Three-dimensional in vivo kinematics of the distal radioulnar joint in malunited distal radius fractures

Moore, Douglas C.; Hogan, Kathleen A.; Crisco, Joseph J.; Akelman, Edward; DaSilva, Manuel F.; Weiss, Arnold‐Peter C.

doi:10.1053/jhsu.2002.31156

Cited by 42 publications

(31 citation statements)

References 27 publications

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“…12 Therefore, for analytical purposes the value of the independent variable of forearm position (supination-pronation with respect to neutral) was determined from the 3D kinematic analysis of the CT volume images and not from the protractor reading. Because forearm prono-supination at each preselected position was not consistent within or between subjects, we linearly interpolated the values of the four dependent variables (ulnar JSA, ulnar JSC, and radioulnar ligament lengths) for each 158 increment of prono-supination, from À90 to 908 of forearm rotation.…”

Section: Discussionmentioning

confidence: 99%

“…The outer cortical bone surfaces and 3D in vivo kinematic data from the nine patients in the previous study 12 were used to calculate the interbone joint space area, the location of the radius on the distal ulnar articular surface, and the path length and deflection of the dorsal and palmar radioulnar ligaments. These values were then compared between the malunited and uninjured forearm over the range of forearm rotation.…”

Section: Methodsmentioning

confidence: 99%

“…12 Briefly, after obtaining informed consent, subjects with unilateral distal radial malunions were recruited into the study. Clinical eligibility included a history of a unilateral distal radius fracture, without fracture of the sigmoid notch, treated by closed reduction and casting.…”

Section: Patient Selection and Ct Scanningmentioning

confidence: 99%

“…[12][13][14] To simplify comparison of the malunited and uninjured wrists, the CT volume of the left wrist from each subject was mathematically transformed so that it looked like a right wrist. [12][13][14] In brief, the transformation involved multiplication of the X coordinate of the bone surface contours by À1 and reversing the direction of the contours in each CT image slice. This transformation made the bone shapes and motions of the left wrists directly comparable to the right wrists.…”

Section: Kinematic Analysismentioning

confidence: 99%

“…9 However, an in vivo analysis of radioulnar kinematics in patients with unilateral malunion of the distal radius and functionally limited pronosupination revealed no change in the location or orientation of the radius' rotation axis that was caused by the malunion. 12 Interestingly, no bony impingement at the sigmoid notch could be identified to explain the reduced range of motion (ROM). In both forearms of these patients, the rotation axis passed through the distal head of the ulna near its geometrical center.…”

Section: Introductionmentioning

confidence: 99%

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Effects of distal radius malunion on distal radioulnar joint mechanics—an in vivo study

Crisco

Moore

Marai

et al. 2007

Journal Orthopaedic Research

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Patients with a malunited distal radius often have painful and limited forearm rotation, and may progress to arthritis of the distal radioulnar joint (DRUJ). The purpose of this study was to determine if DRUJ congruency and mechanics were altered in patients with malunited distal radius fractures. In nine subjects with unilateral malunions, interbone distances and dorsal and palmar radioulnar ligament lengths were computed from tomographic images of both forearms in multiple forearm positions using markerless bone registration (MBR) techniques. The significance of the changes were assessed using a generalized linear model, which controlled for forearm rotation angle (À608 to 608). In the malunited forearm, compared to the contralateral uninjured arm, we found that ulnar joint space area significantly decreased by approximately 25%, the centroid of this area moved an average of 1.3 mm proximally, and the dorsal radioulnar ligament elongated. Despite our previous findings of insignificant changes in the pattern of radioulnar kinematics in patients with malunited fractures, we found significant changes in DRUJ joint area and ligament lengthening. These findings suggest that alterations in joint mechanics and soft tissues may play an important role in the dysfunction associated with these injuries. ß

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Patient Selection and Ct Scanningmentioning

confidence: 99%

Section: Kinematic Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effects of distal radius malunion on distal radioulnar joint mechanics—an in vivo study

Crisco

Moore

Marai

et al. 2007

Journal Orthopaedic Research

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Three‐Dimensional In Vivo Analysis of Malunited Distal Radius Fractures With Restricted Forearm Rotation

Abe

Oka

Miyamura

et al. 2019

Journal Orthopaedic Research

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Malunited distal radius fractures (DRFs) occasionally restrict forearm rotation, but the underlying pathology remains unclear. We aimed to elucidate the mechanism of rotational restriction by retrospective analysis of 23 patients with unilateral malunited DRFs who presented restricted forearm rotation. We conducted computed tomography during forearm rotation on both sides. Three-dimensional (3D) bone surface models of the forearm were created, and 3D deformity of the distal radius, translation of the distal radius relative to the ulna, distal radioulnar joint (DRUJ) contact area, and estimated path length (EPL) of distal radioulnar ligaments (DRUL) during forearm rotation were evaluated. In total, 18 patients had dorsal angular deformities (DA group) and five had volar angular deformities (VA group). In the DA group, the closest point between the distal radius and ulna on DRUJ was displaced to the volar side during supination and pronation (p < 0.001); DRUJ contact area was not significantly different between the DA and normal groups. In bone-ligament model simulation, the EPL of dorsal DRUL was longer in the DA group than in the normal group (p < 0.001); opposite phenomena were observed in the VA group. In the DA group, translation of the distal radius in a volar direction relative to the ulna during pronation was impaired presumably due to dorsal DRUL tightness. Anatomical normal reduction of the distal radius by corrective osteotomy may improve forearm rotation by improving triangular fibrocartilage complex tightness and normalizing translation of the distal radius relative to the ulna.

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Orthopaedics Biomechanics in Sports Medicine Thrower’s Elbow

Pederzini

Cheli

Nicoletta

et al. 2021

Orthopaedic Biomechanics in Sports Medicine

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Three-dimensional in vivo kinematics of the distal radioulnar joint in malunited distal radius fractures

Cited by 42 publications

References 27 publications

Effects of distal radius malunion on distal radioulnar joint mechanics—an in vivo study

Effects of distal radius malunion on distal radioulnar joint mechanics—an in vivo study

Three‐Dimensional In Vivo Analysis of Malunited Distal Radius Fractures With Restricted Forearm Rotation

Orthopaedics Biomechanics in Sports Medicine Thrower’s Elbow

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