar intercalated segmental instabilities. They often originate in the palmar subregion, which is most important for maintaining stability. These tears are difficult to visualize through the 4, 5, or 6R portals. They are well seen through a VU portal, and the direct line of sight facilitates debridement. The VU portal has potential use in the arthroscopic diagnosis and treatment of patientswith injuries tothe ulnarslingmechanism.Itaidsin triangular fibrocartilage repairs especially those involving the dorsal aspect between the ulnar styloid and the radial insertion, because the proximity of the 4, 5, and 6R portals makes triangulation of the instruments difficult.Although arthroscopy of the dorsal aspect of the distal radioulnar joint has been well described, it has largely remained a curiosity, with few clinical indica-tions. Recent biomechanical studies have highlighted the importance of the deep attachment of the triangular fibrocartilage complex in maintaining distal radioulnar joint stability. The volar distal radioulnar portal is useful for assessing the foveal attachment. It may be used where there is the suspicion of a peripheral triangular fibrocartilage detachment due to a loss of its normal tension despite the lack of a visible tear during radio-carpal arthroscopy. The judicious use of these portals deserves consideration for inclusion as part of a thorough arthroscopic examination of selected patients with ulnarsided wrist pain. Keywords: arthroscopy, DRUJ, volar, portal | HISTORICAL PERSPECTIVEThe indications for wrist arthroscopy have steadily grown from a mostly diagnostic tool to a valuable adjunctive procedure in the treatment of myriad wrist disorders. The ulnocarpal joint has been the proverbial ''black box^ of the wrist pain. Instability of the distal radioulnar joint (DRUJ) is a hotbed for research, with new and innovative techniques appearing monthly. Although the new generation of 3-T magnetic resonance imaging scanners holds promise for the future, many of the causes of ulnar-sided wrist pain are revealed only at the time of arthroscopy. Establishing the diagnosis of a peripheral detachment of the triangular fibrocartilage complex (TFCC) or a tear of the ulnar sling mechanism remains an exacting challenge even for the experienced arthroscopist.The clinical utility of volar portals has been recently elucidated. 1 As kinematic and biomechanical studies have shed light on the role of the dorsal capsular structures and palmar subregions of the interosseous ligaments in maintaining carpal stability, it has become prudent to view the wrist from a palmar perspective. Volar portals for wrist arthroscopy have certain advantages over the standard dorsal portals for visualizing dorsal capsular struct...

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An analysis of the constraint properties of the distal radioulnar ligament attachments to the ulna

Cited by 43 publications

References 19 publications

Stability of the distal radioulnar joint contributed by the joint capsule

Stability of the distal radioulnar joint contributed by the joint capsule

Relative Contributions of the Ulnar Attachments of the Triangular Fibrocartilage Complex to the Dynamic Stability of the Distal Radioulnar Joint

Distal Radioulnar Joint Arthroscopy and the Volar Ulnar Portal

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