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Distal radioulnar joint

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https://www.readbyqxmd.com/read/28259283/impact-of-distal-ulnar-fracture-malunion-on-distal-radioulnar-joint-instability-a-biomechanical-study-of-the-distal-interosseous-membrane-using-a-cadaver-model
#1
Satoshi Miyamura, Atsuo Shigi, Jirachart Kraisarin, Shohei Omokawa, Tsuyoshi Murase, Hideki Yoshikawa, Hisao Moritomo
PURPOSE: Certain distal ulna fractures may contribute to distal radioulnar joint (DRUJ) instability. We hypothesized that residual distal ulna translation could affect DRUJ stability by slackening the distal interosseous membrane (DIOM). We aimed to test this hypothesis in a cadaver model. METHODS: We created an ulnar translated distal ulna fracture model in 6 cadavers. Dorsal and palmar displacements of the ulna relative to the radius were measured and DRUJ instability was staged under the following conditions: (1) 0-, 2-, and 4-mm ulnar translation of the distal ulna with an intact triangular fibrocartilage complex (TFCC) and DIOM; (2) 0-, 2-, and 4-mm translations with TFCC divided and an intact DIOM; and (3) a 0-mm translation with TFCC and DIOM divided...
March 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28249978/the-influence-of-cartilage-thickness-at-the-sigmoid-notch-on-inclination-at-the-distal-radioulnar-joint
#2
M Ross, M Wiemann, S E Peters, R Benson, G B Couzens
AIMS: The aims of this study were: firstly, to investigate the influence of the thickness of cartilage at the sigmoid notch on the inclination of the distal radioulnar joint (DRUJ), and secondly, to compare the sensitivity and specificity of MRI with plain radiographs for the assessment of the inclination of the articular surface of the DRUJ in the coronal plane. PATIENTS AND METHODS: Contemporaneous MRI images and radiographs of 100 wrists from 98 asymptomatic patients (mean age 43 years, (16 to 67); 52 male, 53%) with no history of a fracture involving the wrist or surgery to the wrist, were reviewed...
March 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28238092/radial-shortening-osteotomy-reduces-radiocapitellar-contact-pressures-while-preserving-valgus-stability-of-the-elbow
#3
Michael Hackl, Kilian Wegmann, Stephanie L Kahmann, Nicolai Heinze, Manfred Staat, Wolfram F Neiss, Martin Scaal, Lars P Müller
PURPOSE: Shortening osteotomy of the proximal radius might represent a potential salvage procedure in symptomatic radiocapitellar osteoarthritis, which could decrease radiocapitellar load while preserving the native radial head. In an in-vitro biomechanical investigation, we sought to determine whether shortening osteotomy of the proximal radius (1) decreases the radiocapitellar joint pressure upon axial loading and (2) retains valgus stability of the elbow. In addition, the anatomic configuration of the lesser sigmoid notch was evaluated to assess possible contraindications...
February 25, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28216758/-quadrangular-construct-modification-of-sauve-kapandji-procedure
#4
Ravi K Gupta, Ashwani Soni, Anubhav Malhotra, Gladson D Masih
BACKGROUND: Subluxation of ulna in distal radioulnar joint disorders causes pain on motion, loss of grip strength, and a restriction of forearm rotation. Several procedures have been described to salvage DRUJ disorders including the Darrach procedure, the matched distal ulnar resection, the hemiresection interposition arthroplasty (Bowers procedure) and the Sauve-Kapandji (S-K) procedure. All these procedures are associated with either loss of grip, pain over proximal ulnar stump or instability...
January 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28211292/clinical-and-functional-outcome-of-open-primary-repair-of-triangular-fibrocartilage-complex-tears-associated-with-distal-radius-fractures
#5
Faisal Johandi, Sreedharan Sechachalam
PURPOSE: We evaluate the clinical and functional outcome of open primary repair of acute TFCC tears in distal radius fracture, when there is gross intraoperative distal radioulnar joint (DRUJ) instability after fixation of the distal radius, in the absence of an ulnar styloid fracture or when the ulnar fracture fragment is too small to be fixed. METHODS: A retrospective review of our institution's distal radius fracture database over a 4-year period (January 2010 to December 2013)...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28185125/ulnar-sided-wrist-pain-in-the-athlete-tfcc-druj-ecu
#6
REVIEW
Eric Quan Pang, Jeffrey Yao
PURPOSE OF REVIEW: The goal of this manuscript is to review key historic and recent literature regarding extensor carpi ulnaris (ECU), triangular fibrocartilage complex (TFCC) and distal radioulnar joint (DRUJ) injuries, particularly in athletes. RECENT FINDINGS: Many recent studies examining the ECU focus on clinical and radiographic diagnosis. Several physical exam findings are described in addition to the use of MRI and US. Imaging studies must be clinically correlated due to high incidence of findings in asymptomatic patients...
March 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28137437/pronation-and-supination-of-the-hand-anatomy-and-biomechanics
#7
M Soubeyrand, B Assabah, M Bégin, E Laemmel, A Dos Santos, M Crézé
Proper functioning of the hand relies on its capacity to rotate and point the palm upward (i.e. supination) or downward (i.e. pronation) when standing up with the elbow in 90° flexion. Hand rotation is possible because of forearm rotation and also rotation of the whole upper limb at the shoulder. Two distinct mechanisms contribute to hand rotation: one in which the ulna is immobile and another in which the ulna is mobile. In this review, we first summarize how evolution of the human species has led to the progressive development of specific forearm anatomy that allows for pronation and supination...
February 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/28126003/magnetic-resonance-imaging-evaluation-of-the-distal-oblique-bundle-in-the-distal-interosseous-membrane-of-the-forearm
#8
Yeon Ho Kim, Hyun Sik Gong, Jin Woo Park, Hyun Kyung Yang, Kahyun Kim, Goo Hyun Baek
BACKGROUND: Some cadaveric studies have reported the role of the distal oblique bundle (DOB) in the distal radioulnar joint stability. We aimed to determine whether the presence of the DOB can be identified and its thickness can be measured in magnetic resonance imaging (MRI) examinations. METHODS: We retrospectively reviewed 468 wrist and forearm MRIs. Inclusion criteria were wrist or forearm MRIs taken in patients older than 18 years of age, and exclusion criteria were patients with acute wrist or forearm fractures, infections, or malignant tumors...
January 26, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28119800/ulna-rotation-osteotomy-in-complete-dislocation-of-the-distal-radioulnar-joint
#9
Markus Gabl, Rohit Arora, Eva Maria Gassner, Gernot Schmidle
Background Complete dislocation of the distal radioulnar joint (DRUJ) is a rare injury. Dislocation can present as uni- or multidirectional, acute or chronic, reducible or irreducible. It can occur due to isolated loss of ligamentous restraints or more frequent in Galeazzi - or Essex-Lopresti-type fractures. Case Description A 28-year-old man sustained a distal radius fracture and presented after conservative treatment with blocked supination. Examination revealed a malunion of the distal radius in combination with an irreducible dorsal dislocation of the DRUJ...
February 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28060785/instability-and-arthritis-of-the-distal-radioulnar-joint-a-critical-analysis-review
#10
Gregory K Faucher, Ryan M Zimmerman, Neal B Zimmerman
No abstract text is available yet for this article.
December 20, 2016: JBJS Reviews
https://www.readbyqxmd.com/read/28058967/the-value-of-computed-tomography-in-detecting-distal-radio-ulnar-joint-instability-after-a-distal-radius-fracture
#11
R H van Leerdam, M M E Wijffels, M Reijnierse, W Stomp, P Krijnen, I B Schipper
This study evaluated the value of computed tomography scans for the diagnosis of distal radioulnar joint instability. A total of 46 patients, conservatively treated for a unilateral distal radius fracture, were evaluated. Clinical instability was tested using the stress test and clunk test. A computed tomography scan of both wrists was performed in pronation and supination. Two independent observers reviewed the computed tomography scans using: the radioulnar line, subluxation ratio, epicentre and radioulnar ratio methods...
January 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28052828/forearm-instability-anatomy-biomechanics-and-treatment-options
#12
REVIEW
Julie E Adams
The forearm unit consists of the radius and ulna, a complex and interrelated set of joints (distal radioulnar joint, proximal radioulnar joint) and the soft tissue stabilizers between the 3 bones. Distally, this is represented by the triangular fibrocartilage complex at the wrist, proximally by the annular ligament at the elbow, and in the forearm by the interosseous membrane. Disruptions in any of these structures may lead to forearm instability, with consequences at each of the remaining structures.
January 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28018072/distal-radius-fracture-with-associated-ulnar-head-fracture
#13
Naser Fuaz, Samer Mackuli, Ronit Wollstein
Ulnar head and neck fractures are rare and the mechanism of injury is not always clear. We describe a case of a distal radioulnar joint (DRUJ) fracture dislocation. The fracture included a distal radius fracture with a vertical ulnar head fracture that was treated with open reduction and internal fixation with a headless screw. We describe the mechanism of injury and approach to the treatment of this injury.
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/27932401/medium-to-long-term-outcomes-of-anatomical-reconstruction-of-the-radioulnar-ligament-to-the-ulnar-fovea
#14
T Nakamura, K Abe, M Nishiwaki, T Iwamoto, K Sato
We examined the medium- to long-term outcome of the original reconstruction technique of the radioulnar ligament using a half-slip of the extensor carpi ulnaris tendon for chronic foveal avulsion of the triangular fibrocartilage complex. We treated 37 wrists in 36 patients with a minimum follow-up of 5 years. Of 36 patients, 12 had more than 10 years follow-up. At final follow-up, 30 patients (31 wrists) reported no pain, five patients (five wrists) reported mild occasional pain and one patient reported severe persistent pain...
December 8, 2016: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/27917687/a-long-term-20-years-follow-up-after-arthroscopically-assisted-repair-of-the-tfcc
#15
Endre Soreide, Torstein Husby, Jan Ragnar Haugstvedt
OBJECTIVE: The present study aimed to assess long-term functional outcome for patients after arthroscopic assisted suture for peripheral tears of the triangular fibrocartilage complex (TFCC). METHODS: Eleven patients, 26 (15-59) years old at time of surgery, 48 (35-78) years old at time of follow-up, were available for this 20-year follow-up. Subjective and objective outcomes, such as range of motion, grip strength, patients' satisfaction, pain, and Mayo Modified Wrist Score, were assessed, as well as asking the question if the patients would have had the surgery done again, knowing the outcome, based on a clinical examination and patient reported questionnaires...
December 5, 2016: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/27909756/-ligament-injuries-of-the-wrist
#16
R Schmitt
The distal radioulnar joint, the triangular fibrocartilage complex (TFCC) and the wrist are stabilized by many ligaments allowing not only a wide range of motion but also providing sufficient stability. The complex arrangement of carpal ligaments and prosupination around the forearm joint enables multiaxial motion patterns. In the wrist, intra-articular ligaments can be differentiated from extra-articular capsular ligaments as well as intrinsic and extrinsic ligament courses. Imaging is essential for classification of dynamic and static instability patterns...
December 2016: Der Radiologe
https://www.readbyqxmd.com/read/27890221/-treatment-of-distal-radius-extra-articular-malunion-in-young-active-patients
#17
N Pauchard, S Huguet, F Dap, G Dautel
Malunion is a common complication of distal radius fractures despite new fixation devices. The authors discuss the surgical indications, preoperative management and the various surgical techniques used to treat distal radius extra-articular malunion, specifically in active young subjects. The treatment goals in this population group are anatomical restoration of the distal radius and distal radioulnar joint, short immobilization period, quick functional recovery and stable results over time, consistent with high functional demands...
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27890200/-are-there-any-indications-for-surgery-of-distal-radius-malunion-in-elderly-patients
#18
M Rongières
Malunions of the distal radius are associated most of the time with disturbances of the distal radioulnar (DRU) joint. While a corrective osteotomy of the distal radius is a well-known procedure in younger patients, manual workers and active patients, is it justified in independent elderly patients above 70 years of age? These techniques improve function, reorient the articular surfaces, protect against complications such as degenerative osteoarthritis and stiffness of the wrist, and they improve DRU balance...
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27824735/surgical-treatment-of-chronic-essex-lopresti-lesion-interosseous-membrane-reconstruction-and-radial-head-prosthesis
#19
Prospero Bigazzi, Letizia Marenghi, Marco Biondi, Maura Zucchini, Massimo Ceruso
The Essex-Lopresti lesion, or radioulnar longitudinal dissociation, results from an axial load to the forearm with lesion to the radial head, interosseous membrane and distal radioulnar joint. The lesion is rarely diagnosed early, therefore treatment is often subacute or chronic. In these cases, procedures such as radial head replacement, ulnar shortening and/or wafer procedures should be combined with reconstruction of the interosseous membrane central band to restore longitudinal stability of the forearm...
March 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27823874/ipsilateral-plastic-deformation-monteggia-and-galeazzi-type-fracture-in-a-child-a-case-report
#20
Andrew Greer, Christopher John Lowry, Shammi Ramlakhan
A 7-year-old boy attended the emergency department after falling from a climbing frame onto his outstretched left wrist. On examination, there was mild swelling to the left elbow and tenderness to the antecubital fossa. There was also tenderness diffusely to the distal ulnar and radius. There was no neurovascular deficit. Radiographs revealed a plastic deformation fracture of the left radius and ulna, with dislocations of the ipsilateral radiocapitellar joint and distal radioulnar joint. A diagnosis of combined Monteggia and Galeazzi-type fractures of the left forearm was made...
November 4, 2016: Annals of Emergency Medicine
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