Contact area inside the distal radioulnar joint: Effect of axial loading and position of the forearm

Shaaban, Hassan; Giakas, Giannis; Bolton, M.; Williams, Robert Lee; Wicks, Paul; Scheker, Luis R.; Lees, Vivien C.

doi:10.1016/j.clinbiomech.2006.05.010

Cited by 20 publications

(15 citation statements)

References 11 publications

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“…Absolute values of peak transmitted force and contact areas measured in this study were slightly less than those we have previously published (Shaaban et al, 2007). The demographics of the cadaver arms' source were slightly different between the two studies, and a more sensitive version of the Tekscan wrist sensor has been used in the present study.…”

mentioning

confidence: 47%

“…It demonstrates most distensibility with initial loading and then reduced distension with further applied loads. As found in earlier experiments by our laboratory (Shaaban et al, 2004;2007), the ligaments of the DRUJ also have a role in load transmission and will also account for some of this observed lack of proportionality of strain in the IOL.…”

Section: Strain In the Iolmentioning

confidence: 84%

See 1 more Smart Citation

The biomechanical and functional relationships of the proximal radioulnar joint, distal radioulnar joint, and interosseous ligament

Malone

Cooley

Morris

et al. 2014

J Hand Surg Eur Vol

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This biomechanical study assessed integrated function of the proximal radioulnar joint (PRUJ), interosseous ligament (IOL), and distal radioulnar joint (DRUJ). Tekscan™ pressure sensors were inserted into the DRUJ and PRUJ of 15 cadaveric specimens. MicroStrain(®) sensors were mounted onto the IOL on nine of these specimens. A customized biomechanical jig was used to apply axial loads and take measurements through pronosupination. The PRUJ, IOL, and DRUJ were shown to function as an integrated osseoligamentous system distributing applied load. The PRUJ has transmitted pressure profiles similar to those of the DRUJ. Different IOL components support loading at different stages of pronosupination. The IOL is lax during pronation. Mid-IOL tension peaks in the midrange of forearm rotation; distal-IOL tension peaks in supination. Axial loading consistently increases IOL strain in a non-linear fashion. There are clinical implications of this work: disease or surgical modification of any of these structures may compromise normal biomechanics and function.

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mentioning

confidence: 47%

Section: Strain In the Iolmentioning

confidence: 84%

The biomechanical and functional relationships of the proximal radioulnar joint, distal radioulnar joint, and interosseous ligament

Malone

Cooley

Morris

et al. 2014

J Hand Surg Eur Vol

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show abstract

“…En estos casos, la alteración biomecánica es máxima, pues se anula el sustento del radio al mismo tiempo que se pierde la adecuada transmisión de fuerzas verticales en el antebrazo. En estas condiciones, se produce un «pellizcamiento cubital», donde el radio sin sustento «cae» e impacta con el cúbito, hecho que se hace muy llamativo al elevar un objeto con la muñeca en posición neutra de pronosupinación [4][5][6] . Por convención, se utiliza el término «pellizcamiento cubital», en referencia a que el cúbito se mueve contra el radio, cuando en realidad es lo contrario 7 .…”

Section: Palabras Claves: Articulación Radiocubital Distal Prótesisunclassified

Artroplastia total de la articulación radiocubital distal

Scheker

Breyer

2007

Rev Iberoam Cir Mano

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D entro de las patologías causantes de dolor cubital de muñeca, se encuentran aquellas relacionadas con la articulación radiocubital distal (ARCD), pudiendo afectar al componente osteocartilaginoso, al ligamentoso o a ambos. En cuanto al tratamiento se refiere, si bien estas patologías pueden ser tratadas tanto de forma conservadora como quirúrgica, existen una serie de casos en los que la lesión es tan grave y/o donde han fallado todos los tratamientos quirúrgicos previos, que la única forma de restaurar la función de la extremidad es mediante una artroplastia total radiocubital distal.El radio y el cúbito se articulan tanto proximal como distalmente mediante una articula- La articulación radiocubital distal es un importante eslabón en la transmisión de los movimientos del antebrazo y es la base fundamental para la función en la elevación de objetos. Existen numerosas causas que pueden conducir a una grave lesión de la misma, con importante dolor y limitación funcional. En estos casos la artroplastia total es la única alternativa de tratamiento. En el presente artículo, se discuten las indicaciones y técnica quirúrgica de la prótesis total de la articulación radiocubital distal, la cual constituye un método efectivo de tratamiento en articulaciones gravemente destruidas. Sólo con la sustitución de todos sus elementos articulares mediante una pró-tesis autoestable, se devuelve la movilidad a la extremidad, de manera inmediata, estable e indolora. Palabras claves: articulación radiocubital distal, prótesis, artroplastia.The distal radio-ulnar joint is an important joint that supports the mobility of the forearm and the elevation of objects. There are many causes that lead to severe damage of the joint, in association with severe pain and lost of the function. In these cases of advanced joint destruction, the complete replacement of the joint is the only option of treatment.In this paper we discus the indications and surgical techniques of a distal radio-ulnar joint total prosthesis, which is a very effective treatment of very severe destroyed joints. Only with the replacement of all the structures involved in the distal radio-ulnar joint with a complete self stabilizing prosthesis, the extremity will recover a stable and painless mobility.

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“…The first series of these was undertaken on 12 cadaver limbs mounted on a custom-made jig. [19][20][21] Axial loads were applied via a balanced pulley system mounted to the rear of the jig. Force was measured in the DRUJ using Tekscan (Boston, MA, US) wrist sensors and, from these measurements, pressure profiles and contact areas and centroid positions were derived.…”

Section: Leesmentioning

confidence: 99%

Functional anatomy of the distal radioulnar joint in health and disease

Lees

2013

annals

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The distal radioulnar joint (DRUJ) is critical to the function of the forearm as a mechanical unit. This paper is concerned with the concepts and observations that have changed understanding of the function of the DRUJ, notably with respect to the biomechanics of this joint. The DRUJ has been shown to be important in acting to distribute load and removal of the ulna head leads to the biomechanical equivalent of a one-bone forearm. The soft tissues with topographical relations to the distal forearm and DRUJ have also been investigated in our experimental series with findings including the description of a clinical disorder termed subluxation-related ulna neuropathy syndrome.A working knowledge of the applied anatomy and biomechanics of the forearm and wrist is useful for any practitioner treating traumatic, developmental and degenerative disorders of the distal radioulnar joint (DRUJ), hand and forearm. The elbow, forearm and wrist act as a unified structure to provide a stable, strong and highly mobile strut for positioning the hand in space and for conducting load-bearing tasks. This paper is concerned with illuminating current concepts regarding the DRUJ and defining its place in the function of the forearm as a mechanical unit. What follows is a personal view and details some of our own experiments that have built on the contributions of other authors working in this field. Comparative anatomy of the DRUJThe DRUJ facilitates forearm rotation. During evolution the development of the DRUJ was probably as important as development of the opposable thumb in allowing human beings to manipulate their environment, facilitating development as hunter-gatherers. The human DRUJ is recognisable in that of the great apes whereas 'lower' mammals have a syndesmosis for a DRUJ. Mobility of the forearm allows apes to place the hand in three-dimensional (3D) space and enables them to swing through the tree branches, an action known as brachiation. Mobility of the hand and forearm in hominids that developed an upright stance was instability owing to ligament injury sustained as a result of falls on the outstretched hand. Applied anatomy of the DRUJ, TFC complex and osseoligamentous structures of the forearmThe DRUJ is one of a pair of hemijoints (uniaxial pivot joints) that function simultaneously permitting the movement of the forearm through the range of pronosupination, the other being the proximal radioulnar joint (PRUJ). The articulations occur between the head of the ulna on the sigmoid notch of the radius (DRUJ) and the head of the radius on the radial notch of the ulna (PRUJ). The key concept in understanding the pathophysiology of the DRUJ is to appreciate that one of its components, namely the ulna head, is essentially a fixed structure about which the specially adapted radius bone rotates.The ulna is essentially a straight bone with a dense, strong condensation of stabilising ligaments known as the triangular fibrocartilage (TFC) complex attaching the distal ulna to the hand and the ulna to the radius. The TFC...

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Contact area inside the distal radioulnar joint: Effect of axial loading and position of the forearm

Cited by 20 publications

References 11 publications

The biomechanical and functional relationships of the proximal radioulnar joint, distal radioulnar joint, and interosseous ligament

The biomechanical and functional relationships of the proximal radioulnar joint, distal radioulnar joint, and interosseous ligament

Artroplastia total de la articulación radiocubital distal

Functional anatomy of the distal radioulnar joint in health and disease

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