Abstract:Distal radial decompression osteotomy of the DRUJ preserves DRUJ function while relieving painful impingement. Further surgical interventions are not compromised in case of failure.
“…The mean thickness was 0.9 mm, similar to Dy et al's (2014) results (0.85 mm) and slightly thinner in comparison with Kitamura et al's (2011) result of 1.2 mm. Various authors (Krimmer et al, 2016;Moritomo, 2015;Moritomo and Omori, 2014;Noda et al, 2009) described a connection of the DOB with the dorsal and palmar radioulnar ligaments of the TFCC. This and the fact that the DOB's ulnar origin almost coincides with the axis of forearm rotation might be the reason for its stabilizing effect on the DRUJ (Moritomo, 2015).…”
Section: Discussionmentioning
confidence: 99%
“…The DOB has an anatomic relationship to the triangular fibrocartilage complex (TFCC) and connects partially to its palmar and dorsal radioulnar ligaments (Moritomo, 2012). It is believed to act as an isometric stabilizer of the DRUJ since its ulnar insertion aligns with the axis of forearm rotation (Krimmer et al., 2016; Moritomo, 2015) (Figure 1). Figure 1.Diagram showing the position of the DOB and its relationship to the axis of forearm rotation.Red arrows represent axis.…”
A study was undertaken to examine the presence of the distal oblique bundle of the forearm in a large sample in order to describe its true prevalence. The study sample consisted of 200 cadaveric forearms. Fifteen were excluded due to defects in the distal interosseous membrane. In the remaining 185 specimens, the distal interosseous membrane was examined following removal of soft tissue, to determine whether a distal oblique bundle was present and whether there were connecting fibres to the distal radio-ulnar joint. The distal oblique bundle was observed in 53 specimens (29%). In 45 of these forearms (85%), one or more connecting fibres to the distal radio-ulnar joint were identified. The presence of a distal oblique bundle in 29% is less frequent than that reported in previous literature. The presence of the distal oblique bundle should be noted and may be of importance in the management of disorders of the distal radio-ulnar joint.
“…The mean thickness was 0.9 mm, similar to Dy et al's (2014) results (0.85 mm) and slightly thinner in comparison with Kitamura et al's (2011) result of 1.2 mm. Various authors (Krimmer et al, 2016;Moritomo, 2015;Moritomo and Omori, 2014;Noda et al, 2009) described a connection of the DOB with the dorsal and palmar radioulnar ligaments of the TFCC. This and the fact that the DOB's ulnar origin almost coincides with the axis of forearm rotation might be the reason for its stabilizing effect on the DRUJ (Moritomo, 2015).…”
Section: Discussionmentioning
confidence: 99%
“…The DOB has an anatomic relationship to the triangular fibrocartilage complex (TFCC) and connects partially to its palmar and dorsal radioulnar ligaments (Moritomo, 2012). It is believed to act as an isometric stabilizer of the DRUJ since its ulnar insertion aligns with the axis of forearm rotation (Krimmer et al., 2016; Moritomo, 2015) (Figure 1). Figure 1.Diagram showing the position of the DOB and its relationship to the axis of forearm rotation.Red arrows represent axis.…”
A study was undertaken to examine the presence of the distal oblique bundle of the forearm in a large sample in order to describe its true prevalence. The study sample consisted of 200 cadaveric forearms. Fifteen were excluded due to defects in the distal interosseous membrane. In the remaining 185 specimens, the distal interosseous membrane was examined following removal of soft tissue, to determine whether a distal oblique bundle was present and whether there were connecting fibres to the distal radio-ulnar joint. The distal oblique bundle was observed in 53 specimens (29%). In 45 of these forearms (85%), one or more connecting fibres to the distal radio-ulnar joint were identified. The presence of a distal oblique bundle in 29% is less frequent than that reported in previous literature. The presence of the distal oblique bundle should be noted and may be of importance in the management of disorders of the distal radio-ulnar joint.
“…They were partly used in combination with external fixation. However, secondary dislocation still occurred [9][10][11][12][13][14], that necessitated correction and salvage procedures [15][16][17][18][19][20][21][22][23][24][25][26][27].…”
A wide range of different classifications exist for distal radius fractures (DRF). Most of them are based on plane X-rays and do not give us any information on how to treat these fractures. A biomechanical understanding of the mechanical forces underlying each fracture type is important to treat each injury specifically and ensure the optimal choice for stabilization. The main cause of DRFs are forces acting on the carpus and the radius as well as the position of the wrist in relation to the radius. Reconstructing the mechanism of the injury gives insight into which structures are involved, such as ruptured ligaments, bone fragments as well as the dislocated osteoligamentous units. This article attempts to define certain key fragments, which seem crucial to reduce and stabilize each type of DRF. Once the definition is established, an ideal implant can be selected to sufficiently maintain reduction of these key fragments. Additionally, the perfect approach is selected. By applying the following principles, the surgeon may be assisted in choosing the ideal form of treatment approach and implant selection.
“…Although the biomechanics of fracture are well understood today and modern locking implants respect fracture biology, distal radius fractures are still associated with a high complication rate and frequently poor outcome [18,22,32,51,53,55,56,57]. One of the most common complications is malunion, which may lead to symptomatic ulnar impaction syndrome [8,12,27,55].…”
A malunited distal radius fracture can lead to symptomatic ulnar impaction syndrome, which is a common cause for ulnarsided wrist pain. If conservative treatment fails and symptoms persist after an arthroscopic ulnocarpal debridement, ulnar shortening osteotomy (USO) is the treatment of choice. Since the first USO described by Milch in 1941 after a malunited Colles fracture, many techniques have been described varying in surgical approach, type of osteotomy and osteosynthesis material used. Many studies demonstrated good to very good functional results after USO, reporting, however, a delayed union or non-union rate up to 18%. A modern, low profile, locking plate showed in our short-term study very good functional results and no implant-associated complications, in particular no non-union.
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