Literature DB >> 14751110

The distal radioulnar joint as a load-bearing mechanism--a biomechanical study.

Hassan Shaaban1, Giannis Giakas, Mike Bolton, Robert Williams, Louis R Scheker, Vivien C Lees.   

Abstract

PURPOSE: A biomechanical study was performed to define the normal profiles of force transmission across the distal radioulnar joint (DRUJ) and their alteration as the result of surgical modification of the joint and its ligaments.
METHODS: Twelve cadaver arms were used in this investigation. A custom-made jig was designed to hold the arm and allow axial loading of the hand. Force transmitted across the DRUJ was measured with sensor film. The axial force transmitted through the ulna and radius was measured with strain gauges mounted to the surface of each bone and the strain in the dorsal and volar distal radioulnar ligaments (DRUL) was measured with differential variable reluctance transducers. Measurements of force and strain with the DRUJ in the surgically unmodified condition were performed in various positions of forearm rotation and with sequential loads. Subsequently, the same series of measurements was performed after DRUL division and after reconstruction of the ligament. The effect of excision of the ulna head (Darrach's procedure) was also studied.
RESULTS: Force varied significantly (p <.05) with the applied load and with forearm position, being greater in supination than pronation (sensor film data). Force transmitted through the ulna varied in an approximately reciprocal pattern with that of the radius. The greatest forces through the ulna occurred in supination and therefore mirrored the change in force transmission across the DRUJ. Between 32% and 34%, respectively, of the applied load (5-10 kg) was transmitted through the ulna and the remainder was transmitted through the radius (strain gauge data). Division of either the volar or the dorsal DRUL tended to increase the force transmitted across the DRUJ (p =.09), and reconstruction of the disrupted DRUL restored the force pattern toward the previous values (not significant) (differential variable reluctance transducer data). Excision of the ulna head disrupted the force transmission profiles, producing the biomechanical equivalent of a 1-bone forearm. Only 1.8% and 2.7% of the applied force (10 kg and 5 kg), respectively, was transmitted through the ulna (strain gauge data only).
CONCLUSIONS: The data show consistent and characteristic force transmission profiles across the DRUJ and through both ulna and radius. The joint is important in the transmission of load and its anatomic integrity should be respected in surgical procedures if normal biomechanics are to be preserved.

Mesh:

Year:  2004        PMID: 14751110     DOI: 10.1016/j.jhsa.2003.10.020

Source DB:  PubMed          Journal:  J Hand Surg Am        ISSN: 0363-5023            Impact factor:   2.230


  24 in total

1.  Assessment of dorsal instability of the ulnar head in the distal radioulnar joint: comparison between normal wrist joints and cases of ruptured extensor tendons.

Authors:  Kiyohito Naito; Yoichi Sugiyama; Kentaro Aritomi; Yasushi Nagahama; Yoshimasa Tomita; Osamu Obayashi; Kazuo Kaneko
Journal:  Eur J Orthop Surg Traumatol       Date:  2015-11-09

2.  Indications and early to mid-term results of ulnar head replacement.

Authors:  D Warwick; G Shyamalan; E Balabanidou
Journal:  Ann R Coll Surg Engl       Date:  2013-09       Impact factor: 1.891

Review 3.  Techniques of Force and Pressure Measurement in the Small Joints of the Wrist.

Authors:  Michael J Schreck; Meghan Kelly; Colin D Canham; John C Elfar
Journal:  Hand (N Y)       Date:  2017-02-06

4.  Functional anatomy of the distal radioulnar joint in health and disease.

Authors:  V C Lees
Journal:  Ann R Coll Surg Engl       Date:  2013-04       Impact factor: 1.891

5.  A novel technique for detecting instability of the distal radioulnar joint in complete triangular fibrocartilage complex lesions.

Authors:  Florian Hess; Mazda Farshad; Reto Sutter; Ladislav Nagy; Andreas Schweizer
Journal:  J Wrist Surg       Date:  2012-11

6.  Stability and Clinical Outcome after Reconstruction of Complete Triangular Fibrocartilage Disruption.

Authors:  Florian Hess; Reto Sutter; Ladislav Nagy; Andreas Schweizer
Journal:  J Wrist Surg       Date:  2016-01-15

7.  Outcomes of a self-constrained distal radioulnar joint arthroplasty: a case series of six patients.

Authors:  Ryan M Zimmerman; Jesse B Jupiter
Journal:  Hand (N Y)       Date:  2011-09-24

8.  The functional anatomy of forearm rotation.

Authors:  Vivien C Lees
Journal:  J Hand Microsurg       Date:  2010-01-08

9.  Radiographic parameter analysis on modified sauvé-kapandji procedure.

Authors:  Norikazu Ota; Toshiyasu Nakamura; Takuji Iwamoto; Kazuki Sato; Yoshiaki Toyama
Journal:  J Wrist Surg       Date:  2013-02

10.  Semiconstrained distal radioulnar joint prosthesis.

Authors:  Christiana Savvidou; Erin Murphy; Emilie Mailhot; Shushan Jacob; Luis R Scheker
Journal:  J Wrist Surg       Date:  2013-02
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