Role of the interosseous membrane in post-traumatic forearm instability: instructional review

Meglic, Uros; Szakács, Noémi; Menozzi, Margherita; Barco, Raúl; Alentorn-Geli, Eduard; Colozza, Alessandra

doi:10.1007/s00264-021-05149-4

Cited by 7 publications

(4 citation statements)

References 74 publications

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“…A prominent ulnar bow sign indicates the considerable severity of the interosseous membrane injury 25 – 27 . Our data indicated that the angle formation of ulna in proximal ulnar osteotomy was related to the P-MUB and R-MUB.…”

Section: Discussionmentioning

confidence: 99%

Influence of ulnar bow sign on surgical treatment of missed Bado type I Monteggia fracture in children

Liao

Wang

Huang

et al. 2022

Sci Rep

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The present study aimed to explore the influence of ulnar bow on the surgical treatment of Bado type I missed Monteggia fracture in children. A retrospective review of 28 patients was conducted between November 2010 and June 2020. All patients were treated with open reduction of the radial head and ulnar opening wedge osteotomy without annular ligament reconstruction. Four months (range 1–12 months) was the mean interval between injury onset and surgery. The average age of patients at the time of surgery was 6.1 years old (range 2–10 years old). The maximum ulnar bow (MUB) and MUB position (P-MUB) via radiography were evaluated. The patients were divided into two groups according to P-MUB, as follows: middle group (A) included 17 cases, and the MUB was located at 40–60% of the distal ulna; and distal group (B) included 11 cases, and the MUB was located at 20–40% from the distal end of the ulna. The mean follow-up period was 33 months (range 6–102 months). At the last follow-up, all the children showed stable reduction of the radial head, and the flexion function of elbow joint improved after the operation (P < 0.05). Group A presented a larger ratio of maximum ulnar bow (R-MUB) and angle of ulnar osteotomy (OA) than group B (P < 0.05). The osteotomy angle was positively correlated with the R-MUB (R2 = 0.394, P = 0.038). The osteotomy angle was positively correlated with the P-MUB (R2 = 0.683, P = 0.000). The R-MUB was proportional to the P-MUB (R2 = 0.459, P < 0.0001). The regression equation of P-MUB and osteotomy angle was as follows: OA = 32.64* P-MUB + 7.206. If the ulnar bow was positioned at the middle ulna, then a stable reduction of radial head needed to be achieved through a large angle in the ulnar osteotomy. If the position of maximum ulnar bow (P-MUB) was closer to the middle of the ulna, or the ratio of maximum ulnar bow (R-MUB) was larger, then the osteotomy angle was larger.

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Section: Discussionmentioning

confidence: 99%

Influence of ulnar bow sign on surgical treatment of missed Bado type I Monteggia fracture in children

Liao

Wang

Huang

et al. 2022

Sci Rep

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“…The periosteum and interosseous membrane are affected together with certain related complications like a radial head injury or displacements, and these are the hallmarks of an unstable fracture, especially in the setting of a forearm injury [10]. A physiotherapy approach was put together to increase the upper limb's active range of motion, avoid contractures, and lessen muscle stiffness.…”

Section: Introductionmentioning

confidence: 99%

A Muscle Energy Techniques-Based Physiotherapeutic Intervention Protocol for Managing Nightstick Fracture: A Case Report

Ambekar,

Deshmukh,

Thakre

et al. 2024

Cureus

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Distal ulna and radius fractures are the most frequent upper extremity fractures seen in emergency rooms. The axis of rotation for forearm pronation and supination runs through the radial head (proximal) and the ulnar fovea (distal). Throughout pronation and supination, the radius can rotate relative to the ulna, thanks to the way its head articulates with it. The ulna remains relatively stable during these movements. However, in cases of fractures of these bones, surgery to repair the radius is usually the best course of action for a distal ulna fracture. Most distal ulna fractures heal successfully with only conservative treatment once the radius is stabilized. To achieve the best results, medical personnel must take into account patient characteristics including age, level of activity, and aspirations. The majority of distal ulna injuries do not require surgery, but there are several circumstances where it is necessary. In therapeutic practice, muscle energy techniques (METs) are comparatively painless methods for restoring a restricted spectrum of motion. Malunion, reduced grasp, and other significant problems might result from a lack of understanding of this illness. The 48-year-old patient in the present study was reported to have sustained injuries to his left forearm in a road traffic accident (RTA) as he fell from his bike and slid during a traffic collision. X-ray imaging of the left forearm revealed an isolated ulnar shaft fracture. METs, isometric contractions, and active concentric and eccentric movements were all part of the physiotherapy intervention protocol to produce an active range of motion in the upper extremity. In this particular case, the specified physiotherapy management was found to be effective.

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“…In this process, axial loads, joint rotation, and inversion/eversion force can be important injury factors (1)(2)(3)(4), each causing different degrees and types of injuries to the related bones, joint capsules, and ligaments, thus increasing the complexity of diagnosis and treatment (5). The severity of the injury is related to the strength and distribution of the external force as well as the position of the upper limb during the injury (6).…”

Section: Introductionmentioning

confidence: 99%

Surgical management of acute combined injuries of the ipsilateral wrist and elbow joints

Niu¹,

Huang²,

Xu³

et al. 2023

Ann Transl Med

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Background: Combined injuries of ipsilateral wrist and elbow joints are rare in clinical practice, characterized by multiple joint dislocations or/and fractures and varying manifestations. As there are still no clinical guidelines and no consensus on the standard treatment, this study aimed to explore the surgical intervention and complications of this kind of combined injuries.Methods: This retrospective study was conducted in a single center. A total of 13 patients with acute combined injuries of the ipsilateral wrist and elbow joints receiving surgical treatment from August 2013to May 2016 were retrospectively analyzed. The fracture and joint instability and structural damages were repaired and reconstructed.Results: All 13 patients were followed up for a mean duration of 17 months (range: 14 to 22 months). The X-ray films showed good fracture reduction and joint alignment, no fixation failure, re-displacement, bone nonunion, or ischemic necrosis in all cases. According to the Mayo Elbow Performance Score (MEPS), the excellent and good rate of joint function was 84.6%. According to the Mayo Modified Wrist Score (MMWS), the excellent and good rate of joint function was 76.9%. There were no significant restrictions on elbow and wrist movements. The disabilities of the arm, shoulder, and hand (DASH) score was excellent, with an average of 18.5 points. Conclusions:The key to intervention of combined injuries of the wrist and elbow is to identify the types of injuries and conduct an overall assessment to determine the appropriate surgical methods. Early surgical intervention and rehabilitation exercise are the main principles for the treatment.

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Role of the interosseous membrane in post-traumatic forearm instability: instructional review

Cited by 7 publications

References 74 publications

Influence of ulnar bow sign on surgical treatment of missed Bado type I Monteggia fracture in children

Influence of ulnar bow sign on surgical treatment of missed Bado type I Monteggia fracture in children

A Muscle Energy Techniques-Based Physiotherapeutic Intervention Protocol for Managing Nightstick Fracture: A Case Report

Surgical management of acute combined injuries of the ipsilateral wrist and elbow joints

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