Contribution of the Interosseous Membrane to Distal Radioulnar Joint Constraint

Watanabe, Hiroshi; Berger, Richard A.; Berglund, Lawrence J.; Zobitz, Mark E.; An, Kai Nan

doi:10.1016/j.jhsa.2005.06.013

Cited by 128 publications

(70 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…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.…”

mentioning

confidence: 99%

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

Moritomo

2013

Jnl Wrist Surg

View full text Add to dashboard Cite

The distal interosseous membrane (DIOM) of the forearm is on the distal side of the central band of the interosseous membrane, spanning the radius and ulna at the dorsal region of the pronator quadratus muscle. Recent anatomical studies have revealed that the thickness of the DIOM varies widely among specimens (0.5-2.6 mm), and an obvious thick fiber within the DIOM, called the distal oblique bundle (DOB), exists in 40% of specimens. 1,2 The DOB originates from the distal ulna 54 mm (on average; range, 50-57 mm) proximal to the ulnar head and runs distally to insert on the dorsal inferior rim of the sigmoid notch of the radius (►Fig. 1a,b). The DOB has an anatomical relationship with the triangular fibrocartilage complex (TFCC) (►Fig. 2), both of which probably work as isometric collateral ligaments of the distal radioulnar joint (DRUJ) because the ulnar insertions of the DOB and the deep limbs of the radioulnar ligament almost coincide with the course of the axis of forearm rotation. 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. The clinical relevance of the DIOM includes its stabilizing effect on the DRUJ in ulnar shortening procedures. Recent study has revealed that ulnar shortening with the osteotomy performed proximal to the attachment of the DIOM has a more favorable effect on stability of the DRUJ as compared to distal osteotomy, The distal radius with the distal interosseous membrane and TFCC viewed from the dorsoulnar side. The ulna has been removed. DOB inserts on the dorsal inferior rim of the sigmoid notch of the radius. R, radius; U, ulna.

show abstract

mentioning

confidence: 99%

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

Moritomo

2013

Jnl Wrist Surg

View full text Add to dashboard Cite

show abstract

“…They are consistently found in the forearm like the central band, but accessory bands are less substantial, and their role in forearm stability is minor [ 9 ] . The distal oblique band is important in DRUJ stability, but not as much in axial stability [ 8,21,22 ] .…”

Section: Anatomy and Biomechanics Of The Forearmmentioning

confidence: 99%

Secondary Surgery Following Failed Forearm Reconstruction

Jacob

Tsai

Osterman

2012

Reoperative Hand Surgery

View full text Add to dashboard Cite

It is not uncommon for longitudinal forearm instability to be recognized quite late after the injury. Frequently, this injury is not appreciated until there have already been changes at both the wrist (ulnar carpal abutment) and the elbow (radiocapitellar abutment). These late cases frequently require an ulnar shortening osteotomy, as well as radial head prosthesis and/or reconstruction of the interosseous ligament. If continued problems result and there are degenerative changes or chronic pain at the radial capitellar joint, a radiocapitellar prosthesis can be considered. The fi nal treatment for some patients may require creation of a one-bone forearm. This prevents any further longitudinal instability of the forearm; however, it obviously results in loss of forearm rotation. These injuries are best treated early and aggressively, as later reconstructive options will usually result in decreased function of the extremity. This chapter goes through the different reconstructive options that are available to the reoperative surgeon.

show abstract

“…The interosseous membrane in conjunction with the triangular fibrocartilage complex (TFCC) as the most important stabilizer of the DRUJ enables unrestricted forearm rotation [5][6][7][8][9][10][11][12][13]. While the TFCC has both centric and epicentric insertions at the ulnar head the interosseous membrane consists of different oriented fibers to guarantee stability of the DRUJ during pronosupination [5,[14][15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

“…Specifically the distal part of the interosseous membrane (DIOM) contributes to the stability of the DRUJ [13]. A distinct thick fiber among others is defined as the distal oblique bundle within the DIOM which is not always present but provides further sturdiness to the joint (Fig.…”

Section: Introductionmentioning

confidence: 99%